Active SLED Opportunity · CALIFORNIA · PUBLIC WORKS/ENGINEERING DIVISION
AI Summary
The City of South San Francisco seeks a professional billing firm for ambulance billing services under a 5-year consulting contract. The Fire Department operates ALS and BLS ambulances with about 4,300 transports annually. Proposals are due June 11, 2026, with detailed submission and evaluation criteria provided.
The City is seeking a professional billing firm to provide the City with submission of reimbursement claims services. The City intends to enter into a consulting services contract with the selected provider (Consultant) for a period of five (5) years, with the option of three (3), two (2) year extensions contingent on the continued operation of EMS Ambulance service and successful performance by Consultant of assigned tasks.
The City of South San Francisco provides ambulance service as part of its Fire Department services. The City operates both Advanced Life Support (ALS) and Basic Life Support (BLS) ambulances, handling calls for service of both 911 and Inter-facility origination. The City of South San Francisco Fire Department provides Advanced Life Support (ALS) and Basic Life Support (BLS) ambulance transport services for both emergency (911) and, though rare, the ability to do interfacility transports. The Department processes approximately 4,300 ambulance transports annually. Current ambulance billing rates are published on the City’s website.
Demonstrated understanding of the RFP objectives and work requirements. Identification of key issues. Methods of approach, work plan, and experience with similar projects related to type of services.
Qualifications of project staff (particularly key personnel such as the project manager), key personnel’s level of involvement in performing related work and the team’s experience in maintaining schedule.
Experience with similar projects. Technical experience in performing work related to type of services; record of completing work on schedule; strength and stability of the firm; technical experience and strength and stability of proposed subconsultants; demonstrated communications quality and success; and assessments by client references as available.
Submission Requirement: Introductory letter
The letter shall be on Proposer’s letterhead and include the Proposer’s contact name, mailing address, telephone number, and email address. The letter will address the Proposer’s understanding of the services being requested and any other pertinent information the Proposer believes should be included. All addendums received must be acknowledged in the e-Procurement proposal submission. The letter shall be signed in blue ink or digitally signed by the individual authorized to bind the Proposer to the proposal.
Submission Requirement: Firm qualifications and experience
Prior experience history and qualifications of the Proposer, and the proposed team, in providing like services in a similar environment; record of completing work on schedule; strength and stability of the firm, as demonstrated by financial statements; demonstrated communications quality and success.
Submission Requirement: Detailed service approach
Approach to the Scope of Work; proposal demonstrates clear understanding of service requirements and addresses all proposal requirements adequately, including the proposed project timeline and the required submissions, including samples and forms, as may be required.
Submission Requirement: Implementation and transition plan
The implementation and transition plan should clearly summarize the Proposer’s understanding of the project and the approach for completing the tasks in this RFP. It should be brief yet detailed enough to explain the proposed methodology. The plan should outline how the project objectives will be met, assign responsibilities to team members, and describe deliverables.
Submission Requirement: Staffing plan and organizational structure
The professional, technical and managerial qualifications and experience of personnel named in the proposal; previous relevant experience which demonstrates capability to successfully manage work; years of experience; extent of experience applicable to this work; experience in key staff positions.
Submission Requirement: References
References, including SSF's prior experience with the Proposer, or at least one municipal client.
Submission Requirement: Cost proposal
Effective and efficient delivery of quality services is demonstrated through clearly itemized cost allocation.
Please upload your proposal for this RFP as a single PDF file here.
PLEASE READ CAREFULLY. Proposer must confirm below.
In addition to the electronic proposal submitted below in ProcureNow, proposer must submit five (5) hard copies of the Consultant’s proposal, and one (1) hard copy of a cost proposal submitted in a separate sealed envelope. The hard copies shall be MAILED ONLY WITH A POSTMARK date no later than the RFP Submission Deadline, Wednesday, June 10, 2026. Proposals shall be submitted in a sealed package clearly marked
“Ambulance Billing Services” and addressed as follows:
Richard Walls
Project Manager
City of South San Francisco
Engineering Division
Public Works Department
315 Maple Avenue
South San Francisco, CA 94080
Electronic Proposals received after the time and date specified are not allowed in ProcureNow.
Hardcopies must be identical to electronic version. Submissions of a paper version that differs from the electronic version will result in disqualification.
Please upload your completed Cost Proposal as described in Appendix A - Proposal Requirements, Sections 10, Page 14 of the RFP. Upload your response as 1 PDF Document.
Will this solicitation require a bid bond?
Would you like to have bidders respond to an electronic pricing table through ProcureNow?
Choose this if:
Will you want your bidder to separate a Price Proposal from the rest of the Response?
(if you say yes, it will show you where you can define the criteria, if you say no, you'll have the opportunity to do it before the evaluation committee starts)
Q (No subject): Has the current contract gone full term?
A: Yes. The current contract was for 7-years, signed in 2019.
Q (No subject): Have all options to extend the current contract been exercised?
A: Yes.
Q (No subject): Who is the incumbent, and how long has the incumbent been providing the requested services?
A: Wittman Enterprises was first contracted by the City in 2018 and is the current incumbent provider. Prior to Wittman Enterprises, the City contracted with Novato Fire Protection District for approximately one year. Prior to that, the City utilized ADPI for ambulance billing services for many years.
Q (No subject): To what extent will the location of the bidder’s proposed location or headquarters have a bearing on any award?
A: The location of the proposer’s headquarters or operating office is expected to have minimal bearing on the award. The City will evaluate proposals based on the criteria identified in the RFP.
Q (No subject): How are fees currently being billed by any incumbent(s), by category, and at what rates?
A: The current agreement compensates the incumbent on a percentage-of-collections basis at 4%
Q (No subject): What were your annual gross charges last year or for the last 12 months?
A: Annual gross charges for the most recent 12-month period were approximately $12.98 million
Q (No subject): What were your annual total adjustments for last year or for the last 12 months?
A: Total annual contractual adjustments, write-downs, and related reductions for the most recent 12-month period were approximately $7.6 million. This includes Medicare write-downs, Medi-Cal write-downs, other contractual write-downs, California Assembly Bill 716 (AB 716) adjustments, collection adjustments, bad debt write-offs, and balance write-offs.
Q (No subject): What were your annual contractual allowance write offs for last year or for the last 12 months?
A: Annual contractual allowance-related write-downs for the most recent 12-month period were approximately $7.6 million and were primarily associated with Medicare, Medi-Cal, commercial payer contractual adjustments, and California Assembly Bill 716 (AB 716) reductions.
Q (No subject): What were your annual gross collections last year or for the last 12 months?
A: Annual gross collections for the most recent 12-month period were approximately $4.85 million.
Q (No subject): What are your per-mile ground transport charges?
A: The current per-mile ground transport charge is $57.00 per mile and is scheduled to increase to $59.00 per mile effective July 1, 2026.
Q (No subject): What are your advanced life support charges?
A: The City currently utilizes a flat base rate of $2,920 for ALS1, ALS2, and BLS-E transports. These rates are scheduled to increase to $2,993 effective July 1, 2026.
Q (No subject): What are your advanced life support emergency level 1 charges?
A: The City currently utilizes a flat base rate of $2,920 for ALS1, ALS2, and BLS-E transports. These rates are scheduled to increase to $2,993 effective July 1, 2026.
Q (No subject): What are your advanced life support emergency level 2 charges?
A: The City currently utilizes a flat base rate of $2,920 for ALS1, ALS2, and BLS-E transports. These rates are scheduled to increase to $2,993 effective July 1, 2026.
Q (No subject): What are your basic life support charges?
A: The City currently utilizes a flat base rate of $2,920 for ALS1, ALS2, and BLS-E transports. These rates are scheduled to increase to $2,993 effective July 1, 2026.
Q (No subject): What are your basic life support emergency charges?
A: The City currently utilizes a flat base rate of $2,920 for ALS1, ALS2, and BLS-E transports. These rates are scheduled to increase to $2,993 effective July 1, 2026.
Q (No subject): What are your specialty care transport charges?
A: The City does not currently provide specialty care transport (SCT) services and therefore does not maintain a specialty care transport billing rate
Q (No subject): What are your treatment without transport charges?
A: The City does not currently bill for treatment without transport (TWT) services. The City’s operational practice is to encourage patients to seek definitive care and transport to an appropriate receiving facility when medically indicated.
Q (No subject): What is your average per-trip charge?
A: The average gross billed charge per transport for the most recent 12-month period was approximately $3,210.
Q (No subject): When were the last changes to your transport rates, and are you considering raising any of the rates currently charged?
A: The City evaluates ambulance billing rates annually. The most recent rate adjustment occurred on July 1, 2024. Additional rate adjustments are scheduled to take effect on July 1, 2026, including an increase in the ALS1, ALS2, and BLS-E base transport rate from $2,920 to $2,993 and an increase in the mileage rate from $57.00 to $59.00 per mile.
Q (No subject): Are there any other charges you assess not otherwise covered by our questions?
A: The City charges $159 (July 1, 2026 rate) for oxygen administration.
Q (No subject): What percentage of your patients are residents versus non-residents, and do you charge the two groups differently?
A: The City does not differentiate ambulance transport billing rates between residents and non-residents. The City does not currently maintain or routinely report residency-based transport utilization statistics
Q (No subject): Do you operate any shared services agreements with any other municipal or county governments in the region and, if so, with whom?
A: The City participates in automatic aid and mutual aid response relationships within San Mateo County, including occasional responses supporting the San Francisco International Airport (SFO) area and coordination with American Medical Response (AMR). The City’s ambulance transport services are otherwise provided within the City’s exclusive operating area (EOA) established pursuant to California EMS law.
Q (No subject): What were your transports per year for advanced life support for last year or for the last 12 months?
A: Approximately 4,300
Q (No subject): What were your transports per year for advanced life support emergency level 1 for last year or for the last 12 months?
A: Representative monthly billing activity reflects approximately 202 ALS transports (combined ALS1 and ALS2). Annual transport volumes are approximately 4,300 total ambulance transports systemwide.
Q (No subject): What were your transports per year for advanced life support emergency level 2 for last year or for the last 12 months?
A: Representative monthly billing activity reflects approximately 202 ALS transports (combined ALS1 and ALS2). Annual transport volumes are approximately 4,300 total ambulance transports systemwide.
Q (No subject): What were your transports per year for basic life support for last year or for the last 12 months?
A: Representative monthly billing activity reflects approximately 172 BLS-E transports
Q (No subject): What were your transports per year for basic life support emergency for last year or for the last 12 months?
A: Representative monthly billing activity reflects approximately 172 BLS-E transports
Q (No subject): What were your transports per year for specialty care transport for last year or for the last 12 months?
A: The City does not offer Specialty Care Transport services.
Q (No subject): What were your transports per year for treatment without transport for last year or for the last 12 months?
A: The City does not currently bill for treatment without transport (TWT) services and therefore does not maintain transport volume statistics associated with a TWT billing category.
Q (No subject): What is your payer mix expressed as percentages of 100% billed?
A: Based on representative year-to-date billing data by charges, the City’s approximate payer mix is as follows: Medicare HMO: 30.38% Private Pay: 24.40% Medi-Cal HMO: 18.56% Uninsured: 14.20% Medicare: 11.16% Medi-Cal: 1.33% Percentages are approximate and based on billed charges.
Q (No subject): What is your payer remit mix expressed as percentages of 100% of what you typically receive?
A: Based on representative year-to-date payment data, the City’s approximate payer remit mix is as follows: Uninsured: 44.70% Medi-Cal HMO: 26.68% Medicare HMO: 13.78% Medicare: 6.07% Private Pay: 5.45% Medi-Cal: 3.32% Percentages are approximate and based on received payments.
Q (No subject): How many total transport vehicles do you now operate?
A: The City currently operates six (6) ambulances, with three (3) ambulances staffed and in frontline service daily.
Q (No subject): What is your average loaded miles per trip?
A: Average loaded mileage per transport is approximately 3.9 miles.
Q (No subject): What is your average revenue per call?
A: Average collected revenue per transport for the most recent 12-month period was approximately $1,210
Q (No subject): Do you have a lockbox provider and, if so, which provider?
A: Yes. The City currently utilizes a lockbox service through JPMorgan Chase.
Q (No subject): If you have a lockbox provider, will that provider remain in place as a result of this procurement?
A: The City currently intends to maintain its existing lockbox arrangement; however, the City may consider alternative approaches proposed by the selected consultant as part of implementation discussions.
Q (No subject): Do you have a collection agency provider and, if so, which provider?
A: The City does not currently utilize a formal third-party collections agency. The City currently utilizes Resolve Insurance Services for secondary ambulance billing review and verification support services. Future continuation of that relationship will be evaluated as part of this procurement process.
Q (No subject): Which local hospitals or care facilities typically receive most of your patients?
A: The City’s most common receiving facilities include Kaiser South San Francisco, Mills-Peninsula Medical Center, and Seton Medical Center. Higher-acuity specialty transports may be directed to Zuckerberg San Francisco General Hospital, Kaiser Redwood City, or Stanford Health Care, depending on patient condition and specialty care needs. The City does not restrict transport destinations by policy within San Francisco County or San Mateo County.
Q (No subject): If there was a previous solicitation for these services, what was its title, number, release date, and due date?
A: The City’s previous solicitation for ambulance billing services was conducted in 2019. Additional solicitation records, including solicitation number and release/due dates, are not readily available.
Q (No subject): Why has this bid been released at this time?
A: The City is conducting this solicitation as part of a competitive procurement process following the completion of the current agreement term and available extensions. The City has not conducted a formal RFP process for ambulance billing services since 2019.
Q (No subject): When is the anticipated go-live date?
A: The anticipated contract start and go-live date is August 1, 2026, subject to City Council approval and completion of the contract execution process.
Q (No subject): What are the required types of insurance that bidders must have?
A: Required insurance coverages generally include: • Workers’ Compensation and Employer’s Liability • Commercial General Liability • Automobile Liability • Professional Liability (Errors & Omissions) • Cyber Liability / Data Security coverage Applicable limits, endorsements, and additional insured requirements will be included in the final agreement.
Q (No subject): Are bidders permitted to deviate in any way from any manner of quoting fees you may be expecting? For example, if there is a pricing page in the RFP, can bidders submit an alternate fee structure? If there is no pricing page in the RFP, do you have any preference for how bidders should quote fees or can bidders create their own pricing categories?
A: Proposers may submit alternative pricing structures or fee approaches for the City’s consideration; however, proposers are encouraged to address the pricing framework and service expectations identified in the RFP. The City reserves the right to evaluate proposals based on overall value, operational compatibility, and the City’s best interests.
Q (No subject): Please describe your level of satisfaction with your current or recent vendor(s) for the same purchasing activity, if applicable.
A: The City’s current and recent vendors have generally provided satisfactory services. The City is conducting this solicitation as part of its standard competitive procurement process and to evaluate current market capabilities, service models, reporting tools, and pricing structures.
Q (No subject): What estimated or actual dollars were paid last year, last month, or last quarter to any incumbent(s)?
A: Estimated annual payments for incumbent ambulance billing services are approximately $125,000 based on current contractual amounts and historical payment activity. Monthly payments generally range from approximately $12,000–$19,000 depending on billing volume and processing timing, with estimated quarterly expenditures ranging from approximately $35,000–$50,000.
SLED stands for State, Local, and Education. These are solicitations issued by state governments, counties, cities, school districts, utilities, and higher education institutions — as opposed to federal agencies.
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