318-22 Exhibit A-Coronis Health for Emergency Transport Third Party Billing - 2022.pdf

C&@)RONIS HEALTH Upon completion of the skip tracing review for each record Coronis Health shall determine patient eligibility for Medicare, primary and secondary insurance, if the claim is directly paid by the patient, or if the claim is ineligible for billing (i.e. Medicaid transport or special case transport). For all eligible patient claims, Coronis Health shall generate a claim for payment in the form of one of the following formats: @ A Medicare claim in either an NSF or ANSI electronic format, as applicable; @ An invoice for a claim to the primary insurance company. At the sole option of the insurance company, claim can be issued in other formats such e-mail, batch tapes, or disc. @ Aninvoice to the patient or responsible party. PCRs without the required medical release signature are not released to Medicare or the insurance company. Such claims shall be forwarded directly to the patient or provider to obtain the required signature(s). INVOICE SUBMISSION: Coronis Health’s staff are all highly qualified and trained in all Medicare, Medicaid, Automobile, Workers Compensation and Commercial Health Benefits. All employees are fully trained in Medicare and HIPAA compliance rules and regulation. We offer our clients HIPAA rules and regulations training for privacy and security. Our system not only meets Medicare and HIPAA compliance standards, but has been customized over the years to overcome almost every possible billing obstacle in order to attain our client’s revenue goals. Coronis Health maintains one of the highest rates of revenue returns per billed claim in the industry. The submission department at Coronis Health is responsible for generating all invoices after the billing entry has been completed. An additional quality assurance step relies upon software edits that report any errors in patient or payer fields. At this point in the process, errors are less than 0.25% (one error per 400 claims). Any errors are immediately corrected and the printed or electronic claim is created and forwarded to the responsible party for payment without delay. Ninety-eight percent of all claims are released for payment within five business days of receipt from the provider. All electronic claims transmissions are confirmed within 24-48 hours to insure receipt by the appropriate payers. Confirmation of paper claims, for private patients and those insurance

m the provider. All electronic claims transmissions are confirmed within 24-48 hours to insure receipt by the appropriate payers. Confirmation of paper claims, for private patients and those insurance companies that do not yet accept electronic claims, begin 10-14 days after printing. Reminder notices are mailed every 30 days thereafter up to 90 days, when collection notices are generated. 12

C@)RONIS on HEALTH ao MEDICARE CLAIMS: All claims shall be transmitted in an electronic format acceptable to Medicare. Coronis Health shall forward the claims determined to be medically necessary or not necessary to Medicare with all required supporting documentation. The claims shall clearly indicate the determination status. Coronis Health has successfully billed over 140,000 Medicare claims last year alone. INSURANCE CLAIMS INCLUDING MEDICARE AND MEDICAID HMO’S: Coronis Health shall generate an insurance claim in either an invoice format (currently HCFA 1500 form) or electronic format upon receipt of patient approval and notice of the appropriate primary carrier. Coronis Health shall provide information as required by the insurance company's standard claim format which may include such information as delineated herein and appropriate medical determination and medical coding criteria. Coronis Health shall forward claims determined to be medically necessary or medically not necessary to the insurance carriers with all required supporting documentation. After verification of receipt of payment from primary insurance carrier, Coronis Health shall determine if there is a secondary carrier for the patient. If a second carrier exists, Coronis Health shall generate an insurance claim to the second carrier. In addition to providing all standard insurance company claim information, Coronis Health shall furnish proof of payment from the primary carrier. Proof of payment generally consists of statement from the insurance carrier or a facsimile check. The balance of any revenue, deductibles, or the co-payment fee due after receipt of payment by the insurance carrier are billed to the patient or written off according to client policies. Coronis Health shall not directly bill any patients that are known to be covered by Medicaid (except for Medicaid HMOs). AUTO ACCIDENT CLAIMS: Coronis Health makes every effort in obtaining auto insurance information by either contacting the patient or obtaining a police report. When Coronis Health bills an auto accident claim in which the patient is not the responsible party, the patient is obligated to file a claim under their own auto policy, or as PER specific state No-Fault guidelines. Coronis Health will follow up with these insurance companies or the patient in the event of delayed claim filing. 13

C@RONIS — HEALTH QUR COLLECTIONS PROCESS WE_ AGGRESSIVELY MANAGE YOUR ACCOUNTS RECEIVABLE. Coronis Health has a strong philosophy of taking an aggressive approach towards EMS Accounts Receivable collections. We work with insurers to insure you receive the maximum reimbursement allowed under each policy. We also work hard to exhaust secondary and co-insurance payment all the while taking a compassionate approach towards the patients. We develop cordial relationships with patients as they are sometimes needed in the collection process when outstanding balances are due from insurance carriers. We also operate a denials department that appeals all denied claims, refusing to rest until they are fully paid. When necessary, Coronis Health is prepared to file complaints with various State Department of Banking and Insurance agencies when insurers fail to process claims properly. Sending claims to third-party collections agencies, although necessary, would expose the Township of West Orange to higher collection rates. Coronis Health works extremely hard to avoid write offs to assist with maximizing per event revenue for our clients. Correspondence and denials from insurance companies received in regular mail are separated by insurance and worked by collectors. Thirty (30) days after a call is entered into the system, calls are then made to the insurance company for the status of the payment on the claim. If there is a denial on the claim there is a request to have the claim reprocessed for payment. Appeals are written to insurance on behalf of the patients to obtain payment. As an incentive to increase cash flow we will offer discounts to patients who pay within 10 days. We also offer patients the option of payment plans. Aging reports are reviewed by manager for consistency. Coronis Health reviews all criteria before sending claims out to an outside collection agency. In general, accounts that go to collection are grouped into non-residents that don’t pay, nor respond to insurance requests over a specified period of time outlined below. Insurance inquiry/Bill sent to patient 25 Days later a second request is sent to patient 25 Days after the 2 past due notice is sent to the patient 10 Days later a pre-collection letter is sent to the patient 5. 20 Days later the claim is reviewed by the Collections Manager, and as deemed appropriate and in consultation with

sent to the patient 10 Days later a pre-collection letter is sent to the patient 5. 20 Days later the claim is reviewed by the Collections Manager, and as deemed appropriate and in consultation with the client a decision will be made to either continue trying to collect on the outstanding claim or have the claim sent to an outside collection agency. PIN pe 14

C@)RONIS — FHEALT SA In addition, all patients who receive money directly from their insurance company and fail to turn it over to Coronis Health are also turned to an outside collection agency. During this process multiple attempts are made to contact patient and research address insurance information. The process normally takes 80 days, but can be shorter or longer depending on any information incurred during the cycle. When receiving notices from estates and/or bankruptcies, Coronis Health will treat the bill as a write-off. Cases dealing with requests for hardship status are reviewed individually and judged accordingly. Even after payment has been received on accounts that have been turned over to the collection agency, Coronis Health will work with the agency to process payment of bills and/or submit these to the insurance companies on behalf of the agency/ patient should it be determined that the patient is eligible for benefits under the insurance. Coronis Health concentrates on exhausting every possible avenue of collection before turning these accounts to collection agencies; we understand profit is lost when such methods are consistently employed. However, Coronis Health will consult with the Township of West Orange and establish guidelines as to when this approach will be used and to what extent. CUSTOM INVOICES Coronis Health is capable of customizing patient invoices to meet the needs of the Township of West Orange. These invoices can be designed and redesigned with ease. REPORTING Coronis Health understands the importance of being able to generate reports and the significance in interpreting these to maximize your revenue. Reporting financial data accurately is a business priority for an ever-increasing percentage of EMS companies, particularly in the complex and fast-paced industry. We are aware that the function of these generators is to pull up any field from any record in order to show it as a data item on a report. Coronis Health has the level of customization in their financial and revenue management reporting that your organization requires. We can provide any type of statement that is useful to communicate the activities performed. We provide true customization, enabling your Agency to view financial data according to the precise criteria you set. Not only does our reporting software come with a host of standardized reports, it

We provide true customization, enabling your Agency to view financial data according to the precise criteria you set. Not only does our reporting software come with a host of standardized reports, it also enables you to customize them. Following are samples of our standard reports, and customized patient data reports, as well as additional ones that you will find helpful as well as informative. 15

C&RONIS HEALTH Coronis Health will provide the Township of West Orange with an extensive library of report options listed below as well as any requested customized reports. These reports are deliverable in the time frames and format deemed acceptable to each individual client. Available reports include, but are not limited to, the following: Monthly Reports: Miscellaneous Reports: = Open Accounts Report > Insurance, medical and/or commercial => Closed Accounts Reports with company names = Patient Summary Reports > Medicare payments => Billing Receivables Reports > Individual payments => Collection Reports >Source of any other payments => Quarterly Trip Statistics => Contractor Reports => Medicare/ Medicaid Reports CUSTOMER SERVICE Coronis Health’s staffing levels are sufficient to accommodate the anticipated call volume of the Township of West Orange with the over 60 members of the billing and collection department. Our staff is divided into three categories (Primary Billing Staff, Primary Backup Billing staff, and Secondary Backup Billing and Collections) in order to manage and support the services required by each department. Our billing system is fully integrated with EMS Charts, ESO, Safety Pad, Image Trend, Zoll, Emergency Reporting, Firehouse Software and others to facilitate expedient claims processing. A brief description of our staffing requirements and training is included below as an outline of Coronis Health’s criteria. Over 75 municipalities, Hospital-based billing operations, and General Transport Ambulance Service is supported and assisted by Coronis Health’s staff. 16

C@RONIS HEALTH a RECRUITING / TRAINING Coronis Health routinely recruits new staff members through local nursing schools, First Aid and Rescue Squads, and vocational schools offering Medical Billing and Coding courses. Potential applicants meeting our hiring requirements are screened for medical terminology knowledge, data entry accuracy, and interpretation of sample E- PCRs to evaluate their ability to translate the E-PCR into a completed claim. Should the applicant demonstrate suitable proficiency in all areas, they are approved for training. Coronis Health requires that all new employees have a minimum of two years relevant experience in medical billing, collections, or insurance claims processing, or have successfully completed an approved Medical Billing and Coding program. A suitable background of three or more years in direct patient care (preferably EMS) experience with strong medical terminology knowledge may be substituted for entry level positions. All employees are subject to a mandatory training period of no less than 80 hours regardless of experience. A minimum probationary period of 30 days for experienced staff, 90 days for entry level staff, under direct supervision of senior staff, enables us to ensure that all permanent staff members have demonstrated satisfactory knowledge and expertise to provide efficient, effective claims management skills. During this time, applicants are granted limited access rights to network information at read and write only levels. Should an applicant fail to achieve expected levels of competency throughout the training or probationary period, they will be terminated. Such applicants will not be permitted to re-apply for a period of no less than one year. Permanent employees receive training updates on a regular basis to ensure that they are thoroughly knowledgeable in all areas of claims management. All personnel involved in claims management procedures are routinely audited and evaluated by supervisory personnel to ensure proper claims handling at all levels. Billing staff receive additional billing/coding training specific to the ambulance industry with focus on Medicare standards of documentation for medical necessity regarding emergent ambulance transports. Additionally, all employees, regardless of department, receive annual HIPAA compliance training. 17

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