Resolution 2003-244
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RESOLUTION NO. 03 - 244
RESOLUTION APPROVING UP-DATED USER FEES FOR
COLLIER COUNTY AMBULANCE SERVICES PURSUANT TO
COLLIER COUNTY ORDINANCE NO. 96 - 36 FOR 2004 FISCAL
YEAR; ADOPTING BILLING AND COLLECTION PROCEDURE;
PROVIDING CLARIFICATION ON ADJUSTMENTS AND
WAIVERS; PROVIDING CLARIFICATION ON WAIVER OF
SPECIAL EVENTS; AND PROVIDING A PROCEDURE FOR
APPROVING HARDSHIP CASES AND PAYMENT PLANS
WHEREAS, Collier County Emergency Medical Services (hereinafter sometimes
referred to as "EMS") provides ambulance services to the residents and visitors of Collier
County; and
WHEREAS, the Collier County EMS operating budget is funded exclusively
through ad valorem taxes and user fees; and
WHEREAS, Collier County staff analysis of the cost for ambulance services
requires an adjustment to the user fees to properly identify current costs of services to
the residents and visitors of Collier County; and
WHEREAS, Collier County Ordinance 96 - 36 provides that the user fees for
ambulance services may be established by Resolution of the Board of County
Commissioners (hereinafter sometimes referred to as "the Board").
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA THAT:
SERVICE LEVELS
A. EMS - BLS NON-EMERGENCY
B. EMS - BLS EMERGENCY
C. EMS - ALS 1 NON-EMERGENCY
D. EMS - ALS 1 EMERGENCY
E. EMS - ALS 2 EMERG ENCY
F. EMS - SPECIALTY CARE
G. EMS - HELICOPTER (LOGISTICAL)
H. EMS - HELICOPTER (TRAUMA)
BASE RATES
I. EMS - BLS GROUND BASE RATE A0428
(BENEFICIARY DEATH IN ACCORDANCE WITH
CMS GUIDELINES)
SECTION ONE: EMS USER FEES
BASE RATES
CODES
A0428
A0429
A0426
A0427
A0433
A0434
A0431
A0431
BASE CHARGE
$ 350.00
$ 375.00
$ 425.00
$ 475.00
$ 550.00
$ 650.00
$ 2,400.00
$ 4,200.00
$350.00
J. EMS - BLS AIR BASE RATE A0431
(BENEFICIARY DEATH IN ACCORDANCE WITH
CMS GUIDELINES)
MILEAGE RATES
SERVICE LEVELS
A. EMS - IN COUNTY GROUND UNIT
$2,400.00
CODES
MILEAGE CHARGE
A0425
$ 9.00
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(MINIMUM CHARGE OF 1 MILE AND NO CAP)
B. EMS - OUT OF COUNTY GROUND UNIT A0425
(MINIMUM CHARGE OF 1 MILE AND NO CAP)
C. EMS -IN COUNTY AIR UNIT A0436
(MINIMUM CHARGE OF 1 MILE AND NO CAP)
D. EMS - OUT OF COUNTY AIR UNIT A0436
(MINIMUM CHARGE OF 1 MILE WITH NO CAP)
SPECIAL EVENTS AND MISCELANEOUS RATES
SERVICE LEVELS
- TWO (2) MEDICS/ONE ALS VEHICLE (PER HOUR)
$ 9.00
$ 65.00
$ 65.00
RATES
150.00
- ONE (1) MEDIC/NO VEHICLE
(PER HOUR)
$
$
$
50.00
COPIES OF DOCUMENTS/PER PAGE
(EXCLUDING GOVERNMENTAL AGENCIES)
INTEREST ON PAST DUE ACCOUNTS
1.00
1 % monthly
SECTION TWO: BILLING AND COLLECTION PROCEDURE
The following shall be the minimum guidelines for billing and collection
procedures for ambulance service fees and charges:
A. Initial fees and charges for ambulance service(s) shall be assessed either
prior to or following the provision of service, as service dynamics
reasonably permit. Unpaid fees and charges, subsequent to time of
service, shall be reflected in an accounts receivable subsidiary ledger
system to be maintained by the EMS Department.
B. An initial bill for ambulance services shall be processed in the following
manner within thirty (30) days after service is provided.
1. The County will send an initial bill to the service recipient's or
responsible party's insurance carrier provided that appropriate
insurance information is made available to the EMS Billing Section.
The EMS Billing Section will accept Medicare assignment, as a
participating provider, and will wait no less than 45 days for payment if
Medicare or other insurance carrier's are billed. If the claim is denied,
a bill will be sent to the service recipient or responsible party.
2. The County will also send a bill to Medicaid and accept assignment if
appropriate insurance information is made available to the EMS Billing
Section by the service recipient or responsible party. The EMS Billing
Section will wait no less than 60 days for payment if Medicaid is billed.
If the claim is denied because of no coverage at time of service, a bill
will sent to the service recipient or responsible party. If Medicaid
denies because they felt it was not medically necessary to be
transported by ambulance, then the account will be adjusted off per
the rules and regulations of Medicaid.
3. In the event the service recipient or responsible party does not have
or does not provide proof of insurance coverage, the bill for
ambulance service(s) shall be sent directly to the service recipient or
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responsible party for payment. The EMS Billing Section will wait no
less than 30 days for payment.
The following will occur if payment has not been received within above
set guidelines:
1. A past due notice will be sent in accordance with the
above provisions, (45 days after billing third party or
Medicare, 60 days after billing Medicaid and 30 days after
billing responsible party or service recipient).
2. Thirty (30) days) after the first past due notice is sent, a
second past due notice will be sent.
3. After a ten (10) day grace period following the second past
due notice, the account will be sent to the County's
contracted collection agency.
C. Interest will be assessed at 1 % per month, on all accounts that are
sent to the County's contracted collection agency, (excluding
hardships as defined by County policy)
D. A reasonable and customary payment plan will be made available for
all service recipients or responsible parties. Should the service
recipient or responsible party at any time fail to meet the terms and
conditions of the payment plan, the unpaid balance shall be
administered in accordance with Section B.3 above.
E. When ambulance service bill(s). at any stage in this billing and
collection procedure, are returned because the Postal Service cannot
effectuate delivery, the EMS Billing Section shall make a reasonable
effort to ascertain the correct mailing address. If reasonable efforts
to ascertain a correct address fail, the account(s) may be considered
for other collection alternatives.
F. Nothing contained in this section shall preclude reasonable
telephone or other appropriate contact for billing and collection
purposes, in accordance with all applicable laws.
G. Throughout the fiscal year, the EMS Billing Section shall review all
past due accounts and report to the Board of County Commissioners
on an annual basis, of all past due accounts which are believed to be
uncollectible.
The Board may, after reviewing these past due accounts and after
finding that diligent efforts at collection have proven unsuccessful,
remove these past due accounts from active accounts receivable in
accordance with generally accepted accounting procedures and
pursuant to law by Resolution.
SECTION THREE: ADJUSTMENT OF EMS USER FEES
The following shall be minimum guidelines for adjustments to ambulance service
fees. The Board of County Commissioners, in accordance with criteria established by
the enabling Ordinance, may authorize other adjustments.
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A. Medicare and Medicaid Adiustments
Contractual adjustments under Medicare and/or Medicaid assignment will be made in
accordance with applicable Medicare and/or Medicaid rules and regulations.
B. Victim's Comcensation Contractual Adiustments
Contractual adjustments will be made in accordance with applicable state. federal and
local rules and regulations.
C. Worker's Comcensation Contractual Adiustments
Contractual adjustments will be made in accordance with applicable state. federal and
local rules and regulations.
D. County Emofovee Adiustments
Board of County Commissioners and Constitutional Officers' employees that have
Primary coverage under Collier County's insurance policy will be responsible for any
deductibles, co-payments or unpaid balances. An employee may dispute his/her
ambulance charge in accordance with procedures set forth in Ordinance 96-36.
E. Chamous/Tricare Adiustments
Contractual adjustments will be made in accordance with applicable Champus/Trlcare
rules and regulations.
F. Railroad Retirement Adiustments
Contractual adjustments will be made in accordance with applicable state, federal and
local rules and regulations pertaining to Railroad Retirement Adjustments.
G. Social Services Adiustments
Contractual adjustments will be made in accordance with rules established by the
County Manager and memorialized by a memorandum of understanding executed by the
Social Services Director and the EMS Director.
SECTION FOUR: WAIVER OF EMS USER FEE FOR SPECIAL EVENTS
Pursuant to Ordinance No. 96 - 36, and from the effective date of this Resolution,
user fees for EMS ambulance stand-by services may be waived if the Board finds that a
valid public purpose has been established in recognition of their charitable contributions
to the Community.
SECTION FIVE: HARDSHIP CASES AND PAYMENT PLANS
The Board recognizes that certain service recipients may need to be identified
and processed as hardship cases. Payment plans will be established pursuant to the
minimum guidelines set forth in this Resolution.
A. Hardship cases will be established in accordance with the Federal Poverty
guidelines, as used by the Social Services Department of Collier County.
B. Payment plans for hardship cases will be set up on a monthly basis, with a
minimum payment of $10.00 per month. Hardship cases, placed on a payment plan will
not accrue interest or be placed into collection. Notwithstanding the foregoing, if a
service recipient has a payment plan and does not make the agreed scheduled
payments for a period longer than two (2) months, the account will be turned over to the
County's contracted collection agency and interest will begin to accrue.
SECTION SIX: SUPERSESSION OF RESOLUTION 2002-429
This Resolution shall supersede Resolution No. 2002-429
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SECTION SEVEN: ADOPTION AND EFFECTIVE DATE
This Resolution shall become effective on October 1, 2003.
PASSED AND DULY ADOPTED by the Board of County Commissioners of Collier
County, Florida, this 2.q4I- day of ]V r ~ ' 2003.
ATTES1::. " {":'~',
DWIGH'! E. BROCK.'.CLERK
By:;.~;~ik~'.'~.., .....
,',;.-" .
Attest ~ tO~""'.
ItgnltUf"'f oA1J..
Approved as to form and
legal sufficiency:
BY:
Tom Hennmg, Chairman
1-1ll-03
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