Agenda 07/09/2019 Item #16E 3 (Resolution - Removing Ambulance Service Accounts)07/09/2019
EXECUTIVE SUMMARY
Recommendation to adopt a resolution authorizing the removal of 7,820 ambulance service
accounts and their respective uncollectible accounts receivable balances which total $5,390,407.16,
from the accounts receivable of Collier County Fund 490 (Emergency Medical Services) finding
diligent efforts to collect have been exhausted and proved unsuccessful.
OBJECTIVE: To remove $5,390,407.16 in ambulance service fee receivables from the accounts
receivable for Fund 490 (Emergency Medical Services) for uncollected ambulance service fees for 7,820
accounts from Fiscal Year 2015 where diligent efforts to collect have been exhausted and proved
unsuccessful.
CONSIDERATIONS: Collier County began providing emergency ambulance transportation services in
1981. As the County is responsible for protecting the public health, safety and welfare of the public,
emergency ambulance services are provided when needed and fees are received after the fact. This
scenario results in certain accounts being uncollectible.
The values below identify ambulance service fee activity for Fiscal Year 2015.
Gross Charges
Billed
Contractual &
Other
Adjustments
Net Billed Amount
Collected
Net
Collection
%
Write Off
Amount
Write
Off
%
Total
Accounts
$24,853,622.75 $7,531,038.58 $17,322,584.17 $11,932,177.01 69% $5,390,407.16 31% 7,820
There are two types of adjustments that can be made to an ambulance service account: Contractual and/or
bad debt.
Contractual adjustments represent Collier County’s acceptance of the Federal Medicare limits on amounts
that can be collected for medical services, Medicaid statutory limits, Railroad Retirement statutory limits,
and Victim Compensation Rights statutory adjustments. Receivables are recorded at 100%. When
payment is received, contractual adjustments are recorded as a reduction to revenue.
The annual review of past due accounts was completed, and accounts deemed uncollectible were
identified by EMS. Collection efforts for these accounts have been exhausted. Bad debt is recognized for
a variety of reasons, including patients who cannot be located, services provided to transients or migrants,
patients who die with no assets and bankruptcies. These accounts cannot be removed without the Board’s
adoption of an authorizing resolution. Detailed reports listing the accounts to be removed are on file in
the Office of Emergency Medical Services.
The Finance Department, in accordance with generally accepted accounting procedures, annually
estimates and sets an allowance for bad debts based on accounts receivable analysis.
Those accounts for which the billing agency has exhausted their collection attempts were sent to the
County’s contracted collection agency and remain outstanding. If any payments are received, they will be
processed through the Board’s accounting system.
FISCAL IMPACT: The budget is adopted on a cash basis year over year and removal of these
uncollectable accounts will have zero budgetary impact. Any residual collections simply add to fund
balance.
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LEGAL CONSIDERATIONS:
County Resolution No. 08-27, Section 2. H and I, provides as follows:
H. 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.
I. The Board may, after reviewing these past due accounts and after finding that diligent efforts at
collection have been unsuccessful, remove these past due accounts from active accounts receivable in
accordance with generally accepted accounting procedures and pursuant to law by Resolution.
By approving this item, the Board is finding that diligent efforts at collection have been unsuccessful.
This item is sufficient as to form and legality and requires a majority vote for Board approval. - JAK
GROWTH MANAGEMENT IMPACT: There is no Growth Management impact associated with this
action.
RECOMMENDATION: To adopt a resolution authorizing the removal of 7,820 individual accounts
with a total receivable balance of $5,390,407.16 from the Emergency Medical Services Fund (Fund 490)
accounts receivable.
PREPARED BY: Tabatha Butcher, Chief, Emergency Medical Services
ATTACHMENT(S)
1. Resolution - JAK signed 2015 Write Off (PDF)
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COLLIER COUNTY
Board of County Commissioners
Item Number: 16.E.3
Doc ID: 9341
Item Summary: Recommendation to adopt a resolution authorizing the removal of 7,820
ambulance service accounts and their respective uncollectible accounts receivable balances which total
$5,390,407.16, from the accounts receivable of Collier County Fund 490 (Emergency Medical Services)
finding diligent efforts to collect have been exhausted and proved unsuccessful.
Meeting Date: 07/09/2019
Prepared by:
Title: Division Director - EMS Operations – Emergency Medical Services
Name: Tabatha Butcher
06/18/2019 1:32 PM
Submitted by:
Title: Division Director - EMS Operations – Emergency Medical Services
Name: Tabatha Butcher
06/18/2019 1:32 PM
Approved By:
Review:
Administrative Services Department Michael Cox Level 1 Division Reviewer Completed 06/26/2019 9:36 AM
Administrative Services Department Len Price Level 2 Division Administrator Review Completed 06/26/2019 2:41 PM
Office of Management and Budget Laura Wells Level 3 OMB Gatekeeper Review Completed 06/26/2019 2:47 PM
Budget and Management Office Mark Isackson Additional Reviewer Completed 06/26/2019 3:02 PM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 06/26/2019 4:43 PM
County Manager's Office Leo E. Ochs Level 4 County Manager Review Completed 06/27/2019 8:49 AM
Board of County Commissioners MaryJo Brock Meeting Pending 07/09/2019 9:00 AM
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16.E.3.a
Packet Pg. 1506 Attachment: Resolution - JAK signed 2015 Write Off (9341 : 2015 EMS Write Off)
16.E.3.a
Packet Pg. 1507 Attachment: Resolution - JAK signed 2015 Write Off (9341 : 2015 EMS Write Off)