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Resolution 2002-429 108 ... ,41 ; )~~ 1 2 3 4 RESOLUTION NO. 02-429 S 6 7 RESOLUTION APPROVING USER FEES FOR COLLIER 8 COUNTY AMBULANCE SERVICES PURSUANT TO COLLIER 9 COUNTY ORDINANCE NO. 96 - 36; ADOPTING BILLING AND 10 COLLECTION PROCEDURE; PROVIDING ADJUSTMENTS AND 11 WAIVERS; AND APPROVING HARDSHIP CASES AND 12 PAYMENT PLANS 13 14 15 16 WHEREAS, Collier County Emergency Medical Services (hereinafter sometimes 17 referred to as "EMS") provides ambulance services to the residents and visitors of Collier 18 County; and 19 WHEREAS, the Collier County EMS operating budget is funded exclusively 20 through ad valorem taxes and user fees; and 21 WHEREAS, Collier County staff analysis of the cost for ambulance services 22 requires an adjustment to the user fees to properly identify current costs of services to 23 the residents and visitors of Collier County; and 24 WHEREAS, Collier County Ordinance 96 - 36 provides that the user fees for 25 ambulance services may be established by Resolution of the Board of County 26 Commissioners (hereinafter sometimes referred to as "the Board"). 27 NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY 28 COMMISSIONERS OF COLLIER COUNTY, FLORIDA THAT: 29 30 SECTION ONE: EMS USER FEES 31 32 33 34 35 36 37 38 39 40 41 42 43 44 BASE RATES SERVICE LEVELS CODES BASE CHARGE $ 300.00 $ 325.00 $ 350.00 $ 400.00 $ 550.00 $ 650.00 $ 3,407.00 A. EMS - BLS NON-EMERGENCY B. EMS - BLS EMERGENCY C. EMS - ALS 1 NON-EMERGENCY D. EMS - ALS 1 EMERGENCY E. EMS - ALS 2 EMERGENCY F. EMS - SPECIALTY CARE G. EMS - HELICOPTER F. EMS - HELICOPTER LOGISTICAL A0428 A0429 A0426 A0427 A0433 A0434 A0431 A0431 $ 650.00 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 lOB ""1 ':1 2 3 MILEAGE RATES SERVICE LEVELS CODES MILEAGE CHARGE A. EMS - IN COUNTY GROUND UNIT (MINIMUM OF 1 MILE - CAP OF 10 MILES) B. EMS - OUT OF COUNTY GROUND UNIT (MINIMUM OF 1 MILE WITH NO CAP) C. EMS - IN COUNTY AIR UNIT (MINIMUM OF 1 MILE - CAP OF 10 MILES) D. EMS - OUT OF COUNTY AIR UNIT (MINIMUM OF 1 MILE WITH NO CAP) $ 7.00 $ 7.00 $ 49.00 $ 49.00 SPECIAL EVENTS AND MISCELANEOUS RATES SERVICE LEVELS RATES - TWO (2) MEDICS/ONE ALS VEHICLE (PER HOUR) $ $ $ 1.00 150.00 - ONE (1) MEDIC/NO VEHICLE (PER HOUR) 50.00 COPIES OF DOCUMENTS/PER PAGE (EXCLUDING GOVERNMENTAL AGENCIES) INTEREST ON PAST DUE ACCOUNTS 1% 32 SECTION TWO: BILLING AND COLLECTION PROCEDURE 33 The following shall be the minimum guidelines for billing and collection 34 procedures for ambulance service fees and charges: 35 A. Initial fees and charges for ambulance service(s) shall be assessed either 36 prior to or following the service provision, as service dynamics reasonably permit. 37 Unpaid fees and charges, subsequent to time of service, shall be reflected in an 38 accounts receivable subsidiary ledger system to be maintained by the EMS Department. 39 B. An initial bill for ambulance services shall be processed in the following 40 manner within thirty (30) days after service is provided. 41 1. The County will send an initial bill to the service recipient's or 42 responsible party's insurance carrier provided that appropriate 43 insurance information is made available to the EMS Billing Section. 44 The EMS Billing Section will accept Medicare assignment, as a 45 participating provider. and will wait no less than 45 days for payment if 47 a bill will be sent to the service recipient or responsible party. 46 Medicare or other insurance carrier's are billed. If the claim is denied, 2 108 "j 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 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 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 alter 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. Alter a ten (10) day grace period, 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 that adhere to 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 6.3 above. E. When ambulance service bill(s), at any stage in this billing and collection procedure, are returned because the Postal Service cannot 3 lOB effectuate delivery, the EMS Billing Section shall make a reasonable 2 effort to ascertain the correct mailing address. If reasonable efforts 3 to ascertain a correct address fail, the account(s) may be considered 4 for other collection alternatives. 5 F. Nothing contained in this section shall preclude reasonable 6 telephone or other appropriate contact for billing and collection 7 purposes, in accordance with all applicable laws. 8 G. Throughout the fiscal year, the EMS Billing Section shall review all 9 past due accounts and report to the Board of County Commissioners 10 on an annual basis, of all past due accounts which are believed to be 11 uncollectible. 12 The Board shall, after reviewing these past due accounts and after 13 finding that diligent efforts at collection have proven unsuccessful, 14 remove these past due accounts from active accounts receivable in 15 accordance with generally accepted accounting procedures and 16 pursuant to law by Resolution. 17 18 SECTION THREE: ADJUSTMENT OF EMS USER FEES 19 The following shall be minimum guidelines for adjustments to ambulance service 20 fees. The Board of County Commissioners in accordance with criteria established by 21 the enabling Ordinance may authorize other adjustments. 22 A. Medicare and Medicaid Adiustments 23 Contractual adjustments under Medicare and/or Medicaid assignment will be made in 24 accordance with applicable rules and regulations. 25 B. Victim's Compensation Contractual Adiustments 26 Contractual adjustments will be made in accordance with applicable rules and 27 regulations. 28 C. Worker's Compensation Contractual Adiustments 29 Contractual adjustments will be made in accordance with applicable rules and 30 regulations. 31 D. County Emplovee Adiustments 32 Board of County Commissioners and Constitutional Officers' employees that have 33 34 Primary coverage under Collier County's insurance policy will receive an adjustment in 35 36 accordance with applicable rules and regulations of Ordinance 96-36. 4 ....~ lOB ~ . :1j 2 E. ChamousfTricare Adiustments 3 Contractual adjustments will be made in accordance with applicable rules and 4 5 regulations. 6 7 F. Railroad Retirement Adiustments 8 Contractual adjustments will be made in accordance with applicable rules and 9 10 regulations. 11 12 G. Social Services Adiustments 13 Contractual adjustments will be made in accordance with rules established by the 14 15 County Manager and memorialized by a memorandum of understanding executed by the 16 17 Social Services Director and the EMS Operations Director. 18 19 20 SECTION FOUR: WAIVER OF EMS USER FEE 21 Pursuant to Ordinance No. 96 - 36, and from the effective date of this Resolution, 22 user fees for EMS ambulance stand-by services for the following community special 23 events shall be waived as the Board finds that a valid public purpose is hereby 24 established in recognition of their charitable contributions to the Community: (1) Collier 25 County Fair; (2) Everglades Seafood Festival; (3) Collier County Public High School 26 varsity football games. Fees for other community special events may be waived in 27 accordance with criteria established by the enabling Ordinance. 28 29 SECTION FIVE: HARDSHIP CASES AND PAYMENT PLANS 30 The Board recognizes that certain service recipients may need to be identified 31 and processed as hardship cases. Payment plans will be established pursuant to the 32 minimum guidelines set forth in this Resolution. 33 A. Hardship cases will be established in accordance with the Federal Poverty 34 guidelines, as used by the Social Services Department of Collier County. 35 B. Payment plans for hardship cases will be set up on a monthly basis, with a 36 minimum payment of $10.00 per month. Hardship cases, placed on a payment plan will 37 not accrue interest or be placed into collection. Notwithstanding the foregoing, if a 38 service recipient has a payment plan and does not make the agreed scheduled 39 payments for a period longer than two (2) months, the account will be tumed over to the 40 County's contracted collection agency and interest will begin to accrue. 41 42 5 108,1 SECTION SIX: SUPERSESSION OF RESOLUTION 2001-410 2 This Resolution shall supersede Resolution No. 2001-410 3 4 SECTION SEVEN: ADOPTION AND EFFECTIVE DATE 5 6 This Resolution shall become effective on October ,2002. 7 PASSED AND DULY ADOPTED by the Board of County Commissioners of Collier County, Florida, this sa day Of([)~ ,2002. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 ~,i:J'J ~ ~ ~ : ,~':) c,;;> .:. . (;'., (" l"": ~., . ::-.) Ams+~ !-~'~-' DWI?HT E.'~,~~K:.CLERK BY: "~4;;~# '..J~ , , .' BY: Jame . Coletta, Chairman Attest as to Chairun's signature Olll_ Approved as to form and legal sufficiency: c eline Hubbard Robinson ssistant County Attorney 6