Agenda 01/29/2008 Item #16F 1
Agenda Item No. 16F1
January 29, 2008
Page 1 of 13
EXECUTIVE SUMMARY
Recommendation to approve a Resolution providing for user fees for Collier County
ambulance services, billing and collection procedure, hospital transport billing and up-
dated fees to generate revenues of approximately $103,750 which will help offset an
anticipated shortfall for the FY 08 budget, adjustments of EMS llser fees pursuant to
Collier County Ordinance No. 96-36, waiver of EMS llser fees for special events, and a
procedure for approving hardship cases and payment plans; superseding Resolution No.
07-192; and providing for an effective date.
OBJECTIVE: To obtain BCC approval of a Resolution providing for user fees for Collier
County ambulance services, up-dated billing and collection procedure, up-dated hospital
transport billing and fees which would result in revenues of approximately $103,750,
adjustments of EMS user fees pursuant to Collier County Ordinance No. 96-36, waiver of EMS
user fee, for special events, and a procedure I,)r approving hardship eases and payment plans;
'mperseding Resolution No. 07-] 92: and providing I()[ an effective date.
CONSIDERATIONS: Collier County Ordinance No. 96-36 provides that the BCC may, by
Resolution, establish user fees for ambulance services. A copy of the strike-through underline
version ufthe pr9posed Resolution is made part of this item for comparison purposes. Collier
County staff has reviewed the County's EMS user fee schedule adopted by the BCC in FY 07
~. and recommends the proposed increase in !'ates to more closely align with fces being charged by
other EMS agencies in the state. A new category (Item G in Rate Table below) is being addcd
which will address patient treatment without transport. The charge will be $175. However, this
charge will not be assessed in the following cascs:
1. EMS is called to a private residence by a patient's neighbor and an assessment is done,
but no treatment is involved.
2, All Pnblic Assistance calls.
3, Traffic accidents where only assessments are perfOlmed and no treatment is required.
4. EMS is called to a public facility (i.e. Wal-Mart) by store personnel or a bystander
concemed about a customer and only assessment and no definitive treatment is provided.
The Treatment Without Transport (TWT) charge is one being adopted by many other counties
throughout the state, including Charlotte, Lee, Sarasota, Polk and Osceola, to help offset
operating costs. An additional stipulation incorporated into this Resolution is that accounts with
balances of $ 10 and less would be written off due to inefficiencies of processing such minimal
balances.
BASE RATES:
SERVICE LEVELS
CURRENT PROPOSED
RATE RATE
$ 675,00 $ 700.00
$ 675.00 $ 700.00
$ 675.00 $ 700.00
$ 675.00 $ 700.00
/"'" A. EMS - BLS NON-EMERGENCY
B, EMS-BLSEMERGENCY
C. EMS - ALS 1 NON-EMERGENCY
D, EMS-ALSIEMERGENCY
Agenda Item No. 16F1
January 29. 2008
Page 2 of 13
E. EMS-ALS2EMERGENCY
F. EMS - SPECIALTY CARE
G. EMS - TREATMENT WITHOUT TRANSPORT
H. EMS - HELICOPTER
$ 675.00
$ 675.00
N/A
$5,900.00
$ 750.00
$ 800.00
$ 175.00
$5,900.00
MILEAGE RATES:
SERVICE LEVELS
A. EMS - GROUND UNIT
(Minimum charge of 1 mile and no cap)
B. EMS ... AIR UNIT
(Minimum charge of I mile and no cap)
$ 12.00
$ 12.25
$100.00
Sl JO.OO
The projected revenue resulting from these increases ror the balance of FY 08 is relatively
modest due to the payer mix thc billing consultant, ADPl, IS clHTently experiencing.
L\pproximatcly. 470/;) of the hillahlc transports arc billed through ~1edicare, \vhich rcumins at a
contractual schedule and consequently. Gnly about half of the fee is realized as revenue. The
hilling consultant is currently reasscsslng pn~iections based on actual experience fJ"om the point
in May 2007 where they actually assumed the billing process to the current date. A complde
listing of CUlTent services and fees are contained in the proposed Resolution.
Also revised in the proposed resolution is the reference to Resolution No. 98-498 pertaining to
copying costs. This is because Resolution No. 98-498 was superseded by Resolution No. 07-327
on November 13, 2007. The proposed resolution now references Resolution No. 07-327. The
copying costs were not changed by Resolution No. 07-327.
A copy of the Executive Summary, along with the updated Resolution and a strike-through copy
of the Resolution were sent to the Emergency Medical Services Advisory Council (EMSAC) for
infonnational purposes on January 16'h To date, no comments have been received from the
Council.
FISCAL IMPACT: Approval of this Resolution would result in revenue of approximately
$103,750 which will help offset an anticipated shortfall for the FY 08 budget.
GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact resulting
from this action.
RECOMMENDA nON: That the Board of County Commissioners:
1. Approve the attached Resolution amending EMS ambulance service user fees, which
Resolution shall supersede and replace Resolution No, 07-] 92; and,
2. Authorize the Chaim1an to execute the Resolution.
Prepared bv: Artie Bay, Operations Analyst, Emergency Medical Services
RESOLUTION NO. 08 -
Agenda Item No. 16F1
January 29, 2008
Page 3 of 13
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, PROVIDING FOR UP-DATED EMS USER
FEES FOR COLLIER COUNTY AMBULANCE SERVICES, UP-DATED
BILLING AND COLLECTION PROCEDURE, HOSPITAL TRANSPORT
BILLING AND FEES, ADJUSTMENTS OF EMS USER FEES PURSUANT
TO COLLIER COUNTY ORDINANCE NO. 96-36, WAIVER OF EMS USER
FEES FOR SPECIAL EVENTS, AND AN UPDATED PROCEDURE FOR
APPROVING HARDSIDP CASES AND PAYMENT PLANS; SUPERSEDING
RESOLUTION NO. 07-192; AND PROVIDING FOR AN EFFECTIVE DATE.
(
WHEREAS. Collier County Emergency Medical Services (hereinafter 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
,"VHEREAS, the Board of County Commissioners recently entered into an Agreement with
Advanced Data Processing, rnc. (hereinafter referred to as to "Billing Consultant") to provide
collection sen.dcefl for amhulance services and associated fees; and
WHEREAS, this Resolution is intended to apply irrespective of whether EMS billing staff,
Advanced Data Processing, Inc., or any other billing consultant is responsible for the collection of
fees for ambulance services; and
WHEREAS, Collier County Ordinance No. 96-36 & 5 provideR that the user fees for
ambulance services may be established by Resolution of the Board of County Commissioners
(hereinafter referred to us to "the Board").
NOW THEREt'ORE, BE IT RESOLVED BY THE
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that:
SECTION ONE: EMS USER FEES
BASE RATES:
SERVICE LEVELS
BASE CHARGES
A. EMS - BLS NON-EMERGENCY
B. EMS - BLS EMERGENCY
C. EMS - ALS ] NON-EMERGENCY
D. EMS-ALS1EMERGENCY
E. EMS - ALS 2 EMERGENCY
F. EMS - SPECIALTY CARE
G. EMS - TREATMENT W/O TRANSPORT
H. EMS - HELICOPTER
MILEAGE RATES:
SERVICE LEVELS
A. EMS - GROUND UNIT
(Minimum Charge of 1 mile and no cap)
(
BOARD OF COUNTY
CODES
A0428
$ 700.00
$ 700.00
$ 700.00
$ 700.00
$ 750.00
$ 800.00
$ 175.00
$ 5,900.00
A0429
A0426
A0427
A0433
A0434
A0098
A043 1
CODES
A0425
MILEAGE CHARGE
$ 12.25
B. EMS - AIR UNIT A0436
SPECIAL EVENTS AND MISCELLANEOUS RATES:
SERVICE LEVELS
A TWO (2) MEDICS/ONE ALS VEHICLE (PER HOUR)
$ 11 0.00
RATES
$ 150.00
B. ONE (I) MEDICINO VEHICLE (PER HOUR)
COPIES':
s
Agenda Item No. 16F1
January 29, 2008
50.00 Page 4 of 13
Suhjeet to statutory exemptions, "public records" are required by Chapter 119, F.S. to be
open to inspection and copying. Consistent with Chapter 119, Resolution No. 07-327 establishes
copying fees as follows:
COPIES OF DOCUMENTS
RATES
$ .15
$ .20
A. Onc.sidcd copy which is 14 inches by 8 Yl inches or less
B. Two-sided copy which is 14 inches by 8 Yo inches or less
COPY SERVICES
The actual cost of duplication for all other copies will be charged. The first hour of cost of
doplication will not be charged. "Actual cost of duplication" is defined in ~ 119.07(1), F.8. as "the
cost of the material and supplies used to duplicate the record." but does not include (he labor cost
and overhead cost associated with such duplication.
.Copying fees are subject to change only to the extent that either Chapter 119. FS 01'
Resolution No. 07-327, or both, are amended, replaced, Or superseded.
PAST DUE ACCOUNTS
INTEREST ON PAST DUE ACCOUNTS
SECTION TWO: BILLING COLLECTION PROCEDURE
$
1 % monthly
The following shall be the minimum guidelines for billing nnd collection procedures for
ambulance service fees and charges:
A. Initial fees and charges fOT ambulance ::;~rvice(s) shall be assessed either prior to or
following the provision of service, as service dynamics reasonably allow. 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. EMS Billing Staff will transmit all data necessary to Billing Consultant to process the claim.
1. Billing Consultant will send an initial bill to the service recipient's or responsible
pa11y's insurance carrier as soon as insurance information has been received,
validated, and entered by the Billing Consultant on the account.
2. When a valid patient address is present. Ute Billing Consultant will follow the patient
statement cycle outlined below.
i. An initial statement for ambulance services, including the HIP AA. notice of
privacy practices shall be sent fourteen (14) or more days after the data is
entered by the Billing Consultant, but no later than 30 days after service has
been provided.
ii. If a nonwMedicaid account remains unpaid, statements will be sent to the
patient no later than every 60 days from the last filed date. If a claim is denied,
a bill will be sent to the service recipient or responsible party.
iii. For Medicaid accounts, if the claim is denied because of no coverage at the
time of service, or because it was determined to be not medically necessary to
be transported by ambulance, a bill will be sent to the service recipient or
responsibly party.
\
C.
Agenda Item No. 16F1
January 29, 2008
iv. In the event the service recipient or responsible party does not have or does not Page 5 of 13
provide proof of insurance coverage, statements will be sent to the patient no
later than every 60 days from the last statement date.
The Billing ConsulWnt will provide a file with patients to be sent to collections to the
County's contraeted collection agency when all attempts to collect on the account have been
exhausted by the BiUing Consultant. The County may direct the Billing Consultant to not
se11d a patient to collections at any time. Billing Consultant may send a patient to
collections prior to t:xhaustion of all collection efforts when:
1. The patient account has an invalid address.
2. Billing Consultant is directed by County to send a patient to collections.
Interest will be assessed at 1% per month on all accounts that are sent to the County's
contracted collection agency.
A reasonable and customary payment pJ~ will be made available for all service recipients
or responsible parties. Should the service recipient or responsible party at the time fail to
meet the terms and conditions of the payment plan for a period of (60) sixty days, the unpaid
balance shall reenter the collections process set forth in Section C. above at the point in the
collections process at which it was taken out for a payment plan to be administered.
When ambulance service bill(s). at the any stage in this billing and collection procedun:, are
returned because the Postal Service cannot effectuate delivery, the EMS Billing Section
~hall make reasonable effort to ascertain the correct mailing address, If reasonable effort~ to
ascertain a correct address fail, the accotmt(s) may be considered for other collection
allemalives.
D.
E.
1".
G. Nothing contained in this Section shall preclude reasonable telephone or other appropriate
contact for billing and collection purposes, in accordance with all applicable laws.
H. Throughout the fiscal year, the EMS Billing Section shall review all past due accounts and
report to the Board of COWlty Commissioners on an annual basis, of all past due accounts
which are believed to be uncollectible.
1. .lbe Bnard may. after reviewing these past due accounts and after linding 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.
J. Probate Estate Cases: Should a decedent have an unpaid balance for ambulance services,
the following shall occur:
1. The decedent's Personal Representative will notify EMS Billing Staff that a
probate estate has been filed with the Probate Court.
2. EMS Billing Staff shall ensure that a Notice of a Claim is timely filed with the
Probate Court.
3. EMS Billing Staff shall ensure that the Office of the County Attorney is timely
notified of sueh claim and provided with: I) a copy of ambulance bill(s), 2) all
correspondence between EMS Billing StafflBilling Consultant) and Personal
Representative, 3) Notice of Claim filed with the Probate Estate, and any other
information necessary to pursue the claim,
Agenda Item No. 16F1
January 29, 2008
4. The Office of the County Attorney shall take all reasonable actions that are Page 6 of 13
necessary to pursue such claim, including but not limited, to filing a lawsuit in
the County Court to pursue such claim,
5. If the estate has assets and $10,000 or less is owed ff:lr ambulance services, the
EMS Director and the County Attorney (or his designee) are authorized to take
reasonable actions to reach a settlement with the Personal Representative or his
attorney. Should a settlement be reached, the EMS Director and the County
Attorney (or his deslgnee) are authorized to execute a sutisfat.'tion and/or release
on behalf of the County. If the estate has assets and in excess of$10,OOO is owed
for ambulance services, any negotiated settlement/compromise of the ambulance
billing claim shall be approved by the Board of County Commissioners. If the
estate has nominal assets or no assets, the County Manager may waive the rates,
fees, and charges as set forth in Ordinance No. 96-36, as it may be amended,
replaced, or supen~eded.
K. All accounts with a balance of$lO or less will be written off.
SECTION THREE: HOSPITAL TRANSPORT BILLING AND FEES
A. The fees set forth in Section One of this Resolution shall apply to ambulance transports that
occur between a hospital's facilities.
B. Should a hospital within the boundaries of Collier County have the need for a transport of a
patient between hospital facilities located within the houndaries of Collier County,
ambulance transport will be provided.
C Should a hospital within the boundaries of Collier County have the need for a transport of a
patient to hospital facilities located outside the boundaries of Collier County, the County~
will subject to equipment and manpower availability, at its sole discretion, utilize its
resources to provide patient transport.
D. Hospitals requesting ambulance transports shall be invoiced directly for ambulance transport
service on a monthly basis.
SECTION FOUR: ADJUSTMENT OF EMS USER FEES
The following shall be minimum guidelines for adjustments to ambulance service fees. The
Board of County Conunissioners, in accordance \\~th criteria established by the enabJing Ordinance,
may authorize other adjustments.
A. Medicare and Medicaid Adjustments. 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 Comoensation Contrnctual Adiustments. Contractual adjustments will be
made in accordance with applicable state, federal and local rules aud regulations.
C. Worker's Cotn'oensation Contractual Adjustments. Contractual adjustments will be
made in accordance with applicable state, federal and local rules and regulations.
D. County Emolovee Adiustments. Board of County Commissioners and ConstitutionalhOfficers' employees that have Primary coverage under Collier County's insurance policy
will be responsible for any deductibles, co-payments or unpaid balances, An employee
(
Agenda Item No. 16F1
January 29, 2008
may dispute his/her ambulance charge in accordance with procedures set forth in Page 7 of 13
Ordinance No. 96-36.
E. ChamnusITricnre Adiustments. Contractual adjustments will be made in accordance
with applicable Champus/Tricare 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 aud the EJ\1S Director.
SECTION FIVE: WAIVER OF EMS USER FEE FOR SPECIAL EVENTS.
Pursuant to Ordinance No. 96~36, and from the effective date of this Resolution, user [t':cs
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 SIX, 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 Depal1ment of Collier County.
B. Puyment plnns for hardship cases will be set up on a monthly basis, with a minimum
payment of $1 0.00 per month. Hardship cases, placed 011 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 wil1 begin to accrue.
SECTION SEVEN: SlJPERCISION OF RESOLUTION 07-192
TIlis Resolution shall supersede Resolution No. 07-192
SECTION EIGHT: EFFECTIVE DATE
This Resolution shall become effective on January 29, 2008
PASSED AND DULY ADOPTED by the Board of County Commissioners of Collier
County, Florida, this day of , 2008.
ATTEST:
DWIGHT E. BROCK, CLERK
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By:
TOM HENNING, CHAIRMAN
Approved as to form and
legal sufficiency:
~o.?, Q r,"l LU
Jenni r A. Belped!
Assistant County Attorney
Agenda Item No. 16F1
January 29, 2008
Page 8 of 13
RESOLUTION NO.
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, PROVIDING FOR UP-DATED EMS USER
FEES FOR COLLIER COUNTY AMBULANCE SERVICES, UP-DATED
BILLING AND COLLECTION PROCEDURE, VP llATED HOSPITAL
TRANSPORT BILLING AND FEES, ADJUSTMENTS OF EMS USER FEES
PURSUANT TO COLLIER COUNTY ORDINANCE NO. 96-36, WAIVER OF
EMS USER ~-EES FOR SPECIAL EVENTS, AND AN UPDATED PROCEDURE
FOR APPROVING HARDSHIP CASES AND PAYMENT PLANS;
SUPERSEDING RESOLUTION NO. ~!!1:ill; AND PROVIDING FOR AN
EFFECTIVE DATE.
WHEREAS, Collier County Emergency Medical Services (hereinafter referred to a. "EMS")
provides ambulance services to the re....idents 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, the Board of County Commissioners recently entered into an Agreement with
Advanced Data Processing, Inc. (hereinafter refened to as to "Billing ConsultanC') to provide
collection services lor ambulance s~rvices and associated fees; anti
WHEREAS, this Resolution i. intended to apply irrespective of whether EMS billing slatT.
Advanced Data Processing, Inc., or any other billing consultant is responsible for the collection of fees
for ambulance services; and
WHEREAS, Collier County Ordinance No. 96-36 * 5 provides that the user fees for
ambulance services may be established by Resolution of the Board of COWlty Commissioners
(hereinaft.er referred to as to "the Board").
NOW THERE.'ORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that:
SECTION ONE: EMS USER FEES
BASE RATES:
SERVICE LEVELS CODES
BASE CHARGES
A. EMS - BLS NON-EMERGENCY
B. EMS-BLSEMERGENCY
C. EMS-ALS I NON-EMERGENCY
D. EMS-ALSIEMERGENCY
E, EMS - ALS 2 EMERGENCY
F. EMS - SPECiALTY CARE
G. EMS - TREATMENT WIO TRANSPORT
H. EMS - HELICOPTER
MILEAGE RATES:
SERVICE LEVELS
A. EMS - GROUND UNIT
(Minimum Charge of I mile and no cap)
B. EMS - AIR UNIT A0436
SPECiAL EVENTS AND MISCELLANEOUS RATES:
SERVICE LEVELS
A0428
$ e:/.S,OO 700.00
$ e:/.S,OO 700.00
$ e:/.S,OO 700.00
$ e:/.S,OO 700.00
$ e:/.S,OO 750.00
$ e:/.S,OO 800.00
$ 175.00
$ 5,900.00
A0429
A0426
A0427
A0433
A0434
A0098
A0431
CODES
A0425
MILEAGE CHARGE
$ ~~
$ .[.OO,{lG l1Q.QQ
RATES
\
A TWO (2) MEDICS/ONE ALS VEHICLE (PER HOUR)
B. ONE (I) MEDlC/NO VEHICLE (PER HOUR)
COPIES':
Subject to statutory exemptions, "public records" are required by Chapter 119, F.S. to be open
to inspection and copying. Consistent with Chapter 119, Resolution N(). 9<l-49ll 07-~.:rr.ostablishcs
copying fees as follows:
COPIES OF DOCUMENTS
$
$
150.00
50.00
Agenda Ilem No. 16F1
January 29, 2008
Page 9 of 13
RATES
$ ,15
$ .20
A. One-sided copy which is 14 inches by 8 Y, inches or less
B. Two~sided copy which is 14 inches by 8 Y2. inches or less
COPY SERVICES
The actual cost of duplication for all other copies will be charged. The fIrst hour of cost of duplication
will not be charged. "Actual cost of duplication" is defined in ilI19.07(1), F.S. as "Ule cost of the
material and supplies used to duplicate the record;' hut does not include the labor cost and overhead
cost associated with such duplication.
'Copying fees are subject to change only to the extent that either Chapter 119, F.S. or Resolution
No. 9<l-49ll 07-327, or both, are amended, replaced, or superseded.
PAST Dl.iE ACCOUNTS.
INTEREST ON PAST DUE ACCOUNTS $ 1 % monthly
SECTION TWO: BILLING COLLECTION PROCEDURE
The following shall be the minimum guidelines for billing nnd collection procedures for
ambulance selVice 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 allow. Unpaid fees and charges.
subsequent to time of service shall be retlected in an account.'7j receivltble subsidiary ledger
system to be maintained by the EMS Department.
B. EMS Billing Staff will transmit all data necessary to Billing Consultant tn process the claim.
1. Billing Consultant will send an initial bill to the service recipient's or rcsponsihle
party's insurance carrier as soon as insurance infonnation has been received, validated,
and entered by the Billing Consultant on the account.
2. When a valid patient address is present, the Billing Consultant will follow the patient
statement cycle outlined below.
L An initial statement for ambulance services. including the HIP AA notice of
privacy practices shall be sent fourteen (14) or more days after the data is entered
hy the Billing Consultant, but no later than 30 days after service has been
provided.
ii. If a non. Medicaid account remains unpaid, statements will be sent to the patient
no later than every 60 days from the last filed date. Mediaaid a..OUBt, ':.ill Bet
reeeh'e aElditieB&1 stalOlllOBts after Ill. first. If a claim is denied. a bill will be sent
to the service recinient or resDonsible Dartv.
ffi..:. For Medicaid accounts. if the claim is denied because of no coveraQ:e at the time
of service. or because it was detcnnined to be not medicallv necessarv to be
2
Agenda Item No. 16F1
January 29, 2008
transuorted bv ambulance. a bill will be sent to the service reciuient or resuonsibfyage 10 of 13
l1l!!1Y.
iv. Tn the event the service recipient or responsible party does not have or does not
provide proof of insurance coverage, statements will be sent to the patient no later
than every 60 days :from the last statement date.
C. The Billing Consultant will provide a file with patients to be sent to collections to the County's
contracted collection agency when all attempts to collect on the account have been exhausted
by the Billing Consultant. The County may direct the Billing Consultant to not send a patient
to collections at any time. Billing Consullant may send a patient to collections prior to
exhaustion of all collection effOlts when:
1. The patient account has an invalid address.
2. Billing Consultant is directed. by County 10 send a patient to collections.
D. Interest will be assessed at 1% per month on all accounts that are sent to the County's
contracted collection agency.
E. 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 the time fail to meet the
temls and conditions of the payment plan for a period of (60) sixty days, the unpaid balance
shall reenter the collections process set fOlth in Section C. above at the point in the collections
process at which it was taken out for a payment plan to be administered.
F. When ambulance service bill(s}, at the any stage in this billing and collection procedure, are
returned because the Postal Service cannot effectuate delivery, the EMS Billing Section shall
make reusonable 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
aJtematives.
G. Nothing contained in this Section shall preclude reasonable telephone or other appropriate
contact for hilling and collection purposes, in accordance with all applicable laws.
H. Throughout the fiscal year, the EMS Billing Section shall review ull past due accounts and
report to the Board of County Commissioners on an annual b8sis~ of all past due accounts
which are belicved to he uncollectible.
1. 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.
J. Probate Estale Cases: Should a decedent have an unpaid balance for ambulance services, the
following shaJI occur:
1. The decedent's Personal Representative will notifY EMS Billing Staff that a probate
estate has been filed with the Probate Court.
2. EMS Billing Staff shall ensure that a Notice of a Claim is timely filed with the
Probate Court.
3. EMS Billing Staff shall ensure that the Office of the County Attorney is timely
notified of such claim and provided with: 1) a copy of ambulance bill(s), 2) all
correspondence between EMS Billing Stafli'Billing Consultant) and Personal
J
Agenda Item No. 16F1
January 29, 2008
Representative, 3) Notice of Claim filed with the Probate Estate, and any otlfePge 11 of 13
information necessary to pursue the claim.
4. The Office of the County Attorney shall take all reasonable actions that are
necessary to pursue such claim, including but not limited, to filing a lawsuit in the
County Court to pw'Sue such claim.
5. If the estate has assets and $10,000 or less is owed for ambulance services, the EMS
Director and the County Attorney (or his designee) are authorized to take reasonahle
actions to reach a settlement with the Personal Representative or his attorney.
Should a settlement be reached, the EMS Direclor and the COWlty Attorney (or his
designee) are auLhOlized to execute a satisfaction and/or release on behalf of the
County. If the estate has assets and in excess of $10,000 is owed for ambulance
services, any negotiated settlement/compromise of the ambulance billing claim shall
he approved hy the Board of CoWlty Commissioners. If tlle estate has nominal
assets or no assets, the County Manager may waive the rates, fees. and charges as
set forth in Ordinance No. 96-36, as it may be amended, replaced, or superseded.
K. All accounts with a balance of$l 0 or less will be written off.
SECTION THREE: HOSPITAL TRANSPORT BILLING AND FEES
A The fees set forth in Section One of this Resolution shall apply 10 ambulance transports that
occur between a ho~pltal 's facilities.
B. Should a hospital within the boundaries of Collier County have the need for a transport of a
patient between hospital facilities located within the boundaries of Collier County, ambulance
transport will be provided.
C. Should a hospital within the bOWldaries of Collier County have the need for s transport of a
patient to hospital facilities located outside the boundaries of Collier COWlty, the County, will
subject to equipment and manpower availability, at its sole discretion, utilize its resources to
provide patient transport.
D. Hn'pitals requesting ambulance transports shall be invoiced diroctly for ambulance transport
service on a monthly basis.
SECTION FOUR: ADJUSTMENT OF EMS USER FEES
The following shall he minimum guidelines for adjustments to ambulance service fees, TIle
Board of County Commissioners, in accordance with criteria established by the enabling Ordinance,
may authorize other adjustments.
fu Medicare and Medicaid Adiustments. Contractual adjustments under Medicare and/or
Medicaid assignment will be made in accordance with applicable Medicure and/or
Medicaid rules and regulations. T:a. RasitisA, l\fetiieaifl Het mediea:ll) Heeessary aeeaunts
will ee adjllGled Ie a .er. eel."o..
B. Victim's ComDensation Contractual Adiustments. Contractual adjustments will be made in
accordance with applicable state, federal and local rules and regulations.
C. Worker's Compensation Contractual Adiusbnents. Conlractual adjustments will be made
in accordance with applicable state, federal and local rules and regulations.
D. Countv Emnlovee Adiustments. Board of County Commissioners and Constitutional
Officers' employees that have Primary coverage under Collier COWlty'S insurance policy
4
Agenda Item No. 16F1
January 29, 2008
will be responsible for any deductibles, co-payments or unpaid balances. An employfeage 12 of 13
may dispute his/her ambulance charge in accordance with procedures set forth in Ordinance
No. 96-36.
E. Chamnu.s!fricare Ad1ustments. Contractual adjustments will be made in accordance with
applicable ChampusITricare 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 he 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 FIVE: WAIVER OF EMS USER FEE FOR SPECIAL EVENTS.
Pursuant to OrdinWlce 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
heen established in recognition of their charitable contrib~tioos to the Community.
SECTION SIX: HARDSIDP CASES AND PAYMENT PLANS.
The Board recognizes that certain ~lervice reciplents may need to be identified and processed as
hardship cases, Payment plans will be established pursuant La Lhe minimum ,guidelines set forth in
this Resolution.
A. Hardship cases will be established in accordance with the Federal ~)overty guidelines, as
used by the Social Services Department of Collier Connty.
B. Payment pll.Uls for hardship cases will be set up on a monthly basis, with u 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 a!,>reed achedulcd 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 SEVEN: SUPERCISION OF RESOLUTION NO. ~ 07-192
This Resolution shall supersede Resolution No. ~ 07-192
SECTION EIGHT: EFFECTIVE DATE
n,is Resolution shall hecome effective on July 21,2097. January 29, 2008
PASSED AND DULY ADOPTED by the Board ~f County Commission!"" of Collier COlmty,
Plorida, this day of , i!OO+ 2008.
ATTEST:
DWIGHT E. BROCK, CLERK
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FWRIDA
By:
JAMBS CQLETTA TOM HENNING, CHAIRMAN
Approved as to fonn and
legal sufficiency:
Jennifer A. Belpedio
Assistant County Attorney
s
Page I of I
Agenda Item No. 16F1
January 29, 2008
Page 13 of 13
COLLIER COUNTY
(
BOARD OF COUNTY COMMISSIONERS
Item Number:
Item Summary:
16F1
Recommendation to approve a Resolution providing for user fees for Collier County
ambulance services, billing and collection procedure, hospital transport billing and up-dated
fees to generate revenues of approximately $103,750 which will help offset an anticipated
shortfall for the FY 08 budget. adjustments of EMS user fees pursuant to Collier County
Ordinance No. 96-36, waiver of EMS user fees for special events, and a procedure for
approving hardship cases and payment plans; superseding Resolution No. 07-192; and
providing for an effective date
Meeting Date:
1/29/200890000 AM
Prepared By
Artie Bay
Bureau of Emergency
Services
Senior Administrative Assistant
Date
EMS
1/15120085:01:07 PM
A pproved By
Jeff Page
EMS Chief
Date
Bureau of Emergency
Services
EMS
'1/15/20085:11 PM
( Approved By
Jennifer A. Belpedio
Assistant County Attorney
Date
County Attorney
County Attorney Office
1/16120088:28 AM
Approved By
Dan E. Summers
Bureau of Emergency Services Director
Date
County Manager's Office
Bureau of Emergency Services
1/16/200811:45 AM
Approved By
OMB Coordinator
OMS Coordinator
Date
County Manager's Office
Office of Management & Budget
1/18/20088:44 AM
Approved By
Sherry Pryor
Management & Budget Analyst
Date
County Manager's Office
Office of Management & Budget
1/22/20084:02 PM
Approved By
James V. Mudd
Board of County
Commissioners
County Managef
Date
County Manager's Office
1/23/20083:05 PM
file:/ /C:\AgendaTest\Export\99-January%2029,~202Q08\ 16. %20CONSENT%20AGENDA \.,. 1/23/2008