Resolution 2006-222
RESOLUTION NO. 2006- 222
RESOLUTION OF THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, TO
APPROVE UP-DATED USER FEES FOR COLLIER
COUNTY AMBULANCE SERVICES PURSUANT TO
COLLIER COUNTY ORDINANCE NO. 96-36; 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;
SUPERSEDING RESOLUTION NO. 05-224; AND
PROVIDING FOR AND EFFECTIVE DATE.
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 No. 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:
SECTION ONE: EMS USER FEES
BASE RATES:
SERVICE LEVELS
CODES
BASE CHARGE
A. EMS - BLS NON-EMERGENCY A0428 $675.00
B. EMS - BLS EMERGENCY A0429 $675.00
C. EMS - ALS 1 NON-EMERGENCY A0426 $675.00
D. EMS - ALS 1 EMERGENCY A0427 $675.00
E. EMS - ALS 2 EMERGENCY A0433 $675.00
F. EMS - SPECIALTY CARE A0434 $675.00
G. EMS - HELICOPTER
A0431
$5,900.00
MILEAGE RATES:
SERVICE LEVELS
CODES
A. EMS - GROUND UNIT
(Minimum charge of 1 mile and no cap)
A0425
MILEAGE CHARGE
$12.00
B. EMS - AIR UNIT
(Minimum charge of 1 mile and no cap)
A0436
$100.00
SPECIAL EVENTS AND MISCELANEOUS RATES:
SERVICE LEVELS
RATES
A. TWO (2) MEDICS/ONE ALS VEHICLE (PER HOUR)
B. ONE (1) MEDIC/NO VEHICLE (PER HOUR)
COPIES:
COPIES OF DOCUMENTS/PER PAGE
(Excluding Governmental Agencies)
$150.00
$50.00
$1.00
PAST DUE ACCOUNTS:
INTEREST ON PAST DUE ACCOUNTS:
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
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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
be 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 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.
C. 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.
D. 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).
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 any time fail to meet the terms and conditions of the
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payment plan, the unpaid balance shall be administered in accordance with
Section C.3 above.
F. 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.
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 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 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: HOSPITAL OUT OF COUNTY TRANSPORTS
Should a local hospital have a need for a patient to be transported to an out
of County facility, the County shall, subject to equipment, manpower, availability
and its sole discretion, utilize its resources to provide patient transport. The
County shall invoice the hospital for all out of County transports that remain
uncompensated after a period of ninety (90) days.
SECTION FOUR: 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 Compensation Contractual Adiustments. Contractual
adjustments will be made in accordance with applicable state, federal
and local rules and regulations.
C. Worker's Compensation Contractual Adiustments. Contractual
adjustments will be made in accordance with applicable state, federal
and local rules and regulations.
D. County Employee 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
No. 96-36.
E. Champus/Tricare 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 and the EMS 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 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.
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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 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 SEVEN: SUPERCISION OF RESOLUTION 05-224
This Resolution shall supersede Resolution No. 05-224
SECTION EIGHT: EFFECTIVE DATE
This Resolution shall become effective on October 1, 2006
PASSED AND DULY ADOPTED by the Board of County Commissioners of
Collier County, Florida, this ~'A... day of S-t/k/;ll 6e I ../ ,2006.
,
ATTEST:
DWIGHT t=, BROCK, Clerk
BOARD OF COUNTY COMMISSIONERS,
COLLIER COUNTY, FLORIDA
BY:
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BY: ~<=-~
Frank Halas, Chairman
Approved as to form and
legal sufficiency:
frpf2~!rJ ~ .
Colleen Greene
Assistant County Attorney
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