Resolution 2007-192
RESOLUTION NO. J.9.2..
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, PROVIDING FOR USER FEES FOR
COLLIER COUNTY AMBULANCE SERVICES, UP-DATED BILLING AND
COLLECTION PROCEDURE, UP-DATED 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 A PROCEDURE FOR APPROVING HARDSHIP
CASES AND PAYMENT PLANS; SUPERSEDING RESOLUTION NO. 06-222;
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
WHEREAS, the Board of County Commissioners recently entered into an Agreement with
Advanced Data Processing, Inc. (hereinafter referred to as to "Billing Consultant") to provide
collection services for ambulance 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 96-36 9 5 provides that the user fees for ambulance
services may be established by Resolution of the Board of County Commissioners (hereinafter referred
to as to "the Board").
NOW THEREFORE, BE IT RESOLVED BY THE
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that:
SECTION ONE: EMS USER FEES
BASE RATES:
SERVICE LEVELS
A. EMS - BLS NON-EMERGENCY
B. EMS - BLS EMERGENCY
C. EMS - ALS I NON-EMERGENCY
D. EMS-ALSIEMERGENCY
E. EMS - ALS 2 EMERGENCY
F. EMS - SPECIALTY CARE
G. EMS - HELICOPTER
BOARD OF COUNTY
CODES
BASE CHARGES
$ 675.00
$ 675.00
$ 675.00
$ 675.00
$ 675.00
$ 675.00
$ 5,900.00
A0428
A0429
A0426
A0427
A0433
A0434
A043 I
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:
CODES
A0425
MILEAGE CHARGE
$ 12.00
$
100.00
SERVICE LEVELS
A TWO (2) MEDICS/ONE ALS VEHICLE (PER HOUR)
B. ONE (I) MEDIC/NO VEHICLE (PER HOUR)
COPIES.:
RATES
$ 150.00
$ 50.00
Subject to statutory exemptions, "public records" are required by Chapter 119, FS to be open
to inspection and copying. Consistent with Chapter 119, Resolution No. 98-498 establishes copying
fees as follows:
COPIES OF DOCUMENTS
A. One-sided copy which is 14 inches by 8 Y, inches or less
B. Two-sided copy which is 14 inches by 8 Y, 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 9 119.07(1), FS as "the cost of the
material and supplies used to duplicate the record," but does not include the labor cost and overhead
cost associated with such duplication.
.Copying fees are subject to change only to the extend that either Chapter 119, FS or Resolution
No. 98-498, or both, are amended, replaced, or superseded.
PAST DUE ACCOUNTS
INTEREST ON PAST DUE ACCOUNTS $ I % monthly
SECTION TWO: BILLING COLLECTION PROCEDURE
RATES
$ .15
$ .20
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 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.
I. Billing Consultant will send an initial bill to the service recipient's or responsible
party'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, the Billing Consultant will follow the patient
statement cycle outlined below.
1. An initial statement for ambulance services, including the HIPAA 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.
11. 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. Medicaid accounts will not
receive additional statements after the first.
iii. In 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
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to collections at any time. Billing Consultant may send a patient to collections pnor to
exhaustion of all collection efforts when;
I. The patient account has an invalid address.
2. Billing Consultant is direct by County to send a patient to collections.
D. Interest will be assessed at I % 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
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 be administered.
F. When ambulance service bill(s), at the any stage in this billing and collection procedure, are
returned because the Postal Service carmot effectuate delivery, the EMS Billing Section shall
make 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.
J. Probate Estate Cases: Should a decedent have an unpaid balance for ambulance services, the
following shall occur:
I. 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: I) a copy of ambulance bill(s), 2) all
correspondence between EMS Billing Staff/Billing Consultant) and Personal
Representative, 3) Notice of Claim filed with the Probate Estate, and any other
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 pursue 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 reasonable
actions to reach a settlement with the Personal Representative or his attorney.
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Should a settlement be reached, the EMS Director and the County Attorney (or his
designee) are authorized 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
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 superseded.
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 boundaries 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 it 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 Commissioners, in accordance with criteria established by the enabling Ordinance,
may authorize other adjustments.
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. In addition, Medicaid not medically necessary accounts
will be adjusted to a zero balance.
B. Victim's Compensation Contractual Adjustments. Contractual adjustments will be made in
accordance with applicable state, federal and local rules and regulations.
C. Worker's Compensation Contractual adjustments. Contractual adjustments will be made in
accordance with applicable state, federal and local rules and regulations.
D. County Employee adjustments. 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 hislher ambulance charge in accordance with procedures set forth in Ordinance
No. 96-36.
E. Champus/Tricare Adjustments. Contractual adjustments will be made in accordance with
applicable Campus/Tricare rules and regulations.
F. Railroad Retirement Adjustments. Contractual adjustments will be made in accordance
with applicable state, federal and local rules and regulations pertaining to Railroad
Retirement Adjustments.
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G. Social Services Adjustments. 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: WAIVE 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 oftheir 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 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 06-222
This Resolution shall supersede Resolution No. 06-222
SECTION EIGHT: EFFECTIVE DATE
This Resolution shall become effective on July 24, 2007.
PASSED AND DULY ADOPTED by the Board of County Commissioners of Collier County,
Florida, this JLj+'-' day of :r LA.. \ .:) ,2007.
ATTEST:" ,
DWtGkfE.'~~O.qK, CLERK
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Appro,,~l~ar~qilld'
legal suffiCiency: '
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, F ORIDA
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By:
J ES COLETTA, CHAIRMAN
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