Agenda 09/12/2023 Item #16F 5 (Resolution - Authorizing removal of ambulance service accounts and their respective uncollectable accounts receivable balance)09/12/2023
EXECUTIVE SUMMARY
Recommendation to adopt a resolution authorizing the removal of 7,779 ambulance service accounts and
their respective uncollectible accounts receivable balances which total $5,220,427.30, from the accounts
receivable of Collier County Fund 4050000000 (Emergency Medical Services) finding diligent efforts to
collect have been exhausted and proved unsuccessful.
OBJECTIVE: To remove $5,220,427.30 in ambulance service fee receivables from the accounts receivable for
Fund 4050000000 (Emergency Medical Services) for uncollected ambulance service fees for 7,779 accounts from
Fiscal Year 2019 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 2019.
Gross Charges
Billed
Contractual &
Other
Adjustments
Net Billed Amount
Collected
Net
Collection %
Write Off
Amount
Write
Off %
Total
Accounts
$26,867,689.52 $8,354,081.32 $18,513,608.20 $13,293,180.90 72% $5,220,427.30 28% 7,779
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: Removal of $5,220,427.30 from the EMS Accounts Receivable will remove 7,779 individual
customers’ accounts and reduce the allowance for doubtful accounts in Fund 4050000000.
GROWTH MANAGEMENT IMPACT: There is no Growth Management impact associated with this action.
LEGAL CONSIDERATIONS:
County Resolution No. 2022-152, Section 2. H and I, provides as follows:
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09/12/2023
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 effort s 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 dilige nt efforts at collection have been unsuccessful. This item
has been reviewed by the County Attorney, is approved as to form and legality and requires a majority vote for
Board approval. -JAK
RECOMMENDATION: To adopt a resolution authorizing the removal of 7,779 individual accounts with a total
receivable balance of $5,220,427.30 from the Emergency Medical Services Fund (Fund 4050000000) accounts
receivable.
PREPARED BY: Cherie DuBock, Supervisor Accounting, Emergency Medical Services
ATTACHMENT(S)
1. Resolution - EMS Bad Debt FY19 - JAK signed (PDF)
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09/12/2023
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.F.5
Doc ID: 26476
Item Summary: Recommendation to adopt a resolution authorizing the removal of 7,779 ambulance service
accounts and their respective uncollectible accounts receivable balances which total $5,220,427.30, from the
accounts receivable of Collier County Fund 4050000000 (Emergency Medical Services) finding diligent efforts to
collect have been exhausted and proved unsuccessful.
Meeting Date: 09/12/2023
Prepared by:
Title: – Emergency Medical Services
Name: Cherie DuBock
08/24/2023 4:10 PM
Submitted by:
Title: Division Director - EMS Operations – Emergency Medical Services
Name: Tabatha Butcher
08/24/2023 4:10 PM
Approved By:
Review:
Emergency Medical Services Tabatha Butcher Director Review Completed 08/25/2023 2:23 PM
County Attorney's Office Geoffrey Willig Level 2 Attorney of Record Review Skipped 09/06/2023 2:47 PM
Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review Completed 09/06/2023 2:48 PM
Office of Management and Budget Agnieszka Chudy Additional Reviewer Completed 09/06/2023 3:01 PM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 09/06/2023 3:10 PM
County Manager's Office Amy Patterson Level 4 County Manager Review Completed 09/06/2023 3:16 PM
Board of County Commissioners Geoffrey Willig Meeting Pending 09/12/2023 9:00 AM
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Packet Pg. 1105 Attachment: Resolution - EMS Bad Debt FY19 - JAK signed (26476 : FY19 EMS Bad Debt Write Off)
16.F.5.a
Packet Pg. 1106 Attachment: Resolution - EMS Bad Debt FY19 - JAK signed (26476 : FY19 EMS Bad Debt Write Off)