Agenda 09/10/2024 Item #16F2 (Resolution authorizing the removal of 7,715 ambulance service accounts and their representative uncollectible accounts receivable balances with tottal $5,057,848.03)16. F.2
09/ 10/2024
EXECUTIVE SUMMARY
Recommendation to adopt a resolution authorizing the removal of 7,715 ambulance service accounts and
their respective uncollectible accounts receivable balances which total $5,057,848.03, 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 $5,057,848.03 in ambulance service fee receivables from the accounts receivable for
Fund 4050000000 (Emergency Medical Services) for uncollected ambulance service fees for 7,715 accounts from
Fiscal Year 2020 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 2020.
Gross Charges Contractual & Net Billed Amount Collected Net Write Off Write Total
Billed Other Collection % Amount Off % Accounts
Adjustments
$25,493,635.41 I ($7,733,086.09) I $17,760,549.32 I $12,702,701.29 172% I S5,057,848.03 128% 17,715
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.
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. The annual review of past -due accounts
was completed, and the accounts deemed uncollectible were identified by EMS. Collection efforts for these
accounts have been exhausted.
The contracted EMS billing company reports that the national averages are 43.5% gross collections and 63.4% net
collections. Per the analytical report attached, Collier County EMS falls respectively higher than the national
average in both aspects. Historically, Collier County EMS has sustained a higher collection rate in comparison to
the national average. Digitech has an average net collection rate of 7 1 % per last three write-off fiscal years (FY18,
FY19, FY20).
The contracted billing company has done its due diligence by collecting on these accounts and filing accordingly
with any insurance. Any balances are then balance billed. If the billing statement is ignored after 3 billing cycle
attempts, then the account is turned over to contracted collection agency. 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. It is important to note that accounts that are written off can
Packet Pg. 1506
16. F.2
09/ 10/2024
still be worked on and any payments received on these accounts will be processed through the Board's accounting
system.
FISCAL IMPACT: Removal of $5,057,848.03 from the EMS Accounts Receivable will remove 7,715 individual
customers' accounts and reduce the allowance for doubtful accounts in Fund 4050000000.
LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney. County Resolution No.
2022-152, Section 2. H and I, provides as follows:
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
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 diligent efforts at collection have been unsuccessful. With that
noted, this item is approved as to form and legality and requires a majority vote for Board approval.
-JAK
GROWTH MANAGEMENT IMPACT: There is no Growth Management impact associated with this action.
RECOMMENDATION: To adopt a resolution authorizing the removal of 7,715 individual accounts with a total
receivable balance of $5,057,848.03 from the Emergency Medical Services Fund (Fund 4050000000) accounts
receivable.
PREPARED BY: Cindy Long, EMS Accountant
REVIEWED BY: Cherie DuBock, Supervisor Accounting, Emergency Medical Services
ATTACHMENT(S)
1. Collier County Analytical Scorecard Overall Summary by Financial Group - Dates of Service FY20—as of
07292024 (XLSX)
2. Resolution 2024 Bad Debt WriteOffs FY 20 (DOCX)
3. Collier County Analytical Scorecard Overall Summary by Financial Group - Dates of Service FY18_as of
07292024 (XLSX)
4. Collier County Analytical Scorecard Overall Summary by Financial Group - Dates of Service FY19_as of
07292024 (XLSX)
5. FY20 -Financial Overview (PDF)
6. FY20 - WriteOff Summary (PDF)
Packet Pg. 1507
16. F.2
09/10/2024
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.F.2
Doe ID: 29202
Item Summary: Recommendation to adopt a resolution authorizing the removal of 7,715 ambulance service
accounts and their respective uncollectible accounts receivable balances which total $5,057,848.03, 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: 09/10/2024
Prepared by:
Title: — Emergency Medical Services
Name: Cherie DuBock
06/14/2024 3:24 PM
Submitted by:
Title: — Emergency Medical Services
Name: Bruce Gastineau
06/14/2024 3:24 PM
Approved By:
Review:
Emergency Medical Services
Emergency Management
Corporate Business Operations
Office of Management and Budget
Office of Management and Budget
County Attorney's Office
County Manager's Office
Board of County Commissioners
Bruce Gastineau
EMS Chief Review
Michael Choate
Executive Director Review
Jennifer Reynolds
OMB Reviewer
Debra Windsor
Level 3 OMB Gatekeeper Review
Agnieszka Chudy
OMB Reviewer
Jeffrey A. Klatzkow
Level 3 County Attorney's Office Review
Amy Patterson
Level 4 County Manager Review
Geoffrey Willig
Meeting Pending
Completed
06/14/2024 4:20 PM
Completed
06/18/2024 2:11 PM
Completed
06/18/2024 2:20 PM
Completed
06/18/2024 2:26 PM
Completed
06/18/2024 3:16 PM
Completed
06/20/2024 4:46 PM
Completed
09/04/2024 10:23 AM
09/10/2024 9:00 AM
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RESOLUTION NO.2024-
RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, TO AUTHORIZE THE REMOVAL FROM
THE BOOKS AND RECORDS OF COLLIER COUNTY CERTAIN ACCOUNTS
AND THEIR RESPECTIVE BALANCES WHICH HAVE BEEN IDENTIFIED AS
UNCOLLECTIBLE.
WHEREAS, Collier County provides emergency ambulance transportation services throughout
Collier County; and
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WHEREAS, emergency ambulance transportation service fees are received by the County after
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the services have been rendered due to the County's responsibility to protect the public health, safety and
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welfare; and
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WHEREAS, the County is unable to collect some debts, and others the Board is statutorily
prohibited from collecting or due to contractual arrangements cannot be collected; and
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WHEREAS, the County's generally accepted and practiced accounting method to recognize an
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allowance for bad debts is a periodic or annual bad debt expense in the books and records for accounts
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that have been identified by the Department as uncollectible; and
WHEREAS, Rule 691-71, Florida Administrative Code, allows the Board to adjust accounts
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receivable for less than the full amount if the accounts have not been reported to the Department of
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Financial Services, Division of Accounting and Auditing for disposition; and
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WHEREAS, the subject accounts have not been reported to the Department of Financial
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Services, Division of Accounting and Auditing; and
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WHEREAS, County Resolution No. 2022-152, Section 2. H and I, provides for removing these
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accounts from the Board's Emergency Medical Services Fund Accounts Receivable; and
WHEREAS, the Board of County Commissioners hereby finds that diligent efforts at collection
have proven unsuccessful and circumstances warrant the adjustment.
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NOW THEREFORE, IT IS RESOLVED BY THE BOARD OF COUNTY
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COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that:
1. The following chart sets forth the charges billed, the portion uncollectible due to statutory
prohibitions and Board contractual arrangements, the amount collected and the balance of accounts
receivable to be written off:
Packet Pg. 1511
1 6.F.2.b
Contractual &
Gross Charges other Amount Net Write -Off Write -Off Total
Bill ed Adjustments Net Billed Collected Collection % Amount % Accounts
25,493,635.41 7,733,086.09 17,760,549.32 12,702,701.29 72% 5,057,848.03 28% 7,715
2. The Board authorizes staff to remove 7,715 individual accounts and their respective balances for
a total of $5,057,848.03 from the Board's Emergency Medical Services Fund. Same amount will be
removed from the Accounts Receivable General Ledger control account, and the Allowance for Doubtful
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Accounts General Ledger control account in the Board's Emergency Medical Services Fund.
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This Resolution adopted on this 13th day of August 2024 after motion, second and majority
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vote favoring adoption.
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ATTEST: BOARD OF COUNTY COMMISSIONERS
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CRYSTAL K. KINZEL, CLERK COLLIER COUNTY, FLORIDA
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By:
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Deputy Clerk Chris Hall, Chairman
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Approved as to form and legality:
Jeffrey A. Klatzkow, County Attorney
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FY 20 Write -Off Summary
16.F.2.f
FY 20
Vendor
SAP Charges
Adjustments
Net Billed
Payments
Collection %
Write -Off
Write -Off %
# of I
Digitech & Collection Summary
25,493,635.41
(7,733,086.09)
17,760,549.32
12,702,701.29
72%
28%
Digitech Accounts
239,382.33
2%
Alliance One Accounts
87,528.80
2,040,899.03
16%
RTR Financial Accounts
116,072.13
2,777,566.67
22%
5,057,848.03 28%
5,057,848.03
Totals
25,493,635.41
(7,733,086.09)
17,760,549.32
12,702,701.29
72%
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