Agenda 08/26/2025 Item #16F14 (Resolution - Removing 7,901 ambulance service accounts and their respective uncollectible accounts receivable balances of $5,233,740.02 from the Emergency Medical Services Fund)8/26/2025
Item # 16.F.14
ID# 2025-2479
Executive Summary
Recommendation to adopt a Resolution authorizing the removal of 7,901 ambulance service accounts and their
respective uncollectible accounts receivable balances, totaling $5,223,740.02 from the accounts receivable of the
Emergency Medical Services Fund (4050) finding diligent efforts to collect have been exhausted and proved
unsuccessful.
OBJECTIVE: To remove $5,223,740.02 in ambulance service fee receivables from accounts receivable for the EMS
Fund (4050) for uncollected ambulance service fees for 7,901 accounts from Fiscal Year 2021 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 2021.
Gross Charges
Billed
Contractual & Other
Adjustments
Net Billed Amount
Collected
Net Collection
%
Write Off
Amount
Write Off
%
Total
Accounts
$27,566,262.74 ($8,379,765.65) $19,186,497.0
9
$13,962,757.07 73% $5,223,740.02 27% 7,901
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 CMS (Centers for Medicare and Medicaid
Services) limits on amounts that can be collected for medical services, Medicare statutory limits, Medicaid statutory
limits, Military statutory limits, Railroad Retirement statutory limits, Health Maintenance Organizations (HMO) statutory
limits, Worker’s Compensation 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
individuals who refuse to pay or cannot pay, 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 (Digitech) reports that the national averages are 44.7% gross collections and 64.3%
net collections for CY2024. Per the analytical report attached, Collier County EMS falls higher than the national average
in both respects. Historically, Collier County EMS has sustained a higher collection rate in comparison to the national
average. Digitech has an average gross collection rate of 49% and a net collection rate of 71% based on Fiscal Years
(FY18, FY19, FY20, FY21).
The contracted billing company has done its due diligence by billing and collecting on these accounts and filing
accordingly with any insurance. Any balances are then billed. If the billing statement is ignored after 3 billing cycle
attempts, then the account is turned over to our current 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 still be worked on
Page 4242 of 4682
8/26/2025
Item # 16.F.14
ID# 2025-2479
and any payments received on these accounts will be processed through the Board’s accounting system.
This item is consistent with the Collier County strategic plan objective to support and enhance our commitment to robust
public safety services
FISCAL IMPACT: Removal of $5,223,740.02 from the EMS Accounts Receivable will remove 7,901 individual
customers’ accounts and reduce the allowance for doubtful accounts in the EMS Fund (4050).
GROWTH MANAGEMENT IMPACT: There is no Growth Management impact associated with this action.
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.
-CLD on behalf of JAK
RECOMMENDATIONS: To adopt a Resolution authorizing the removal of 7,901 individual accounts with a total
receivable balance of $5,223,740.02 from the EMS Fund (4050) accounts receivable.
PREPARED BY: Cindy Long, Accountant II, Corporate Financial & Management Services
ATTACHMENTS:
1. Resolution 2025 Bad Debt Write-Off FY21
2. Analytical Scorecard Yearly Comparison
3. FY21 Write-Off Summary
4. FY21 Financial Overview
Page 4243 of 4682
RES()LUTION NO.2025-
RESOLUTION OF THE BOARD OF COUNTY CO}INIISSIONERS OF
COLLIER COUNTY, FLORIDA, TO AUTHORIZE THE RENTOVAL FROM
THE BOOKS AND RECORDS OF COLLIER COUNTY CERTAIN ACCOTINTS
AND THEIR RESPECTIVE BALANCE,S WHICH HAVE BENN IDENTIFIED AS
UNCOLLECTIBLE.
WHEREAS, Collier Countl' pror,ides enrergenc]' ambulance transportation serv'ices throughout
Collier County; and
WHEREAS, emergency ambulance transportation service f'ees are received by the Cor-rnty after
the sen'ices have been rendered due to the Countl's responsibilitl' to protect the public health, sat'etv and
welfare; and
WHEREAS, the County is unable to collect some debts, and others the Board is statutorily
prohibited lrom collecting or due to contractual arrangements cannot be collected; and
WHEREAS, the Count,v's generally accepted and practiced accounting method to recognize an
allowance fbr bad debts is a periodic or annual bad debt expense in the books and records for accourrts
that have been identified by the Department as uncollectible: and
WHEREAS, Rule 691-71. Florida Administrative Code. allor.vs the Board to adjust accounts
receivable for less than the flll amount if the accounts have not been reported to the Department of
Financial Sen,ices, Division ofAccounting and Auditing 1br disposition; and
WHEREAS, the subject accounts have not been reported to the Department of Financial
Services. Division of Accounting and Auditingt and
WHEREAS, County Resolution No. 2022-152. Section 2. H and I, provides for removing these
accounts fl'om the Board's Emergencl Medical Services Fund Accounts Receivable; and
WHEREAS, the Board of Countl Cornmissioners hereby finds that diligent effbrts at collection
have proven unsuccessful and circumstances warrant the adjuslment.
NOW THEREFORE, IT IS RESOLVED BY THE BOARD OF COUNTY
COMNIISSIONERS OF COLLIER COUNTY' FLORIDA' that:
1. I'he following cha( sets fbfih the charges billed. the portion uncollectible due to statutory
prohibitions and Board contractual arrangements. the a.mount collected and the balance of accounts
receivable to be *'ritten ott
Page 4244 of 4682
Gross Charges
Billed
Contractual &
other
Adjustments Net Billed
Amount
Collected
Net
Collection %
Write-Off
Amou nt
Write-Off Total
Accounts
21,s66262.7t 8,379,765.65 19,r86,,t97.09 13,962,157.07 13rh 5,223,110.02 2701,7,901
2. The Board authorizes statlto remor,'e 7.901 individual accounts and their respective balances for
a total of $5,223.740.02 from the Board's Emergency Medical Sen'ices Fund. Same amount will be
removed from the Accounts Receivable General Ledger control account, and the Allou'ance fbr Doubtful
Accounts Ger.reral Ledger control account in the Board's Emergencl' Medical Sen'ices Fund.
This Resolution adopted on this 261h day of August 2025 aller motior.r. second and rnaj ority
vote lal oring adoption.
ATTEST:
CRYSTAL K. KINZEL. CLERK
, Deputy Clerk
Approved as to form and legality:
Courtney L. DaSilva
Assistant County Attome)
BOARD OF COI.INTY COMMISSIONERS
COLLIER COUNTY, FLOzuDA
By:
BurtSaunders- Chairman
tD
Page 4245 of 4682
Filter Criteria
Date of Service From:10/01/2017
Date of Service To:09/30/2021
Source to primary:False
Using Fiscal Year:No
Transp Gross Chrg Contractual Adj Net Chrg Bad Debt Adj Paid Due Transp
Mix
Coll%
Gross
Coll%
Net
Gross Chrg
Transp
Net Chrg
Transp
Paid
Transp
YEAR 2017 7510 6,250,937.10 1,931,854.28 4,319,082.82 1,237,600.13 3,083,302.92 -1,820.23 6%49%71%832.35 575.11 410.56
YEAR 2018 30186 26,091,558.12 8,278,245.89 17,813,312.23 5,286,102.47 12,547,946.39 -20,736.63 24%48%70%864.36 590.12 415.69
YEAR 2019 30791 26,776,589.72 8,339,164.02 18,437,425.70 5,429,702.93 13,014,110.46 -6,387.69 25%49%71%869.62 598.79 422.66
YEAR 2020 30069 25,586,365.42 7,893,966.34 17,692,399.08 5,011,448.59 12,734,438.37 -53,487.88 24%50%72%850.92 588.39 423.51
YEAR 2021 24811 21,036,184.27 6,491,185.01 14,544,999.26 3,979,060.79 10,388,047.09 177,891.38 20%49%71%847.86 586.23 418.69
Grand Total 123367 105,741,634.63 32,934,415.54 72,807,219.09 20,943,914.91 51,767,845.23 95,458.95 100%49%71%857.13 590.17 419.62
®
Printed by CLONG on Tuesday, July 15, 2025 11:24:52 AM
Menu:Reports -> Management Reports -> Analytical Scorecard Page 1 of 1
Analytical Scorecard - Yearly Comparison Summary
Collier County
Dates of Service: From: 10/01/2017 To: 09/30/2021
***Additional filter criteria listed on last page of report***
Page 4246 of 4682
CC EMS Bad Debt Write-Off Summary
FY 2021
FY 21 Vendor SAP Charges Adjustments Net Billed Payments Collection %Write-Off Write-Off %# of Accts
Digitech & Collection Summary 27,566,262.74 (8,379,765.65) 19,186,497.09 13,962,757.07 73%5,223,740.02 27%7901
Digitech Accounts 283,025.83 1%
RTR Financial Accounts 4,940,714.19 26%
Totals 27,566,262.74 (8,379,765.65) 19,186,497.09 13,962,757.07 73%5,223,740.02 27%7901
5,223,740.02
7/22/2025
Page 4247 of 4682
CC EMS Bad Debt Write Off
FY 21
Year Month Claim Count Sales Original Sales Payer Reclass Sales Adj Bad Debt Contractual Adj Cash Receipts AR Net Sales
2020 10 2448 $2,085,485.54 $844,556.53 $838,095.33 $415,935.25 $655,242.66 $1,004,161.30 $16,607.53 $1,436,704.08
2020 11 2509 $2,154,052.00 $896,699.20 $893,523.16 $359,048.95 $681,592.24 $1,113,837.70 $2,749.15 $1,475,635.80
2020 12 2797 $2,370,989.53 $1,015,670.38 $1,009,538.78 $403,849.08 $721,653.13 $1,239,531.10 $12,087.82 $1,655,468.00
2021 1 2855 $2,412,615.92 $1,102,297.46 $1,088,130.96 $438,182.16 $762,399.83 $1,216,937.52 $9,262.91 $1,664,382.59
2021 2 2703 $2,278,386.38 $1,079,814.67 $1,066,915.38 $395,714.95 $710,439.23 $1,188,378.29 ($3,246.80)$1,580,846.44
2021 3 3108 $2,702,470.58 $1,349,438.02 $1,339,104.52 $514,175.91 $827,317.90 $1,355,179.54 $16,130.73 $1,885,486.18
2021 4 2960 $2,483,743.48 $1,091,073.45 $1,083,455.35 $473,846.85 $763,997.58 $1,226,461.05 $27,056.10 $1,727,364.00
2021 5 2691 $2,310,174.92 $1,065,901.88 $1,052,086.49 $463,222.82 $706,178.03 $1,137,511.64 $17,077.82 $1,617,812.28
2021 6 2486 $2,109,817.30 $1,014,144.56 $1,006,699.99 $415,365.68 $663,791.67 $1,019,835.73 $18,268.79 $1,453,470.20
2021 7 2574 $2,131,184.87 $989,365.60 $992,876.02 $422,284.40 $641,232.18 $1,033,791.56 $30,366.31 $1,486,442.27
2021 8 2864 $2,369,045.72 $1,061,440.60 $1,055,389.81 $457,613.36 $730,218.00 $1,147,459.41 $39,805.74 $1,644,878.51
2021 9 2580 $2,160,727.25 $955,901.00 $946,691.10 $398,654.66 $685,610.59 $1,062,492.35 $23,179.55 $1,484,326.56
32575
$27,568,693.49 $12,466,303.35 $12,372,506.89 $5,157,894.07 $8,549,673.04 $13,745,577.19 $209,345.65 $5,440,919.90
SAP $27,566,262.74 $93,796.46 $8,453,445.83
$2,430.75 73,680.18 FY 21 Credit Balances
$283,025.83 Total Active AR Bal
$5,440,919.90 Total Bad Debt (RTR and Active AR)
(217,383.96) RTR Payments
204.08 RTR Adj/interest
(217,179.88) RTR Totals
$4,940,714.19 RTR Balance
$5,223,740.02 FY 21 Write-Off
7/22/2025
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