Resolution 2021-175 RESOLUTION NO.2021 - 1 7 5
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, PROVIDING FOR UPDATED EMS USER
FEES FOR COLLIER COUNTY AMBULANCE SERVICES, UPDATED
BILLING AND COLLECTION PROCEDURE, 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 AN UPDATED PROCEDURE FOR
APPROVING HARDSHIP CASES AND PAYMENT PLANS; SUPERSEDING
RESOLUTION NO. 08-27; 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 through ad valorem taxes
and user fees; and
WHEREAS, the Board of County Commissioners has an Agreement with Digitech
Computer, 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,
Digitech Computer, Inc., or any other billing consultant is responsible for the collection of fees for
ambulance services; and
WHEREAS, Collier County Ordinance No. 96-36 §5 provides that 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 BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA,that:
SECTION ONE: EMS USER FEES
BASE RATES:
SERVICE LEVELS CODES BASE CHARGES
A. EMS—BLS NON-EMERGENCY A0428 $ 800.00
B. EMS—BLS EMERGENCY A0429 $ 800.00
C. EMS—ALS 1 NON-EMERGENCY A0426 $ 800.00
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D. EMS—ALS 1 EMERGENCY A0427 $ 800.00
E. EMS—ALS 2 EMERGENCY A0433 $ 850.00
F. EMS—TREATMENT W/O TRANSPORT A0098 $ 175.00*
G. EMS—HELICOPTER A0431 $ 7,500.00
MILEAGE RATES:
SERVICE LEVELS CODES MILEAGE CHARGE
A. EMS—GROUND UNIT A0425 $ 15.00
(Minimum Charge of 1 mile and no cap)
B. EMS—AIR UNIT A0436 $ 185.00
* There shall be no Treatment W/O Transport (F) charges for third party calls, public assistance
calls,or traffic accidents where only assessments are performed,and no treatment is required.
SPECIAL EVENTS AND MISCELLANEOUS RATES:
SERVICE LEVELS RATES
A TWO (2) MEDICS/ONE ALS VEHICLE(PER HOUR) $ 150.00
B. ONE (1)MEDIC/NO VEHICLE(PER HOUR) $ 50.00
COPIES: Copying fees will be consistent with Resolution No. 07-327, as amended from time to
time.
PAST DUE ACCOUNTS IN COLLECTIONS
INTEREST ON PAST DUE ACCOUNTS 1%monthly
SECTION TWO: BILLING 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 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 Division. Billing Consultant shall follow all
applicable rules and regulations set forth by Centers for Medicare/Medicaid (CMS) that
pertain to ambulance billing.
B. EMS Billing Staff will transmit all data necessary to Billing Consultant to process the claim.
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1. Billing Consultant will send an initial bill to the service recipient's or responsible
parry'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.
i. An initial statement for ambulance services, including the HIPAA notice of
privacy practices shall be sent seven (7) or more days after the data is entered
by the Billing Consultant, but no later than (30) thirty days after service has
been provided.
ii. In the event the service recipient or responsible party does not have or does not
provide proof of insurance coverage after three billing cycles (30-day cycles)
for a total of (90) ninety days, their account will be sent to the County's
Collection Agency vendor.
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 to collections at any time. Billing Consultant may send a patient to
collections prior to exhaustion of all collection efforts when:
1. The patient account has an invalid address.
2. Billing Consultant is directed by County to send a patient to collections.
D. Interest will be assessed at 1% per month on all accounts that are sent to the County's
contracted collection agency. If a time payment plan is established with collection agency,
no bureau reporting will occur unless the account goes into default after (60) sixty days of
non-payment.
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 to be administered.
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 Billing Consultant shall
make reasonable effort to ascertain the correct mailing address. If reasonable efforts to
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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.
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:
1. The decedent's Personal Representative or Attorney representing their estate will
notify EMS Billing Staff that a probate estate has been filed with the Probate
Court.
2. Collier County Clerk of Courts Probate Department sends Collier County EMS a
monthly Probate summary report.
3. Collier County EMS's contracted billing vendor reviews the summary report for
any accounts with unpaid balances and notifies EMS of accounts with balances
due.
4. EMS Billing Staff shall ensure that a Notice of a Claim is timely filed with the
Probate Court.
5. EMS Billing Staff shall ensure that the Office of the County Attorney is timely
notified of such claim and provided with: (1) 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.
6. 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.
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7. If the estate has assets and $10,000 or less is owed for ambulance services, the
EMS Chief and the County Attorney are authorized to take reasonable actions to
reach a settlement with the Personal Representative or his attorney. Should a
settlement be reached, the EMS Chief and the County Attorney 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 this
Resolution or in Ordinance No. 96-36, as it may be amended, replaced, or
superseded.
K. All accounts with a balance of less than$10 will be written off.
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 hospital 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 and at its 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.
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A. Medicare and Medicaid Adjustments. 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 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. Champus/Tricare Adjustments. Contractual adjustments will be made in accordance
with applicable Champus/Tricare rules and regulations.
E. Railroad Retirement Adjustments. Contractual adjustments will be made in accordance
with applicable state, federal and local rules and regulations pertaining to Railroad
Retirement Adjustments.
F. Bankruptcy: After receipt of a signed Discharge of Debtor notice, any account balances
prior to the discharge date will be adjusted off.
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 Service Director and the EMS Director.
SECTION FIVE: WAIVER OF EMS USER FEE FOR SPECIAL EVENTS.
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.
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 for hardship cases will be set up on a monthly basis, with a
minimum payment of$25.00. 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.
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SECTION SEVEN: SUPERCISION OF RESOLUTION NO.08-27.
This Resolution shall supersede Resolution No. 08-27.
SECTION EIGHT: EFFECTIVE DATE
This Resolution shall become effective on October 1, 2021.
PASSED AND DULY ADOPTED by the Board of County Commissioners of Collier
County, Florida,this 1441.1 day of September, 2021.
ATTEST: BOARD OF OUNTY COMMISSIONERS
CRYSTAL K.KINZEI1,-CLERK COLLIER O , FLORIDA
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Deputy •l k Penny Ta or, Chair
Attest as to Chairman s
sigluitwre •
Approved : .1 land 1• • ' .
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Jeffrey A. l:tzk I , unty Attorney
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