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Backup Documents 09/14/2021 Item #16E13 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 E 13 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines#I through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office. Route to Addressee(s) (List in routing order) Office Initials Date 1. County Attorney Office County Attorney Office 2. BCC Office Board of County Commissioners J !•i 3. Minutes and Records Clerk of Court's Office Y /V p PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or missing information. Name of Primary Staff Erin Cook,Accounting Supervisor Contact Information 239-252-3756 Contact/Department Emergency Medical Services Agenda Date Item was September 14,2021 Agenda Item Number 16.E.13 Approved by the BCC Type of Document Resolution Number of Original 1 Attached Documents Attached o0a1 — (15 PO number or account number if document is to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature STAMP OK EC 2. Does the document need to be sent to another agency for additional signatures? If yes, EC provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be EC signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's EC Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the EC document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's EC signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip EC should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 09/14/2021 and all changes made during EC N/A is not the meeting have been incorporated in the attached document. The County an option for Attorney's Office has reviewed the changes,if applicable. this line. 9. Initials of attorney verifying that the attached document is the version approved by the N/A is not BCC,all changes directed by the BCC have been made,and the document is ready for the " an option for Chairman's signature. this line. 1 bE13 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 Co) [21-EMS-01060/1659114/1] 1. 1 6E13 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. CIO) [21-EMS-01060/1659114/1] 2 1 bEI3 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 121-EMS-01060/1659114/1j 3 1 6 [ 13 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. 'a()) [21-EMS-01060/1659114/1] 4 1 6 E13 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. [21-EMS-01 060/1 6591 14/I] 5 --- 1 6E13 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. CNO) [21-EMS-01060/1659114/1] 6 1 6 E13 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 J I{44'1 day of September,2021. ATTEST: BOARD OF OUNTY COMMISSIONERS CRYSTAL K.KINZds„,CLERK COLLIER O , FLORIDA By: Deputy k Penny Ta or, Chair Attest as to Chirrup s siraturs Approved and 1 l Jeffrey A. tzk , unty Attorney CO [21-EMS-01060/1659114/1] 7