RES 1149RESOLUTION NO.U 4^
A RESOLUTION OF THE CITY OF CAMAS,
WASHINGTON adopting an Ambulance Billing and Collection
Policy.
WHEREAS,the City Finance Department has prepared a document entitled "Ambulance
Billing and Collection Policy",which sets forth procedures for billing and collection on
ambulance calls,and
WHEREAS,the City Council has reviewed said document and has determined that the
City's interest will be furthered by adoption of such policy,
NOW,THEREFORE,be it resolved by the Council of the City of Camas as follows:
Section I
There is hereby adopted the document entitled "Ambulance Billing and Collection
Policy",a copy of which is attached hereto and by this reference incorporated herein.
ADOPTED by the Council at a regular meeting this^if day of April,2009.
1 ~~g.\SIGNED:
Mayor
Clerk
X—ATTEST:/
/
APPROVED as
V
CityVAttomey
Ambulance Billing and Collection Policy
Purpose
The purpose of this policy is to outline the procedures to be used in billing for
ambulance services ,receipting of payments ,collections process and write-offs of
uncollectible accounts .
Policy
It is the policy of the City to pursue payment for ambulance services provided.
Charges for services are established with a fee schedule approved by the City
Council.Invoices for service will be processed timely and billing will be in
compliance with State and Federal laws ,Medicare,Medicaid and HIPAA
guidelines .All accounts receivable accounts will be monitored for payment and
delinquent notices will be sent and accounts written off will be documented.The
patient is ultimately responsible for the balance due.
Internal Controls
The Finance Department will use separation of duties as one method of internal
controls over the billing,receipting and reporting processes to insure accurate
accounting of financial information for ambulance services.Ambulance calls and
billing will be managed using software that will be in compliance with Medicare
and their electronic claims submission.The monthly total of all transactions of
billing,receipting and write-offs of accounts will be recorded in the city’s
accounting general ledgers.
Billing
Each billing day an Incident Report is run from the Fire Department database of
all calls from the previous day or since the last billing day .All ambulance calls
are selected and are imported into the ambulance billing software and invoices
are processed using appropriate insurance codes .Billing of ambulance calls will
be mailed within seven days of service and electronic bills sent to Medicare will
be done at least weekly.
The Accounting Manager will approve refunds and forward these accounts to
accounts payable to process the refund checks .The Accounting Manager shall
monitor the billing and receipting process on a regular basis and insure that all
procedures are adhered to .
Collections
All outstanding bills will be managed in an aged receivables system.Accounts
receivable balances will be reviewed for payment status on a monthly basis.The
patient will receive statements notifying them of their account status monthly .
The billing notification timelines are:
Private Pay Accounts -
Original Bill
Past Due Notice
2nd Notice
Final Notice
Pre-Collect
45 days to pay without a late fee
on 46fh day with late fee assessed
on 76th day with late fee assessed
on 106th day with late fee assessed
on 136th day and 15 days to pay or the account
will be sent to a collection agency
on 151st dayToCollections
Insurance Covered Accounts -
Original Bill
Informational Notice
Past Due Notice
Final Notice
Pre-Collect
sent to insurance company
on 46th day to patient
on 76th day to patient now responsible
on 121st day with late fee assessed
on 151st day and 15 days to pay or the account
will be sent to a collection agency
on 166th dayToCollections
Payments are due within forty-five (45)calendar days of billing date.A late fee of
twenty-five ($25)dollars is due on all accounts where the client has not furnished
proof of insurance,not contacted the Billing Office to discuss payment options or
when the client has no insurance and is more than forty-five (45)calendar days
late and has a balance due greater than one-hundred fifty ($150)dollars .
Accounts will be immediately forwarded to collections when the mail is returned
from the post office as undeliverable and due diligence has been done to locate
the patient.Private pay accounts over one hundred fifty (150)days and
insurance accounts over one hundred sixty five (165)days delinquent are
deemed uncollectible and forwarded to the city’s collection agent.
No late fee will be assessed on accounts that the insurance payment is pending
and the patient has not been billed for their share.
Remaining account balances of Medicare and Medicaid patients that have no
supplemental insurance will be documented and written off with the Accounting
Manager’s approval.
Forgiveness Program
The City Council may forgive debts or consider them uncollectible for indigents or
for those who meet the Federal HFIS Poverty Guidelines .
Committee will review these requests on a quarterly basis and forward
recommendations to city council for approval.
The Finance
The current Federal Health &Human Services Poverty Guidelines are used as
the financial standard for the Forgiveness Program.The Poverty Guidelines will
be reviewed annually and updated .The City will adhere to the federal HIPPA
privacy concerns and protect the rights of its patients .
Patients that wish to apply for this program will be required to complete the
Request for Debt Forgiveness form and provide required information and
explanation of their proof of need .
If the Finance Committee denies the patient of the Debt Forgiveness program ,an
appeal to city council can be made.
Extended Payment Plan
The City is aware that some clients may not have any insurance or the ability to
pay their entire bill in one payment but are willing to pay their obligation over a
reasonable period of time .For these situations an extended payment plan is
available.
Extended payment plans will be approved by the Finance Department .The
program will be for a maximum of ten (10)months .Monthly payments will be
divided into ten (10)equal payments based on the total billed owed .No finance
charges or interest will be collected for this program.Bills are considered
delinquent if monthly payments are not received within thirty (30)calendar days
from the payment plan date.Delinquent clients in this program are subject to the
collection processing.If a patient is unable to adhere to the ten month
repayment schedule,alternative arrangements may be made with approval from
the Finance Department.