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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.