1523.02 CREDIT AND COLLECTION POLICY.
(a) Billing Procedures. The Fire Chief (or his designee) shall be responsible for the development of billing procedures and collection of user fees as set forth herein.
(b) Billing Company. Mayfield Village shall enter into an agreement with an established health care billing company (the "Billing Company") to coordinate with the Fire Chief in implementing proper procedures for the collection of the user fees.
(c) Payment for Services.
(1) Self-Pay patients are expected to pay their account in full after the first 30 days following the EMS run. The responsibility for the payment of charges rests with the patient or responsible party. Payment arrangements can be made. All decisions relative to credit and collections must always be tempered by good judgment and reason as the situation may require.
(2) Payment arrangements are to be made as agreed upon by the Billing Company. An attempt to receive the highest monthly payment will be made. A minimal payment of $20.00 will be accepted.
(3) In case of death of client, the Billing Company will contact the Legal Representative of the Estate and pursue filing a claim for payment.
(d) Commercial Insurance.
(1) Mayfield Village will rely on the Billing Company to obtain insurance information for all transfers through electronic interface with the hospital.
(2) As a service to our patients, we will bill commercial companies directly. If the information is not received, the Billing Company will complete the process by contacting the necessary responsible parties. Once the information is obtained, the claim will be filed either electronically or United States Parcel Mail.
(e) Motor Vehicle Accidents. If an Ambulance Claim is caused by a motor vehicle accident and the auto insurance is disputing the claim and or the claim is in legal dispute, the Billing Company will obtain a letter of protection from the attorney. This will ensure that monies will be sent to Mayfield Village directly once the case is settled. If there is no attorney involved, the responsible party is required to make monthly payments on the account.
(f) Medicare and Medicaid.
(1) The Billing Company shall waive all co-payments, deductibles, or balance remaining following payment received from Medicare or Medicaid, otherwise owed to Mayfield Village for persons with Medicare, Medicaid, or Medicare HMO coverage as a source of health insurance.
(2) The Billing Company will bill Medicare and/or Medicaid directly for the ambulance services incurred. Medicare and Medicaid recipients will not receive a bill and payment will be obtained directly from Medicare/Medicaid. Mayfield Village will accept assignment deemed by this payer.
(g) Claim Follow Up Procedures.
30 days Initial submission of claims
45-60 days 1st contact to insurance regarding status of claim
90 days 2nd contact to insurance regarding status of claim.
After 90 days regular contact to resolve problem will be made and/or patient will become responsible.
(h) Delinquent Accounts.
(1) An account will be considered delinquent if there is an outstanding charge after 120 days if insurance was involved, or 60 days for self-pay patients if payment arrangements have not been made. The Billing Company will attempt to make final phone contact with the responsible party 10 days before turning it over to Mayfield Village for an individualized review and determination of write off as non-collectible or referral to a collection agency.
(2) When payment cannot be made in full, responsible party will be encouraged to pay under arrangement.
(i) The Use of Collection Agency.
(1) When an account cannot be collected, the Billing Company will forward an itemized statement and Account Authorization to Mayfield Village. Mayfield Village will review the accounts recommended to collection to assure compliance with policy as established by Mayfield Village Council prior to forwarding the account to a Collection Agency.
(2) The Following circumstances determine whether an account should or should not be sent to a collection Agency.
A. Cases that meet the criteria for financial hardship, or as determined forgivable by the Mayfield Village Director of Finance.
B. Return mail, disconnected phone, skipped town.
C. Payment Agreement repeatedly not kept after 120 days
(j) Account Adjustments.
(1) Accounts will not need to be authorized by Mayfield Village under the following circumstances.
A. Small balance adjustments less than $4.00.
B. Bankruptcy.
C. Contract Service Adjustments. Amounts considered above the allowed amounts for that contractual insurance. (UCR's) The Billing Company will bill patient for balances due after payment received by an insurance company.
(2) A listing of all written off accounts will be maintained by the Billing Company and will be sent monthly to the Mayfield Village Finance Department.
If a payment is received for a written off account, the monies received will be recharged to the accounts and balanced.
A. Cases that meet the criteria for financial hardship. Individual must submit proof that income levels fall below current HUD requirements for low income.
(k) Services Rendered to Prisoners. All persons receiving Mayfield Village Fire Department EMS services while confined as a prisoner in the Village of Gates Mills Jail shall be responsible for payment of appropriate charges, as referenced in Section 1523.01, in accordance with policy guidelines (a) through (i) hereinabove. Unpaid charges will be billed to the arresting Municipality. All persons receiving Mayfield Village Fire Department EMS services while in physical custody of the Mayfield Village Police Department shall be responsible for payment of appropriate charges, as referenced in section 1523.01, in accordance with policy guidelines 1 through 9 hereinabove.
(l) Mutual Aid Transports. When emergency medical services are provided by Mayfield Village personnel to persons outside Mayfield Village limits pursuant to a mutual aid agreement or understanding with another municipality, Mayfield Village shall bill such person in accordance with the practices of Mayfield Village. When emergency medical services are provided within Mayfield Village limits by personnel of another municipality pursuant to a mutual aid agreement of understanding, such person shall be billed in accordance with the billing practices of the other municipality.
(m) Credit to General Fund. Upon collection of the user fees established herein, the funds shall be credited to the General Fund as an offset to the cost of providing emergency services and transport.
(n) The Village has determined that the actual cost per run to be charged pursuant to Codified Ordinance Chapter 1523 shall be $1200.00.
(Ord. 2011-07. Passed 5-16-11.)