(A) Uncollectible accounts policies and procedures.
(1) The Ambulance Service shall develop policies and procedures which will appropriately and uniformly identify uncollectible accounts among the citizens of Pikeville.
(2) It shall be the policy of the Ambulance Service to provide, without charge, ambulance transportation to those that have an essential need for emergency or non-emergency transportation but are unable to pay for such transportation. The awarding of without charge services will be based on a set of consistent criteria and will be available to all recipients of service.
(3) WITHOUT CHARGE SERVICE shall be defined as ambulance transportation, either emergency or non-emergency, which has been determined as medically necessary by the patient’s physician, that is given without the expectation of payment, as a result of an in-depth financial investigation.
(4) The Ambulance Service will budget without charge services of an amount not to exceed three percent (3%) of gross patient service revenues or whenever possible to do so without jeopardizing its own financial stability.
(5) The procedure for application for without charge services shall be drafted and approved by the administrative staff, city officials. A copy of such shall be attached to or included with Ord. 0-04-02, passed - -04.
(6) The Director shall not approve any account adjustment which has not met the criteria of established procedures.
(7) The Director or his or her designee may approve applications for without charge service after review and recommendation of billing staff, subject to the following limitations:
(a) Accounts falling within Federal Poverty Guidelines or extenuating circumstances could be discounted fifty percent (50%) to one hundred percent (100%) at the discretion of the designated authority.
(b) Accounts in which total adjustment would be one thousand dollars ($1,000.00) or less.
(8) Accounts requiring authorization of the City Manager and authorization of the Director:
(a) Accounts which are considered exception to routine policy and procedure.
(b) Accounts in which the total adjustment would be one thousand dollars and one cent ($1,000.01) or greater.
(9) Billing staff may make no ledger adjustment for without charge cases without appropriate documentation of application, conforming to the above guidelines.
(B) Write-offs.
(1) All write-offs are at the discretion of the City of Pikeville Ambulance Service with the exception of the following:
(a) Medicaid. All providers who participate with Medicaid are required to write-off the difference of the allowed amount and cannot bill the patient.
(b) Medicare. All providers who participate with Medicare are required to write-off the difference of the allowed amount and cannot bill the patient. Medicare guidelines require all providers “reasonably attempt” to collect from the patient their twenty percent (20%) copay. After three (3) statements are sent to the patient, this is a “reasonable attempt.” If the patient has not paid by three (3) months after they have been billed, they are not likely to pay. (Need to be looked at to decide action.)
(c) Private insurance. Once the insurance has paid their portion, the patient is immediately sent an itemized bill for the balance due. After the third statement is sent, a phone call is made to set the patient’s account on a payment plan. If this effort is not successful, the account needs to be looked at to determine if it should be turned over to a collection agency or place a block on the patient’s credit.
(d) Self-pay patients. The first bill sent is an itemized bill. The next two (2) are statements. A phone call is then made to try to set the patient’s account on a payment plan. If this effort is not successful, the account needs to be looked at to determine if it should be turned over to a collection agency, or place a block on the patient’s credit.
(e) Homeless shelter patients. If the patient has insurance coverage, accept what the insurance pays and write-off the balance as “uncollectible.” If the patient does not have insurance, send one (1) itemized bill. If no response, write-off the balance as “uncollectible.”
(f) Accounts that are over eighteen (18) months due with balances less than fifty dollars ($50.00) can be looked at by the Director for write-off or turned over to collection process at his or her discretion.
(g) Invalid addresses. If a correct address cannot be obtained or resolution for this type of account cannot be accomplished within one hundred twenty (120) days, it is to be placed on patient’s credit report.
(Ord. 0-04-020, passed - -04)