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Emergency Medical Services EMS (BF-10)C ITY O F D ELRA Y B EA C H A D M IN ISTR A TIV E PO LIC IE S AN D PRO C EDU RES DEPARTMENT: SUBJECT: Finance Emergency Medical Services (EMS) POLICY NUMBER: SUPERSEDES: BF-10 N/A REVISION: APPROVED BY: PURPOSE Terrence R.Moore,ICMA-CM EFFECTIVE DATE: The administrative policies and procedures manual are set forth to establish uniform guidelines and principles for the internal controls,collection and write-off of all bad debts relating to Emergency Medical Services (EMS).Policies contained herein comply with all applicable state laws,rules,and regulations. POLICY This procedure provides a general description of the structure of the Finance department's EMS function. The Finance department or designee is responsible for supervising and facilitating EMS collection and bad debt.When an EMS receivable is known to be delinquent,the Finance Director or designee will make a diligent effort to collect the account in compliance with these procedures.After reasonable effort to collect on the account has been made,the Finance Department or designee will transfer the account to the collection agency that has contracted collection services with the City.If such efforts fail to achieve collection,then the Finance Department may ref er to the City Attorney for legal consultation to find the best solution in achieving the financial interest of the city. PROCEDURE BF -Definitions: Emergency Medical Services (EMS):is a service providing out-of-hospital acute care and transport to definitive care,to patients with illnesses and injuries which the patient believes constitute a medical emergency. Accounts Receivable:A record reflecting amounts due from citizens or other responsible parties for Emergency Medical Services. Treasurer's Office:The office within the Finance department designated by the City responsible for the EMS receivable systems and the receipting of monies due. Debt:An obligation to pay. Finance and Accounting Policies:Procedures established to ensure proper controls,consistency,and accountability of funds collected for the city. 05.30.23 Parking M eter Revenue Collection BF-25 Page 2 of 5 Fiscal Year:The 12-month period from October 1 through September 30. Internal Controls:A system of checks and balances established to provide reasonable assurance that specific objectives are achieved. Write-Off:An accounting adjustment reflecting the portion of an EMS billing account receivable determined not collectible. Designee:A duly authorized representative of the Finance department. Roles and Responsibilities: The Finance Department or designee is responsible for establishing,maintaining,and monitoring an internal control system over the EMS billing functions.This will include adequate segregation of duties, cash handling procedures,restrictive endorsements,receivable aging report analysis,application of penalties,proper documentation for receivable adjustment,and all other functions required to meet state law and government accounting standards. Requirements for Detailed Records: The Finance department or designee must maintain a record detailing the amount due consumers and other responsible parties.It is important that procedures are implemented that maintain accounts efficiently and accurately because of the number of accounts involved.To effectively keep records,the following data are necessary: a.Responsible Party's Name b.Billing Address c.Social Security Number d.Date of Birth e.City account number or similar property identifier f.Date of Transaction g.Insurance Information h.Explanation of Transaction 1 .Amount Due 2.Amount Assessed 3.Adjustment Amounts 4.Insurance Information 5.Insurance Payments 6.Medicare or Medicaid Information 7.Medicare or Medicaid Payments 8.Paid Amounts 9.Write-Off Amounts 10.Balance Due All billing adjustments (,overpayments,billing errors,posting errors etc.)will be authorized by the Finance Director or designee as a normal course of business. Parking Meter Revenue Collection BF-25 Page 3 of 5 Legal Considerations: a.Delinquent Accounts:An account receivable becomes delinquent when payment is not received in accordance with conditions giving rise to the receivable.Thus,if payment is not made in an amount at least equal to that required or within the time specified for the account,such account is delinquent.The Finance department,however,declares an account "past due"if not paid within 30 days of the due date.If not paid within 90 days following its due date,the account is considered "delinquent".In all cases,the exercise of due diligence in collecting an account requires prompt notification of the account's overdue status to the holder of the debt and request for payment. b.Statute of Limitations:Because of changes in applicable statutes and the complexity of applying the statutes to specific cases,the finance department or designee will not attempt to settle or forgive any account receivable without specific authorization from the Finance Director as may be specifically authorized by a law or rule relating to the debt giving rise to the receivable. c.Write-Off Authority:Except as otherwise provided by the City charter,the authority to adjust, forgive,and/or settle accounts or debts owed to the city rests with Finance Director.Accounts receivable under ten (10)dollars or overpayments on closed accounts of less than ten (10)dollars will be summarily dismissed,administratively by the Finance Director and/or designee. Corrections that reduce a fee by reason of error in the assessment or recording must not be regarded as a compromise,write-off,or default.However,any such adjustments to the accounts must be supported by documents fully explaining the reason for the adjustment. Procedure: Responsibility for collecting accounts receivable rests with the Finance department or designee,supported by the pertinent department.The 'Treasurer's office will pursue returned checks. Before declaring an account uncollectible,diligent effort must be made to collect the amount outstanding. The collection effort may be shared by the Finance department,designee,and/or the City Attorney,but must include at least the following: a.If payment is not received within 30 days after its due date,the Finance department or designee will notify the responsible party in writing of the amount that is past due.The account shall have the appropriate penalties applied. b.The Finance department or designee may negotiate an extended payment agreement for the past due payment with the responsible party for a period not to exceed one year.If this is done,it is the Finance department's or designee's responsibility to keep track of payments and a running balance of the amount due.The Finance Director shall approve extended payment agreements that exceed one year. c.If payment is not received,and an extended payment agreement is not reached within 60 days from the due date on receivables,the Finance department or designee will notify the responsible party in writing that the account is overdue.The letter will include the statement that if payment is not received or an extended payment agreement reached within two weeks of notification,the account Parking Meter Revenue Collection BF-25 Page 4 of 5 may be turned over to a collection agency.Further collections efforts may be completed by the Finance department or designee. d.If an adequate resolution of the past due account is not reached within 90 days of the due date,the Finance department or designee may ref er the account to a collection agency,the city attorney,or retain the account for further collection efforts.Before ref erring the account,the Finance department or designee will assemble available documents to assist the collection agency or city attorney in determining an appropriate action.Such documents should include relevant documentation of the debt and efforts made to collect or contact the debtor.Accounts of $2,500 and less will either be referred directly to the collection agency or retained for further collection efforts as it is not deemed to be cost effective to send to the city attorney. e.Annually for the September 30 year end reporting period,the Finance department shall prepare a report of all pending collection items that have not been written-off including accounts referred to the collection agency;those accounts that have been retained and those referred to the city attorney for enforcement and currently due and owing the City.Detailed records will be maintained of all accounts in the formal collection process. f.Collection Agency: a.All debt that has been transferred to the collection agency (for processing is transferred at 90 days aged and held for processing and collections for a further 180 days. b.After 180 days,debt shall be written off as uncollectible bad debt on a quarterly basis.Writing off these accounts allows a more accurate statement of the City's EMS accounts receivable. c.Any payments received shall be reversed in EMS billing software and posted. I.Review Status Accounts d.All accounts under review and 270 days aged that have been worked by the finance department,designee,nd/or the collection agency shall be forwarded to management for final review and written-off when: •Verification of insurance and/or patient responsibility has been met (fact sheets, contact patient,passport). •Verification of denial due to timely filing,comments and documentation attached. •Any payments received will be reversed in theEMS billing software and posted. Request for Write-Off Authority: After all the above procedures have been completed,and the account is determined to be uncollectible,a list of the EMS receivables will be prepared,except as otherwise provided by statute.The Finance Director or designee will be asked to authorize the write-off of the EMS accounts receivable.Accounts receivable due less than ten (10)dollars or over payments on closed accounts of less than ten (10)dollars will be summarily dismissed/discharged by the Finance Director and/or designee. Recording the Write-Off or Collection of Written-Off Accounts: Parking Meter Revenue Collection BF-25 Page 5 of 5 Upon the Finance Director's authorization,the write-off in the accounting system will be documented by educing EMS accounts receivable.Write-offs are not debt forgiveness,but a standard accepted accounting practice.The city is not waiving its right to collect the fees and continues to task its collection agency with recouping unpaid balances. If the account is collected through the Finance department's collection agency,the Treasurer's office will deposit the check into the appropriate fund.The payment will be recorded as a credit to EMS Revenue and a debit to cash.The collection fee withheld by the collection agency is recorded as a debit to a non- operating expenditure and a credit to cash.