AMBULANCE TRANSPORT BILLING AND COLLECTIONS POLICY - El Paso, Texas

AMBULANCE TRANSPORT BILLING AND COLLECTIONS POLICY El Paso Fire Department K. Nicole Cote, Fiscal Operations Manager Monday, September 21, 2015

OVERVIEW Revenue Drivers & Performance Collections Transports Payer Mix Charges and Fees Policy Highlights 2 2

COLLECTIONS BY DEPOSIT DATE 3 3

TRANSPORTS BY DATE OF SERVICE 4 4

PAYMENT VS. PAYER PERCENT BASED ON DATE OF SERVICE FY2013 60% 52% 50% 40% 37% 32% 32% Payer % 30% Payment% 17% 20% 14% 15% 10% 2% 0% Medicare Medicaid Commercial Insurance 5 Self-Pay 5

PERCENTAGE OF ACCOUNTS WITH PAYMENT BY DATE OF SERVICE FY2013 90% 90% 80% 77% 80% 70% 62% 60% 50% 40% 30% 20% 4% 10% 0% Medicare Medicaid Commercial 6 Self Pay Total 6

CHARGES AND FEES AVERAGE CHARGES vs PAYMENTS 900.00 868.78 880.60 871.86 865.25 869.94 800.00 700.00 600.00 447.65 500.00 400.00 337.05 300.00 254.94 221.72 200.00 100.00 22.00 - Medicare Medicaid Commercial Avg. Charges 7 Self-Pay Total Avg. Payments 7

SUMMARY Current contract is with Intermedix (Advanced Data Processing, Inc.) Collections increased by 5% over last year due to continued collection efforts. Transports increased by 3% while total incidents stayed relatively flat at -0.03%. Payer Mix – Medicare – 37% Medicaid – 17% Commercial Insurance – 15% Self Pay – 32% Base rate is 785.00 and 15.00 per mile. Average Charge is 869.94 and Average payment 254.94. 8 8

BILLING AND COLLECTION POLICY To ensure the collection of Ambulance Transport accounts receivable in a timely, fair and cost effective manner for the City of El Paso The maximum recoverable age for ambulance transports is 3 years. Clarifies the roles of the Fire Department, RCM Agency and the 3rd Party Collections Agency. Aligns with the City of El Paso Accounts Receivable Manual (2014) 9 9

BILLING AND COLLECTION POLICY First 30 days – Patient has 30 days from receiving the invoice to pay an initial invoice. Indigent/Charity Reduction1.4.3 The Patient must provide the formal hospital approval letter to RCM Agency for verification of the reduction percentage. 10 10

BILLING AND COLLECTION POLICY 31 Days Past Due to 180 Past Due Statements will be sent to the Patient Phone calls will be made in attempt to collect Payment options will be accepted City Employees and the RCM Agency must adhere to the Fair Debt Collections Practices Act – If payment is not received by 180 days the account may be assigned by the City of El Paso to a 3rd Party Collections Agency. – – – – 11 11

BILLING AND COLLECTION POLICY 180 Days Past Due to 24 Months Past Due – The account may be turned over to a 3rd Party Collections Agency for delinquent account collections. – The account must be identified as self-pay and no more that 2 years from the date of service then it will be referred to the 3rd Party. – 3rd Party Collection will make a series of 5 contact attempts through a combination of mail and telephone contacts. – Payments will be submitted to the 3rd Party Collection Agency 12 12

BILLING AND COLLECTION POLICY 180 Days Past Due to 24 Months Past Due – The account may be turned over to a 3rd Party Collections Agency for delinquent account collections. – The account must be identified as self-pay and no more that 2 years from the date of service then it will be referred to the 3rd Party. – 3rd Party Collection will make a series of 5 contact attempts through a combination of mail and telephone contacts. – Payments will be submitted to the 3rd Party Collection Agency 13 13

ACTION SUMMARY Age of Self Pay Accounts 31 Days – 180 Days after determining account is Self Pay 180 Days to 2 Years Over 36 months from Referral to Collections Agency Date 14 Action RCM Agency unless otherwise noted will: Mail Patient Statement Make phone contact as appropriate Attempt to receive a promise to pay; documents any agreements made. May consider contracting with a 3rd Party Collection Agency El Paso Fire Department will approve the referral of an account to the 3rd Party Collection Agency. RCM Agency reports patient payments to 3rd Party Collection Agency. Upon referral to Collection Agency accounts will have the additional 21% late fee set forth in City Ordinance assessed to each account. 3rd Party Collections Agency will report uncollected accounts to a Credit Reporting Bureau and conclude collection efforts and return it to RCM Agency. The 3rd Party Collection Agency will confirm a status of “Completed Services” on uncollected accounts and return them to the City. Report negative data to the Credit Bureau about the patient account. Monitor accounts for potential indebtedness to the City. 14

QUESTIONS? Delivering Outstanding Services 15

Microsoft PowerPoint - 09-21-2015 FAOC Item 8 - Ambulance Billing and Collections 9-17-2015 Author: roalv Created Date: 9/17/2015 2:22:31 PM .