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EMS searches for solution to $1.1 million in uncollected ambulance bills
County approves write-off policy, debt collection vendor
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Commissioners approved three new actions last week to deal with $1.1 million in uncollected ambulance bills that the county has accrued over the past 10 years.

The commission approved a new debt collection company, a new billing and collections policy and a debt write-off policy to help control the amount of debt the ambulance service has amassed since 2006.

Emergency Services Chief Lanier Swafford and the county's Chief Financial Officer Vickie Neikirk have been working for the past six months to put together an action plan to deal with the debt and find a way to collect what can still be collected.

Swafford and Neikirk have developed a four-step process to address the problem, and the two final steps were given the go-ahead at the Feb. 2 voting session, where a new debt collection policy and a new debt collection agency were approved in a unanimous vote by commissioners.

According to the new debt collection policy, after attempting to contact insurers and after patients have had time to submit a financial hardship application or arrange a payment schedule, the contracted billing agency will invoice patients or whatever party is financially responsible for charges that remain.

If no application for financial hardship is made, any outstanding balance over 180 days old will have a 1 percent finance charge added to the balance.

Also noted in the policy, if a patient makes a partial payment or arranges a payment plan, the finance charge will be delayed for an additional 180 days. After 180 days, any outstanding balance will be classified delinquent and sent to the collection agency, which was also approved in the vote.

According to Swafford, Dawson County has never contracted with a collections agency to try to recover bad debt, particularly in regards to emergency services ambulance billing.

EMS interviewed three debt collection agencies and decided to go with Professional Recovery Consultants Inc., which was approved by the commission.

The collections agency will keep 24 percent of the collections.

This was not the lowest percentage of collections that the considered agency would take, but Swafford said he thought that Professional Recovery Consultants had attributes that made them the best choice.

The new debt write-off policy was also approved, and according to Neikirk will establish a policy and a means of removing uncollectable debt resulting from ambulance billing from Dawson County's financial record.

Neikirk said that via the policy, each quarter the finance department, together with emergency services, would determine the amount of the accounts owing money to Dawson County for ambulance service.

"Accounts over 365 days without productive activity will be written off, that is if they have made no attempt to pay anything, or are ignoring the call," Neikirk said. "Customers who are making payments will not be written off or reported to a creditor. I think that is important to stress- if somebody is paying $5 a month and are doing their best effort, they shouldn't be penalized for it."

Swafford and Neikirk both advocated for credit reporting as an incentive for people to pay their bills, as the absence of it prior meant no punitive action was taken on those who did not make an effort to pay.

The write-off policy outlines three steps that must be taken before the county could write off accounts.

The customer must have been sent three separate notices of account balance. Once the account has to be deemed uncollectable by the billing and turned over to the collection agency, they must determine the debt is uncollectible and the account will be considered for write-off by the county. Bad debt write-offs will be approved each quarter by the board of commissioners.
These measures are the final steps the county has approved to try and keep on top of the mounting ambulance bills.

The first two steps were to increase the billing rates, which the county approved in November, as well as contract with a new billing company, which started on Oct. 1.

The revision to Dawson County's 2006 ambulance billing ordinance increased the rates that patients are charged per ride. With the new rates, bills increased ranging from $50 to $175 depending on the type of transport.

The request from emergency services came after talks between the department and their new EMS billing vendor, EMS Consultants.

Dawson County EMS Ambulance Fees and Charges

Service Rate
Advanced Life Support (Level 1 Non-Emergency) $350.00
Advanced Life Support (Level 1 Emergency) $500.00
Advanced Life Support Level 2 $675.00
Basic Life Support (Non-emergency) $350.00
Basic Life Support (Emergency) $400.00
Mileage (Loaded per mile) $13.00
Non-Sufficient Funds Fee $35.00
Finance Charge (for invoice not paid within 180 days) 1 percent of balance