The Contra Costa County Fire Protection District (District) needs to establish policies and procedures for its emergency ambulance services billing and collections processes. The proposed policies and procedures are aligned with, and heavily reliant upon, the existing structure and framework established by American Medical Response (AMR) as the County’s previous emergency ambulance provider. The proposed policies are also modeled after some of the Health Services Department hospital billing and collections policies. The purpose of the attached policies is to establish procedures for billing and collections that is consistent with current practices for the benefit of the public and the recently formed alliance between the District and AMR. Consistency in billing and collections will ensure continuity with forecasted revenue and business expectations as well as provide the public with similar experiences and expectations when dealing with the District moving forward as the new County emergency ambulance services provider.  
  
The policies and procedures will cover the following areas: billing rates, guidelines for "Dead On Arrival" or "Death During Transportation", returned checks, payment plans, Compassionate Care Program (100% forgiveness of bill), charge-offs, discounts, Victims of Crime (VOC) program, indigent patients, filing of claims, cost of producing reports, patient appeal and complaint handling, and board review and approval of written-off charges. The financial modeling of the District’s ambulance contract was predicated on using the existing policy and procedure framework for billing and collections.  
  
The implementation of these policies, consistent with the current practices of AMR as the provider of emergency ambulance services in the County, is important for the overall financial health and sustainability of the District with respect to its emergency ambulance services contract. Significant alteration or deviation from the current practices of AMR would have a detrimental effect on the financial health of the District’s ambulance operations.  

The District will not have policies in place to handle necessary business related issues required to successfully fulfill its obligations under the emergency ambulance services contract.

No impact.

Speaker:  Ruth Atkin, Heath Insurance Counseling & Advocacy Program (HICAP)> 

ADOPTED recommendations and DIRECTED the Fire Chief to continue working with HICAP on billing policies and provide a report on those practices at the next meeting.