Item C37 BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: October 16, 2013 Division: Emergency Services
Bulk Item: Yes X No _ Department: Fire Rescue
Staff Contact Person: Mary Napoli 289-6010
AGENDA ITEM WORDING: Approval of Resolution authorizing the write-off of 50 accounts
receivable for FY 2012 and FY 2013 totaling $433,418.33 for Monroe County residents who qualified
for the Trauma Star Air Ambulance Fee Waiver Program.
ITEM BACKGROUND: On May 20, 2009 Resolution No. 152-2009 was passed establishing the
Trauma Star Air Ambulance Fee Waver Program effective November 4, 2008. Residents who qualify
for this program are authorized to have all out-of-pocket fees waived for Trauma Star emergency
and/or interfacility air-transports after any third party payments have been received. The attached
Resolution authorizes the write off of the balances of 50 qualified Monroe County resident's accounts
receivable totaling$433,418.33 from December 8, 2008 to April 18, 2013. (See attached Exhibit A).
Sixty-six resident fee waiver applications have been approved since the last write-off in FY 2011. Of
the 66 applications, 16 accounts were frilly-paid by third-party insurance and 50 accounts had
outstanding balances after third-party payments—35 accounts in FY 2012 and 15 accounts in FY 2013.
PREVIOUS RELEVANT BOCC ACTION: On May 20, 2009 the Board approved Resolution No.
152-2009 adopting a fee waiver policy and process for trauma star billing for trauma scene and critical care
interfacility flights for qualifying Monroe County residents for flights that occurred after November 4,
2008. On August 18, 2010 Resolution No. 247-2010 authorized the write off of 22 Fire Rescue air
ambulance resident waivers totaling$150,437.61. On October 19, 2011, Resolution No. 248-2011
authorized the write off of 25 Fire Rescue air ambulance resident waivers totaling$180,916.58.
CONTRACT/AGREEMENT CHANGES: N/A
STAFF RECOMMENDATIONS: Approval.
TOTAL COST: N/A INDIRECT COST: BUDGETED: Yes _ No
DIFFERENTIAL OF LOCAL PREFERENCE: N/A
COST TO COUNTY: N/A SOURCE OFF S: N/A
REVENUE PRODUCING: Yes No AMOUNT PER MONTH Year
APPROVED BY: County Atty,L0MB/PurcLng Risk Management,. ri
DOCUMENTATION: Included X Not Required
DISPOSITION: AGENDA ITEM#
Emergency Services
RESOLUTION NO. -2013
A RESOLUTION OF THE
BOARD OF COUNTY COMMISSIONERS OF
MONROE COUNTY,FLORIDA AUTHORIZING
THE WRITE-OFF OF TRAUMA AIR AMBULANCE
RESIDENT WAIVER ACCOUNTS RECEIVABLE
WHEREAS, Monroe County Fire Rescue Services provides trauma air ambulance service; and
WHEREAS, on May 20, 2009 the Board approved Resolution No. 152-2009 adopting a fee
waiver policy and process for trauma star air ambulance billing or trauma scene and critical care
interfacility flights for qualifying Monroe County residents for flights that occurred after November, 4
2008; and
WHEREAS, the attached accounts have applied for the resident waiver; and
WHEREAS, the Board of County Commissioners of Monroe County contracts with Advanced
Data Processing, Inc. (ADPI) for trauma air Ambulance Billing and Related Professional Services; and
WHEREAS, a report was provided by Advanced Data Processing, Inc. on these accounts and it
was determined that all third party payments have been received and applied to their accounts, that the
balances constituted the amount remains after all third party payments had been credited to the account;
and that residents submitted sufficient documentation to qualify for the resident trauma air ambulance
waiver; and
WHEREAS, it is desired that these resident waiver trauma air ambulance service accounts
receivable be written off at this time;
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF MONROE COUNTY,FLORIDA:
Receivables for resident waiver air ambulance service 50 accounts listed on attached Exhibit A
in the amount of$433,418.33 shall be deleted from the Fine and Forfeiture Fund Account 101-115002.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County,
Florida, at a regular meeting of said Board held on the day of , 2013.
Mayor George Neugent
Mayor Pro Tem Heather Carruthers
Commissioner Danny L. Kolhage
Commissioner Sylvia Murphy
Commissioner David Rice
(SEAL) MONROE "OU NTY ATTORNEY
BOARD OF COUNTY COMMISSIONERS
ASS�STANT COUNTY Op ' OF MONROE COUNTY,FLORIDA
Attest: AMY HEAVILIN, Clerk By:
Mayor/Chairperson
Y
Deputy Clerk
Exhibit A
Monroe County Fire Rescue
Trauma Star Resident Fee Waiver
Account Receivables for October 2013 Write Off
Insurance
Amoun Pending Contractual
t
Account# Date of i
Waiverlly when Amount Pad Adjustment Final l
igin Baance to
Incident ora received by Insurance (Medicare/ Write-Off
Medicaid or
their HMOs)
1 160201-01 12/08/08 $ 12,140.00 11,627.76 $ - $ 512.24
2 160070-01 05/04/09 $ 14,300.00 $ 5,000.00 $ - $ 9,300.00
3 160108-02 06/14/09 $ 14,140.00 $ 6,956.00 $ - $ 7,184.00
4 160144-01 07/17/09 $ 14,140.00 $ $ - $ 1A,140.00
5 160168-01 08/09/09 $ 12,060.00 $ - $ - $ 12,060.00
6 160203-02 10/05/09 $ 9,820.00 $ - $ - $ 9,820.00
7 160029-01 02/08/10 $ 15,660.00 $ 2,500.00 $ - $ 13,160.00
8 160254-02 10/03/10 $ 12,060.00 $ - $ - $ 12,060.00
9 160012-03 01/12/11 $ 14,220.00 $ - $ - $ 14,220.00
10 160025-03 01/24/11 $ 14,140.00 $ - $ - $ 14,140.00
11 160047-03 02/07/11 $ 14,860.00 $ - $ - $ 14,860.00
12 160063-04 02/17/11 $ 14,300.00 $ 10,077.76 $ 862.24 $ 3,360.00
13 160073-03 02/25/11 $ 15,420.00 $ - $ - $ 15,420.00
14 160111-04 03/13/11 $ 13,260.00 $ 3,302.00 $ - $ 9,958.00
15 160101-03 03/19/11 $ 14,620.00 $ 8,664.10 $ 5,805.90 $ 150.00
16 160130-01 04/14/11 $ 16,060.00 $ - $ - $ 16,060.00
17 160172-02 05/17/11 $ 12,060.00 $ 5,062.36 $ 1,685.28 $ 5,312.36
18 160173-02 05/18/11 $ 9,260.00 $ 200.00 $ - $ 9,060.00
19 160197-03 06/04/11 $ 14,700.00 $ - $ - $ 14,700.00
20 160199-03 06/17/11 $ 9,340.00 $ - $ - $ 9,340.00
21 160225-02 06/27/11 $ 9,420.00 $ - $ - $ 9,420.00
22 160237-03 07/12/11 $ 9,420.00 $ 6,516.55 $ 2,703.45 $ 200.00
23 160239-01 07/12/11 $ 13,980.00 $ 6,818.94 $ 5,456.33 $ 1,704.73
24 160249-03 07/21/11 $ 12,140.00 $ 6,156.00 $ - $ 5,984.00
25 160253-02 07/23/11 $ 15,420.00 $ 7,283.63 $ 6,315.47 $ 1,820.90
26 160258-03 07/26/11 $ 15,420.00 $ - $ - $ 15,420.00
27 160267-03 08/01/11 $ 9,420.00 $ 5,350.01 $ - $ 4,069.99
28 160269-03 08/02/11 $ 12,140.00 $ - $ - $ 12,140.00
29 160301-02 09/01/11 $ 16,060.00 $ - $ - $ 16,060.00
30 160306-02 09/12/11 $ 15,420.00 $ - $ - $ 15,420.00
31 8905906 12/09/11 $ 9,660.00 $ - $ - $ 9,660.00
32 9083214 12/19/11 $ 12,860.00 $ 50.00 $ - $ 12,810.00
33 9083215 12/20/11 $ 10,380.00 $ 5,680.45 $ 3,279.44 $ 1,420.11
34 9739807 03/10/12 $ 10,220.00 $ 1,732.80 $ - $ 8,487.20
35 10239949 03/23/12 $ 16,060.00 $ 7,660.38 $ 6,484.52 $ 1,915.10
36 10239955 03/27/12 $ 16,140.00 $ 14,140.00 $ - $ 2,000.00
37 10436624 04/04/12 $ 15,180.00 $ 11,385.00 $ 1,427.00 $ 2,368.00
38 10371147 04/10/12 $ 12,140.00 $ - $ - $ 12,140.00
39 11212120 07/03/12 $ 13,340.00 $ 5,952.87 $ - $ 7,387.13
40 11319006 07/11/12 $ 14,700.00 $ 4,585.71 - $ 10,114.29
41 11641502 07/31/12 $ 10,380.00 J $ - $ - $ 10,380.00
42 12101589 09/07/12 $ 9,420.00 J $ 9,370.02 $ - $ 49.98
1
Exhibit A
Monroe County Fire Rescue
Trauma Star Resident Fee Waiver
Account Receivables for October 2013 Write Off
43 12604094 10/31/12 $ 15,740.00 $ - $ $ 15,740.00
44 12684490 11/08/12 $ 11,340.00 $ $ $ 11,340.00
45 8861285 12/06/12 $ 11,180.00 $ $ $ 11,180.00
46 14241198 12/10/12 $ 12,780.00 $ 6,412.00 $ $ 6,368.00
47 14389385 12/22/12 $ 9,340.00 $ 5,036.00 $ $ 4,304.00
48 14821013 01/09/13 $ 10,700.00 $ 1,664.00 $ $ 9,036.00
49 14262260 01/17/13 $ 13,340.00 $ 4,908.80 $ $ 8,431.20
50 15469117 04/18/13 $ 15,660.00 $ 14,428.90 $ $ 1,231.10
Resident Fee Waiver Totals $ 646,960.00 1_$ 178,522.04 1 $34,019.63 $ 433,418.33
2