Item I2
BOARD OF GOVERNORS
FIRE AMBUALNCE DISTRICT 1
AGENDA ITEM SUMMARY
Meeting Date: April 19. 2006
Division:
Emergency Services
Bulk Item: Yes
No X
Department: Fire Rescue
Staff Contact Person: Camille Dubroff
AGENDA ITEM WORDING: Approval of ResoIution authorizing the write off and deletion of
$22,212.58 from the Fire Rescue Accounts Receivable list.
ITEM BACKGROUND: The attached Resolution requests to write off and delete the balance of the
patient accounts that are listed on Exhibit A, in the total amount of $22,212.58.
This represe t th f 11
ns e 0 owmg:
# of
Reason for Write off accounts Total
BankruPtcy fi led 5 $2,015,08
Deceased-with no money in probate avalJable 14 $4,358. 70
Minor-with no parent or guardian found 16 $6,096.57
MedicareIMedicaid Balances-uncollectible 8 $3,461.56
Exception Balances on accounts that are less than $35.00.
These were not sent to collections due to the low balance. 25 $479.66
Special Medical Needs Evacuees during Hurricanes. 9 $5,801.01
Grand Total: 77 $22,212.58
The write off and deletion of these accounts equates to no further payments being made.
PREVIOUS RELEVANT BOG ACTION: None
CONTRACTIAGREEMENTCHANGES: WA
STAFF RECOMMENDATIONS: Approval.
TOTAL COST:
N/A
BUDGETED: Yes
No
COST TO COUNTY:
N/A
SOURCE OF FUNDS:
N/A
REVENUE PRODUCING: Yes
No
AMOUNT PER MONTH_ Year
APPROVED BY: County Atty YES
DIVISION DIRECTOR APPROVAL:
ement NI A
DOCUMENTATION:
DISPOSITION:
Not Required_
Included X
AGENDA ITEM #
Revised 2/05
Fire Rescue
RESOLUTION NO. -2006
A RESOLUTION OF THE BOARD OF GOVERNORS
OF FIRE AND AMBULANCE DISTRICT 1 OF
MONROE COUNTY, FLORIDA AUTHORIZING
THE WRITE-OFF AND DELETION OF FIRE RESCUE
AMBULANCE ACCOUNTS RECEIVABLE
WHEREAS, Monroe County Fire Rescue Services provides ambulance service on a fee for
service basis; and
WHEREAS, attempts to collect the full amount from the service recipients on attached Exhibit
A have been made; and
WHEREAS, it has been determined that further collection efforts are fruitless as the insurance
has paid the maximum allowable on these claims, and the service recipients are now either deceased
with no available funds in the estate, in bankruptcy, a minor with no guardian or parent found, have
uncollectible balances of Medicaid/Medicare, were Special Medical Needs evacuees during a
Hurricane and/or have small exception balances;
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF GOVERNORS OF THE
FIRE AND AMBULANCE DISTRICT 1 OF MONROE COUNTY, FLORIDA:
That service recipients accounts receivable listed on attached Exhibit A in the amount of
$22,212.58 be written off and deleted from the County Fire Rescue accounts receivable list.
PASSED AND ADOPTED by the Board of Governors, Fire and Ambulance District 1 of
Monroe County, Florida, at a regular meeting of said Board held on the day of
,2006.
Chairperson Kevin Madok
Commissioner David Rice
Commissioner George Neugent
Commissioner Dixie Spehar
Councilman John Cromartie
(SEAL)
BOARD OF GOVERNORS, FIRE AND
AMBULANCE DISTRICf 1 OF
MONROE COUNTY, FLORIDA
By:
Attest: DANNY L.KOLHAGE, Clerk
Ma yor/Chairperson
By
Deputy Clerk
Fire Rescue Accounts Receivable
Exhibit A
ACCOUNT PAYMENTS AMOUNT OF REASON FOR
Account Number DATE OF SERVICE RECEIVABLE MADE WRITE OFF WRITE OFF
1 307578-02 7/24/2001 $ 359.75 $ 304.04 $ 55.71 Bankruptcy
:2 508417-01 8/14/2001 $ 492.97 $ $ 492.97 Bankruptcy
3 508429-01 8/21/2001 $ 466.73 $ 229.05 $ 237.68 Bankruptcy
4 409325-01 9/14/2001 $ 616.35 $ - $ 616.35 Bankruptcy
5 512618-01 12/11/2001 $ 612.37 $ $ 612.37 Bankruptcy
$ 2 015.08
These patients have filed Bankruptcy.
ACCOUNT PAYMENTS AMOUNT OF REASON FOR
Account Number DATE OF SERVICE RECEIVABLE MADE WRITE OFF WRITE OFF
1 609602-01 9/26/2000 $ 366.89 $ 312.76 $ 54.14 Deceased
2 312644-01 12/2/2000 $ 566.69 $ 490.93 $ 75.76 Deceased
3 605496-01 5/10/2001 $ 461.85 $ - $ 461.85 Deceased
4 507348-01 7/3/2001 $ 481.13 $ - $ 481.13 Deceased
5 510539-01 10/17/2001 $ 481.13 $ - $ 481.13 Deceased
6 311890-04 11/8/2001 $ 381.17 $ 322.53 $ 58.64 Deceased
7 611211-01 11/26/2001 $ 359.75 $ - $ 359.75 Deceased
8 612289-01 12/17/2001 $ 366.89 $ - $ 366.89 Deceased
9605236-01 5/15/2000 $ 359.75 $ $ 359.75 Deceased
10 605283-01 5/27/2000 $ 374.03 $ - $ 374.03 Deceased
11 605284-01 5/27/2000 $ 366.89 $ - $ 366.89 Deceased
12 607417-01 7/2/2000 $ 359.75 $ $ 359.75 Deceased
13 609580-01 9/18/2000 $ 461.92 $ 26.15 $ 435.77 Deceased
14 912420-01 12/30/2001 $ 616.07 $ 492.85 $ 123.22 Deceased
$ 4,358.70
These patients are all deceased.
1
Fire Rescue Accounts Receivable
Exhibit A
ACCOUNT PAYMENTS AMOUNT OF REASON FOR
Account Number DATE OF SERVICE RECEIVABLE MADE WRITE OFF WRITE OFF
1 408156-01 8/1/2000 $ 473.99 $ . $ 473.99 Minor
2 405182-01 5/16/2001 $ 452.57 $ 123.20 $ 329.37 Minor
3 505287-01 5/27/2001 $ 520.87 $ - $ 520.87 Minor
4 505290-01 5/29/2001 $ 543.97 $ - $ 543.97 Minor
5 605570-01 5/29/2001 $ 673.91 $ $ 673.91 Minor
6 506305-01 6/10/2001 $ 477.38 $ $ 477.38 Minor
7706231-01 611712001 $ 527.49 $ 440.01 $ 87.48 Minor
8 906195-01 6/18/2001 $ 359.75 $ $ 359.75 Minor
9 706234-01 6/20/2001 $ 416.87 $ - $ 416.87 Minor
10 507358-01 719/2001 $ 522.55 $ 401.60 $ 120.95 Minor
11 308691-01 8/30/2001 $ 388.31 $ - $ 388.31 Minor
12 309743-01 9/14/2001 $ 388.31 $ - $ 388.31 Minor
13 710348-01 10/15/2001 $ 408.31 $ - $ 408.31 Minor
14 411394-01 11/7/2001 $ 466.85 $ - $ 466.85 Minor
15 711378-01 11/17/2001 $ 390.64 $ $ 390.64 Minor
16 311920-01 11/19/2001 $ 378.81 $ 329.20 $ 49.61 Minor
$ 6,096.57
These patients are all minors with no parent or guardian found.
ACCOUNT PAYMENTS AMOUNT OF REASON FOR
Account Number DATE OF SERVICE RECEIVABLE MADE WRITE OFF WRITE OFF
1 308374-01 8/10/2000 468.87 0 $ 468.87 Medicaid/Medicare Balance
2 309468.01 9/29/2000 369.22 0 $ 369.22 Medicaid/Medicare Balance
3611787-01 1 2/6/2000 381 .17 0 $ 381.17 MedicaidlMedicare Balance
4 609949-01 9/16/2001 359.75 0 $ 359.75 Medicaid/Medicare Balance
5 612228-01 12/212001 681.05 0 $ 681.05 Medicaid/Medicare Balance
6 312990-01 12/24/2001 359.75 $ 359.75 Medicaid/Medicare Balance
7 602157-01 2/28/2000 416.75 0 $ 416.75 Medicaid/Medicare Balance
8 704134-01 4/4/2001 525.00 100 $ 425.00 Medicaid/Medicare Balance
$ 3,461.56
These patients had Medicaid/Medicare but were not billed correctly. We can not send these patients to collections.
2
Fire Rescue Accounts Receivable
Exhibit A
ACCOUNT PAYMENTS AMOUNT OF REASON FOR
Account Number DATE OF SERVICE RECEIVABLE MADE WRITE OFF WRITE OFF
1 501046-01 1/28/2000 583.09 563.09 $ 20.00 Exceptions Balance
2 503020-01 3/14/2000 473.99 453.99 $ 20.00 Exceptions Balance
3604174-01 4/26/2000 448.5 427.22 $ 21.28 Exceptions Balance
4 605208-01 5/612000 409.61 388.34 $ 21.27 Exceptions Balance
5 605250-01 5/20/2000 359.75 338.47 $ 21.28 Exceptions Balance
6 605273-01 5/25/2000 359.75 331 .33 $ 28.42 Exceptions Batance
7 705105-01 5/31/2000 443.07 418.8 $ 24.27 Exceptions Balance
B 606297-01 6/1/2000 409.61 389.61 $ 20.00 Exceptions Balance
9 606316-01 6/6/2000 359.75 338.84 $ 20.91 Exceptions Balance
10 706109-01 6/6/2000 421.53 400.26 $ 21.27 Exceptions Balance
11 606332-01 6/11/2000 409.61 388.33 $ 21.28 Exceptions Balance
12 606374-01 6/22/2000 379.99 359.08 $ 20.91 Exceptions Balance
13 506239-01 6/23/2000 371.58 350.3 $ 21.28 Exceptions Balance
14 406129-01 6/27/2000 603.45 583.45 $ 20.00 Exceptions Balance
15 706128-01 6/30/2000 452.57 439.5 $ 13.07 Exceptions Balance
16 607428-01 7/5/2000 494.95 473.29 $ 21.66 Exceptions Balance
17 607446-01 7/11/2000 518.57 497.29 $ 21.28 Exceptions Balance
18 407142-01 7/14/2000 452.57 419.96 $ 32.61 Exceptions Balance
19 307344-01 7/26/2000 387.13 367.13 $ 20.00 Exceptions Balance
20 910235-01 10/4/2000 444.83 438.82 $ 6.01 Exceptions Balance
21 702066-01 2/18/2001 438.29 425.25 $ 13.04 Exceptions Balance
22 605491 -01 5/9/2001 454.78 449.02 $ 5.76 Exceptions Balance
23 608830-01 8/10/2001 381.17 369.44 $ 11.73 Exceptions Balance
24 512620-0 1 12/1212001 579.55 557.22 $ 22.33 Exceptions Balance
25 312995-01 12/26/2001 359.75 349.75 $ 10.00 Exceptions Balance
$ 479.66
These patients all have a balance of less than $35 and ADPI has it set up to not send accounts to col/ections if less than $35.
ACCOUNT PAYMENTS AMOUNT OF REASON FOR
Account Number DATE OF SERVICE RECEIVABLE MADE WRITE OFF WRITE OFF
1 311876-01 11/3/2001 945.23 0 $ 945.23 Hurr Evac. Special Needs
2 311878-05 11/4/2001 381.17 0 $ 381.17 Hurr Evac. Special Needs
3 511567-02 11/5/2001 945.23 0 $ 945.23 Hurr Evac. Special Needs
4 611140-01 11/7/2001 374.03 0 $ 374.03 Hurr Evac. Special Needs
5611561-01 11/4/2001 631.07 0 $ 631.07 Hurr Evac. Special Needs
6 611562-01 11/4/2001 631.07 0 $ 631.07 Hurr Evac. Special Needs
7 311886-03 11/5/2001 631.07 0 $ 631.07 Hurr Evac. Special Needs
8 511566-01 11/5/2001 631.07 0 $ 631.07 Hurr Evac. Special Needs
9 5115662~O2 11/5f2001 631.07 0 $ 631.07 Hurr Evac. Special Needs
Total $ 5,801.01
These patients are all Special Needs patients and were transported to a shelter during a Hurricane.
$ 22,212.58
3