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Florida County To Write Off Overdue EMS Bills

Southwest Florida government leaders face the unpleasant task periodically of having to write off uncollected ambulance fees as bad debt.

The Collier County Commission is being asked to take that step today to the tune of $11,549,642 for uncollected ambulance charges for 2006 and 2007. The expense is for 15,376 accounts during those two years, according to county documents.

The county and its billing agent try to collect the ambulance fees as long as they can, but that can only go so far, said Jeff Page, operations director for Collier County's Emergency Medical Services.

"At some point these have been identified as ready to go back to the (commission) as being bad debt uncollectable," he said. When it comes to unpaid ambulance bills for 2008 and 2009, the county is still working on collecting those fees, he said.

In March, the Lee County Commission approved writing off $8.2 million in uncollected ambulance fees for 2008. In Collier for 2006 and 2007 combined, the ambulance gross charges were $39.1 million. After adjusting for what Medicare and Medicaid pays, the net amount billed was $28.7 million. Of that, the county was able to collect $17.2 million, leaving the $11.5 million for writing off as uncollectible.

Page said EMS does establish payment schedules for hardship cases, but the commission doesn't have the ability to negotiate a discounted rate because it is dealing with a taxpayer-funded service, Page said.

Even though the amount being written off is substantial, Collier's collection rate is better than some other jurisdictions because of its high Medicare and Medicaid population. "It's over 50 percent," he said.

A good chunk of the written-off ambulance bills are from the impoverished, the homeless, people who refuse to pay or who died at the scene, and illegal immigrants who don't have a Social Security number, he said. These accounts have been turned over to a collection agency where permissible.

So far this year, EMS has collected $9.3 million in ambulance fees and has billed out $20 million through August, he said.

Collier's EMS has responded so far this year to more than 2,000 calls, and operates with 24 ambulances and the one medical helicopter.



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