Recommendation Concerning the Uncollectible Bad-Debt Write-Off of Accounts Receivable Recorded in the Emergency Medical Service Fund as Uncollectible Bad Debts - John Dosh, Interim Public Safety Department Director
That the Board adopt the Resolution authorizing the write-off of $2,847,857.53, in Accounts Receivable that have been recorded in the Emergency Medical Service Fund of Escambia County and have been determined to be uncollectible bad debts for patient claims dating December 1, 2017 - February 7, 2019. During this same time frame, a total revenue of $11,701,582.32 was collected.
This Resolution allows an accounting transaction to be recorded and in no way should be construed to be a forgiveness of debt. This Resolution includes write-offs from Emergency Medical Services (EMS) Ambulance Billings for 5,416 accounts that have been through all phases of the billing and collection cycles, to include all primary and secondary insurance filing, and private pay processing pre-collection letter(s).
| Payer |
Number of Claims |
Total Write-Off Amount |
Description |
| Medically Needy |
1,111 |
$687,629.57 |
Recipients who must pay out of pocket a certain dollar amount before qualifying for Medicaid Insurance |
| Medicaid QI1/ SLMB |
194 |
$28,282.74 |
Has income that does not exceed 100% of the federal poverty level and do not qualify for any additional benefits therefore resulting in a deductible or coinsurance payment |
| Self-Pay |
4,111 |
$2,131,945.22 |
No Insurance |
| Total |
5,416 |
$2,847,857.53 |
|
All means of in-house collection have been exhausted and we are confident these accounts are truly uncollectible, and any further action on behalf of EMS Billing would be unproductive. We believe once an adverse credit rating is reported, it would provide additional leverage for the Collection Agency to attempt collection on these accounts. Each patient has received three invoices prior to receiving their notice of pre-collection letter. Each account will be referred to our secondary collection agency in which the outstanding balance will be listed as an outstanding debt with all three credit reporting agencies.
Although, this is a routine practice of writing off uncollectible bad-debt, this write-off is within reason of past practices as shown in the chart below.
| Fiscal Year |
Transport & Stand-by Charges |
|
Revenue |
Bad Debt Adjustments by Fiscal Year |
|
% of Charges that went to Bad Debt |
|
| 2007/2008 |
$20,241,031.19 |
|
$8,343,857 |
$4,844,328.34 |
|
23.93% |
|
| 2008/2009 |
$20,100,677.77 |
|
$9,343,857 |
$4,701,646.05 |
|
23.39% |
|
| 2009/2010 |
$20,166,623.94 |
|
$8,829,820 |
$4,666,009.80 |
|
23.14% |
|
| 2010/2011 |
$20,646,219.80 |
|
$9,704,845 |
$4,110,157.74 |
|
19.91% |
|
| 2011/2012 |
$24,081,658.97 |
|
$9,946,417 |
$5,180,026.20 |
|
21.51% |
|
| 2012/2013 |
$25,815,668.71 |
|
$11,181,918 |
$5,103,850.76 |
|
19.77% |
|
| 2013/2014 |
$26,929,005.80 |
|
$11,569,175 |
$5,088,621.84 |
|
18.90% |
|
| 2014/2015 |
$27,509,179.80 |
|
$12,119,244 |
$5,440,898.32 |
|
19.78% |
|
| 2015/2016 |
$27,878,748.17 |
|
$11,054,658 |
$5,881,992.86 |
|
21.10% |
|
| 2016/2017 |
$28,262,407.40 |
|
$12,302,721 |
$6,015,472.94 |
|
21.28% |
|
| 2017/2018 |
$30,564,840.54 |
|
$9,251,924 |
$1,695,014.46 |
|
5.55% |
|
| 2018/2019 through July 2019 |
$24,223,240.45 |
|
$9,867,514 |
$ - |
|
|
|
| |
|
|
|
|
|
|
|
| Total |
$296,419,302.54 |
|
$123,515,950 |
52,728,019.31 |
|
|
|
** Please note that a bad-debt write-off can cross several fiscal years when submitted to BCC for approval**
**On average Escambia County collects 1% of everything sent to collections** |