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Committee authorizes RFP for ambulance-bill collections while preserving hardship program
Summary
The committee approved drafting an RFP for a collections agency to pursue ambulance bills that are not covered and not eligible for the county hardship program; staff clarified the hardship application process and cited past unpaid insurer payments that resulted in roughly $80,000 in uncollected revenue.
County staff asked the Safety and Legal Affairs Committee to authorize an RFP for a collections agency to pursue outstanding ambulance bills while preserving an existing hardship program for residents who genuinely cannot pay. Staff said the committee previously approved a hardship program and that the RFP would focus on accounts where patients received insurance payments and did not remit funds to the county.
A staff member summarized existing practice: the county sends three letters to patients with unpaid accounts and writes off debts if there is no response. Staff said complications arise when insurers such as Excellus, which operate preferred-provider rules, send payments directly to patients rather than to the ambulance service; staff recalled a prior period with about $80,000 in unpaid accounts when payments went to patients.
Staff said the RFP could be adjusted before issuance and does not by itself obligate the county to contract with any particular firm. Committee member discussion focused on whether the county should seek a collections vendor and how to preserve the hardship-review process. The committee voted to advance the RFP and preserve the hardship-payment review process; staff will return with draft RFP language and procurement details.
"So the current policy ... is that 3 letters are sent to the patient if there is not coverage," a staff member said, describing the process; another staff member summarized insurer-related complications that produced prior uncollected revenue.
The motion to proceed with the RFP was moved, seconded and carried. The committee did not specify a contract award during the meeting; staff will bring a draft RFP back for review and may remove or revise collection provisions before finalizing the solicitation.
