El Dorado County Grand Jury
• 2003-2004
• Agency Response
Ambulance Billing Reason for the report The 2003/2004 Grand Jury received a complaint concerning the county operated
⚠️ Aviso de traducción: Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.
Note: Missing finding numbers detected: F7
Findings and Recommendations 7 findings
F1
Page 2
ABS processes the billing for services provided by The Ambulance Transport Service.
Related Recommendations (1)
R1
ABS employees must be directed to resolve disputes with Medicare prior to billing the patients.
F2
Page 2
Medicare uses the term “Denies” for all services which are disputed or not covered under the Medicare Insurance, and ABS is using the term “Rejected” on bills sent to the patient.
Related Recommendations (1)
R2
Page 1
The County should exclude ABS from sending disputed payment notices to patients per Board of Supervisors’ policy B-4 in collections.
F3
Page 2
Medicare patient bills are sent by ABS to Medicare Insurance for payment.
Related Recommendations (1)
R3
Page 1
County must resolve differences in terminology used by Medicare Insurance and ABS.
F4
Page 2
Medicare Insurance sends disputed invoices back to ABS for clarification/correction.
Related Recommendations (1)
R4
Page 1
The County must immediately direct ABS to develop and implement written policies and procedures for detailed processing of ambulance transport billing.
F5
Page 2
Bills not paid in a reasonable time are referred to County Counsel for collection.
Related Recommendations (1)
R5
Page 1
ABS employees must be trained on the coding of Medicare bills and on the County’s written policies and procedures.
F6
Page 2
As quoted in Auditor-Controller compliance review report, “The Department does not have specific written policies and procedures that pertain to the billing of Medicare beneficiaries for Ambulance services.” 7. Training by department staff is accomplished by on-the-job training rather than formal training.
No recommendations for this finding
F8
Page 2
Per Auditor-Controller compliance review report, ABS’s unwritten policy is to refer bills to the County Counsel collections after 120 days. Findings 1. Rejected/Denied Medicare bills were improperly sent to patients. Additional effort was required by county employees to resolve disputes between Medicare Insurance and ABS. Response to Finding 1: The respondent agrees with the finding.
No recommendations for this finding