[HISTORY: Adopted by the Mayor and Council of the Borough
of Ridgefield 5-28-2013 by Ord. No. 2230. Amendments noted where
applicable.]
The Borough hereby recognizes that it provides certain emergency
medical and ambulance transport services to persons both within and
without the Borough of Ridgefield at great cost and expense to the
Borough of Ridgefield.
The Borough hereby determines that it should exercise the power
and authority to charge for the emergency medical and ambulance transport
services it provides, and to render bills in connection with the delivery
of these services, to individuals receiving these services upon the
terms and conditions set forth in this chapter.
The Borough hereby establishes the following regulations and
provisions in connection with the delivery and billing for emergency
medical and ambulance transport services:
A.
No person requiring emergency medical services and/or ambulance transport
services shall be denied services due to lack of insurance or lack
of ability to pay the appropriate charges.
B.
The Borough shall obtain all necessary licenses from the New Jersey
State Department of Health, or otherwise, and shall apply for a provider
number from the federal and state Medicare/Medicaid programs, and
otherwise take such steps necessary to allow it to bill for the emergency
medical and ambulance transport services.
C.
All patients, whether or not a legal domiciliary of the Borough of
Ridgefield, and/or their financially responsible parties, insurers
or carriers, will be billed for emergency medical and ambulance transport
services provided by the Borough of Ridgefield according to a fee
schedule established by the Mayor and Council of the Borough of Ridgefield.
The Borough will bill for emergency medical and ambulance transport
services rendered by its paid CSO officers and by members of the Borough's
Volunteer Ambulance Corps.
[Amended 4-19-2017 by Ord. No. 2320]
D.
A patient who receives emergency medical and ambulance transport
services from the Borough of Ridgefield is obligated, at the time
of service or as soon as practicable thereafter, to provide the Borough
with all pertinent identification, insurance and/or payment information
to facilitate the Borough's billing of third-party payment sources
for services rendered. The Borough may, at its option, and shall,
where required by law, bill insurers or carriers on a patient's
behalf and accept payment on an assignment basis.
E.
All patients who are not legally domiciled in the Borough of Ridgefield
shall be liable for any copayment or deductible amounts not satisfied
by public or private insurance, and the Borough shall make reasonable
collection efforts for all such balances according to the most current
rules or regulations set forth by applicable Health Care Financing
Administration federal policies and regulations. The Borough may bill
any applicable co-insurance carriers for such amounts. Exceptions
include only those instances where the Borough has knowledge of a
particular patient's indigence or where the Borough has made
a determination that the cost of billing and collecting such copayments
or deductibles exceeds or is disproportionate to the amounts to be
collected.
F.
The Borough shall not bill any individual legally domiciled in the
Borough of Ridgefield for any fee, balance, deductible, or copayments
not satisfied by public or private insurance, including Medicare/Medicaid,
nor will the Borough bill an individual legally domiciled in the Borough
of Ridgefield for emergency medical services provided if that individual
is not covered by private or public insurance for the charges.
G.
The Borough of Ridgefield may, either directly or through any third-party
billing agency with which it has contracted for billing and/or collections
for emergency medical services, make arrangements with patients and/or
their financially responsible parties for installment payments of
bills or forgive any bill or portion thereof, so long as the Borough
determines that: 1) the financial condition of the patient requires
such an arrangement; and 2) the patient and/or financially responsible
party has demonstrated a willingness to make good-faith efforts towards
payment of the bill.
H.
A patient who has received emergency medical or transport services
from the Borough of Ridgefield, including an individual legally domiciled
in the Borough, for whom the Borough of Ridgefield has not received
payment from a third-party payer on assignment, and who receives payment
directly from a third-party payer for emergency medical services rendered
by the Borough, is obligated to remit such monies to the Borough in
the event that the Borough has not been paid for services rendered.
Patients who do not remit such monies may be held liable for costs
of collection in addition to the charges for emergency medical services
rendered.
I.
The Borough of Ridgefield shall be authorized to enter into contracts
with area hospitals that provide advanced life support (ALS) services
to patients that are transported by the Borough. This will allow the
hospitals to bill for all emergency medical services and, if so agreed,
timely reimburse the Borough for its transportation costs within 45
days of receiving payment.
A.
The Borough of Ridgefield is hereby authorized to enter into a contract
with a third-party billing agency for performance of EMS billing and
collection services; provided, however, that the following standards
for such third-party billing contracts are met:
(1)
The third-party billing agency has in place a compliance program
conforming to standards set forth in the Office of the Inspector General's
Compliance Program Guidance for Third-Party Medical Billing Companies,
63 Federal Register 70138, as amended.
(2)
Neither the billing agency nor any of its employees are subject to
exclusion from any state or federal health-care program.
(3)
The billing agency is bonded and/or insured in amounts satisfactory
to the Borough of Ridgefield.
B.
A detailed listing of patients who utilized emergency medical services
and/or transport provided by the Borough of Ridgefield will be compiled
by the Borough. This information will be transmitted to the third-party
billing agency. The information will be subject to the confidentiality
requirements of applicable law. This information will include, at
a minimum, the following:
(1)
Name, address and telephone number of patient.
(2)
Name, address, and claim number of insurance carrier, if applicable.
(3)
Date, time and EMS chart number.
(4)
Point of origin and destination.
(5)
Odometer reading at point of pickup and destination.
(6)
Reason for transport/patient's complaint/current condition.
(7)
Itemization and description of services provided and charges.
(8)
Signature of the patient or authorized decision maker.
(9)
Name of receiving physician.
(10)
Names, titles, and signatures of ambulance personnel, when possible.
C.
The third-party billing agency shall obtain the information from
the Borough of Ridgefield and will bill the patient and/or the patient's
financially responsible parties, insurers or carriers, according to
the fee schedule established herein; provided, however, that the third-party
billing agency shall not bill any individual legally domiciled in
the Borough of Ridgefield for any fee, balance, deductible, or copayments
not satisfied by public or private insurance, including Medicare/Medicaid,
nor will the Borough bill an individual legally domiciled in the Borough
of Ridgefield for emergency medical services or transport provided
if that individual is not covered by private or public insurance.
D.
Fees for emergency medical services. The fees for emergency medical
services, transport miles per trip and nontransports where aid is
provided shall be as follows:
E.
The Borough reserves the right to bill additionally for material,
vehicle and personnel costs in the case of a minor or unique accident.
F.
The Mayor and Council shall review the fees for services listed in Subsection D above annually and adjust said fees based on the recommendations of the Chief of Police, or his/her designee, the Captain of the Ridgefield Volunteer Ambulance Corps and Chief Financial Officer and in accordance with the federally approved Medicare fee schedule. .
[Amended 4-19-2017 by Ord. No. 2320]
G.
The Borough of Ridgefield may, in its discretion, bill additionally
for material, vehicle, and personnel costs in the case of major or
unique accidents.
H.
The Chief of Police, or his/her designee, and the Captain of the
Ridgefield Volunteer Ambulance Corps may promulgate rules and regulations
pursuant to and not inconsistent with this section, state law and
federal law, such as rules and regulations, which rules and regulations
shall become effective upon approval by resolution of the governing
body of the Borough of Ridgefield.
[Amended 4-19-2017 by Ord. No. 2320]
