The following policies are designed to provide guidelines to the accounting department and its billing intermediary (Comstar) in the writing off of ambulance receivables. With a formal write off policy the Town of Hampton and its billing intermediary are clear about who has the authority to approve write offs, when they will occur and under what circumstances will they be brought to the appropriate party for approval.
These policies are classified into five (5) different circumstances under which a write off will occur. For each circumstance the proper authoritative body to approve the write off will be specified. Write offs that are sent to the Board of Selectmen for approval will be brought to their attention on the first Monday of every month, unless circumstances prevent, in which case the closest following Monday as possible. The write offs will be classified in the categories specified below along with the dollar amount, indication of whether the patient is Hampton resident or not, and the name of the patient. Approved write offs will be sent to the Town of Hampton's billing intermediary. Under no circumstances will the billing intermediary write off amounts which have not been approved by the Board of Selectmen of the Town of Hampton unless specifically indicated below.
1.
Insurance Write Downs. The Town of Hampton's billing intermediary will provide the Town of Hampton with a list of insurance adjustments on a monthly basis. The Town of Hampton's billing intermediary will make the appropriate adjustments at that time without further approval from the Town. The Director of Accounting will review the list of adjustments and communicate any discrepancies to the intermediary.
2.
Hardship Write Offs.
A)
Application Forms:
Hardship applications will be issued to those Hampton residents only who require financial assistance. The applications will contain the following:
- All pertinent billing information. |
- Family size. |
- Total annual family income. |
- Signature of applicant. |
- Date of application. |
The billing intermediary will not list or suggest to the applicants the annual income parameters that will be used by the Town of Hampton to assist in the approval or denial of the applicant. |
B)
Approval Process:
All applications received by the Town will be screened by The Town of Hampton's Welfare Director. The screening process will include checking income levels against some predetermined scale, in addition to other steps the welfare director may deem as appropriate. The Welfare Director at any time may require the applicant to produce documentation to document their financial status.
After screening the applications, the Welfare Director will submit her recommendations to the Board of Selectmen for final approval. Upon the Board of Selectmen's approval all approvals and denials will be forwarded to the Town of Hampton's billing intermediary.
C)
Other:
Any write offs approved through this procedure will not be subject to a welfare assistance lien as described in RSA 165:28.
3.
Legal Settlements. Any letters from attorneys requesting to settle an ambulance bill for an amount less than what is determined to be owed the Town of Hampton should be forwarded to the Board of Selectmen for approval.
4.
Bad Address/No Response.
The billing intermediary will send to the Town of Hampton a list of those patients who have not responded to three (3) billing notices and two (2) collection type notices. After the billing intermediary has exhausted collection efforts and reported the no response to the appropriate credit bureaus the Town of Hampton will forward a list of those patients to the Board of Selectmen for write off approval.
The billing intermediary will send to the Town of Hampton a list of those patients who have not been contacted for reasons of a bad address. After the billing intermediary has exhausted collection efforts the Town of Hampton will forward a list of those patients to the Board of Selectmen for write off approval.
A list of these write offs will be kept by the accounting department, sorted by name, for future reference in case of multiple delinquencies by the same individual.
5.
Insignificant Balances. The Town of Hampton's billing intermediary will provide the Town of Hampton with a list of patients with insignificant ($5 and below) balances after it has been determined by the billing intermediary that a good faith effort to pay was shown by the patient. The Director of Accounting for the Town of Hampton will review and approve any write offs in this area.