[Ord. #96-42, § 1]
The City of Ocean City provides full-time professional emergency
medical services (City-EMS) to citizens and visitors to the City of
Ocean City on a twenty-four (24) hour per day basis throughout the
year to the extent that services are available. City-EMS services
are provided by employees of the City of Ocean City, Department of
Public Safety, Division of Fire. Dispatching and other support services
for the City-EMS are provided by employees of the City of Ocean City,
Department of Public Safety, Division of Police.
[Ord. #96-42, § 1]
In addition to the full-time professional emergency medical services as provided in subsection
6-21.1, the City may provide secondary nonemergency transport based on the criteria established by the Department of Public Safety, Division of Fire.
[Ord. #96-42, § 1]
All persons needing City-EMS who are located within the City
of Ocean City shall be served to the extent that services are available
without discrimination on any basis, and without respect to residency,
ability to pay, or any other factor. No person located within the
City at the time emergency services are needed shall be denied available
service, when such services are available. There shall be no delay
in providing available service due to City-EMS cost recovery procedures.
[Ord. #96-42, § 1]
The costs of providing available service due to City-EMS shall
be paid by a combination of (1) insurance payments for service to
persons who have insurance coverage, (2) direct payments from persons
served for amounts not covered by insurance, (3) revenues from service
agreements with persons, agencies, and jurisdictions that rely on
City-EMS and (4) local property taxation for residents who certify
they do not have insurance coverage or other resources to pay for
service.
[Ord. #96-42, § 1]
Personnel of the Division of Fire shall maintain accurate records
of all City-EMS requests for service, service calls, and services
provided on forms approved by the Director of Public Safety. Said
records shall include pertinent information about the general nature
of the call and shall identify the complete name, mailing address,
location and telephone numbers of all persons requesting and receiving
City-EMS services.
[Ord. #96-42, § 1; Ord. #12-06 § 2]
a. Billing to Insurance Companies and/or Persons Served by Emergency
Medical Services. The City of Ocean City shall contract with a third
party billing agent who shall issue a bill in the amount of six hundred
fifty ($650.00) dollars per loaded ambulance run plus a loaded miles
fee of twelve ($12.00) dollars per mile in each instance where City-EMS
services are provided. Said bill shall be issued to the insurance
company providing coverage for the person served, if any or directly
to the person served if insurance coverage is not available.
b. Billings to Insurance Companies and/or Persons Served Nonemergency
Transport Services. The City of Ocean City shall contract with a third
party billing agent who shall issue a bill in the amount as determined
by City of Ocean City for the nonessential services required. The
amount of billing shall be billed in increments of six hundred fifty
($650.00) dollars plus mileage and be reasonable and customary for
service provided. Said bill shall be issued to the insurance company
or requesting party as determined by the procedures outlining the
request for such service.
c. Part of Annual Fee Ordinance. Said fees as outlined in subsection
6-21.6a and
b shall be incorporated in the Fee Ordinance.
[Ord. #96-42, § 1]
Persons receiving bills for City-EMS services shall: (1) make
payment in full to the Director of Financial Management of the City
of Ocean City, or his designee, within thirty (30) days, or, (2) provide
proof that they have submitted a claim to their insurance carrier
for payment within thirty (30) days of receipt of bill. These provisions
shall be subject to the following:
a. Persons receiving City-EMS service who have health insurance to cover
ambulance and emergency medical services are expected to cooperate
with the Director of Financial Management or his designee and other
personnel as designated by City of Ocean City to secure full payment
for services rendered.
b. In the event the health insurance company of a taxpayer or full-time
resident of Ocean County does not pay the bill in full, the City will
accept such partial payment to the extent of the insured's policy
limits, including deductible and co-insurance requirements, as payment
in full.
c. In the event a taxpayer or year-round resident of the City of Ocean
City does not have health insurance, payment in full shall be required
except that upon submission of proof in accordance with the rules
and regulations established concerning the inability to pay the full
charge, a minimum payment in the amount not less than the current
and customary Medicare payment for emergency medical services shall
be accepted.
d. Due to time requirements for the preparation and processing of insurance
claims, interest shall not be charged on EMS billings.
e. The Director of Financial Management or his designee shall be responsible
for receipt of all payments and the communication to the third party
billing agent for payments received. The third party billing agent
shall be responsible for accounting of payments and providing the
City with a current billing and receivable ledger. The third party
billing agent is responsible for the initial billing and two (2) follow-up
billings. Costs associated with the third party billing agent shall
be based solely on a percent of cash collections. After three (3)
attempts to collect said claim, the third party billing agency shall
notify the City and relinquish rights to that billing. The City of
Ocean City shall turn said delinquent accounts to a collection agency
who will be compensated on a percent of cash collections of the delinquent
accounts. The City of Ocean City reserves the right to determine that
a bill is uncollectible and written off.
[Ord. #96-42, § 1]
For the purpose of emergency medical services charges, the following
definitions shall apply:
a. TAXPAYER - Shall mean any individual listed on the deed of ownership
of any property located within the municipal boundaries of the City
of Ocean City and their dependents as defined in paragraph c below.
In the case of corporation or partnership, only those individuals
retaining a twenty-five (25%) percent or greater ownership shall be
considered a taxpayer. For the purpose of determining a twenty-five
(25%) percent or greater ownership, adult married husband and wife
may combine their ownership.
b. YEAR-ROUND RESIDENT - Shall mean any individual residing within the
municipal boundaries of the City of Ocean City for a period of at
least six (6) months during the year prior to EMS service. Verification
of residency shall be based on voter registration, a State of New
Jersey Drivers License, or proof of filing a State of New Jersey Income
Tax Return from a City of Ocean City address. Dependent as defined
in paragraph c below shall be considered a taxpayer.
c. DEPENDENT - Shall mean:
1. Any individual who is the spouse or unmarried child (natural, adopted
or stepchild) under the age of nineteen (19) of a taxpayer or year-round
resident as defined in paragraphs a and b above;
2. Any unmarried child under the age of nineteen (19) for whom the taxpayer
or year-round resident has been appointed legal guardian;
3. Any individual who resides in the permanent domicile of the taxpayer
or year-round resident and is claimed as a dependent for Federal Income
Tax purposes.
4. Any individual who resides in the permanent domicile of the taxpayer
or year-round resident, and who is deemed to be a dependent under
the health insurance policy of the taxpayer or year-round resident.
[Ord. #96-42, § 1]
The governing body is authorized to adopt, by resolution, rules
and regulations to implement the emergency medical services provisions
of this section, including a schedule of specific fees to be included
within the overall Fee Ordinance of the City of Ocean City; criteria
by which the Director of Financial Management or his designee shall
determine ability to pay; and procedures for the cancellation of unpaid
bills due to inability to pay or other factors. On matters not addressed
by provisions of this section or specific regulations and implementation
decisions by resolution of the governing body, the Director of Public
Safety (as to the administration of the service) and Director of Financial
Management or his designee (as to the billing/collection aspect) are
authorized to establish and follow administrative rules and regulations
for the effective administration of this section.