Loading...
Ambulance Service Payment EnhancementsTHE CITY OF Dubuque DUB E ~-~'~ Masterpiece on the Mississippi g~ ~ ;~~ r 2007 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Payment Enhancements for Ambulance Service DATE: February 11, 2008 Fire Chief Dan Brown recommends City Council approval of additional alternatives for paying ambulance bills through website access and use of credit and debit cards. It is recommended that the interest charged on delinquent accounts would not exceed 1.5% per month and that Life Quest be allowed to negotiate settlements as part of the billing process. Fire Chief Dan Brown also recommends that the City join the North Central EMS Cooperative for purchasing medical supplies. concur with the recommendation and respectfully request Mayor and City Council approval. ~l~ ~~ Mi hael C. Van Milligen MCVM/jh Attachment cc: Barry Lindahl, City Attorney Cindy Steinhauser, Assistant City Manager E. Daniel Brown, Fire Chief THE CITY OF Dubuque DUB E ~ r Masterpiece on the Mississippi ~, 2007 TO: Michael C. Van Milligan, City Manager FROM: E. Daniel Brown, Fire Chief ~ ~ ~ SUBJECT: Payment Enhancements for Ambulance Service DATE: February 4, 2008 EMS Supervisor Wayne Dow is recommending that we add alternatives for citizens to pay ambulance bills. This would include a website access and use of credit and debit cards. In addition, it is recommended that interest be charged on delinquent accounts not to exceed 1.5% a month and allowing Life Quest to negotiate settlements as part of the billing process. It is also recommended that we join the North Central EMS Cooperative for purchasing. This will provide another option in order to obtain the best price for medical supplies. Attached is the information from Life Quest and a Value Added Service Questionnaires that require your signatures in order for Life Quest to provide these additional services. Barry Lindahl and Ken TeKippe have reviewed these documents and have found them to be satisfactory. I respectfully request your signatures on the Value Added Service Questionnaires as indicated. EDB/jl DUBU UE ~ F d-y To protect, assist and educate our community and visitors with pride, skill and compassion City of Dubuque, Iowa Memorandum February 4, 2008 TO: Dan Brown, Fire Chief FROM: Wayne Dow, Fire Department Emergency Medical Services Supervisor SUBJECT: Lifequest Value Added Service Enhancements and Questionnaires Enclosed is the packet I received from Lifequest for Value Added Service Enhancements and Questionnaires. I had Barry Lindahl review the packet and he recommended that we have the City Manager sign each page of the questionnaire on behalf of the City of Dubuque. Ken TeKippe and myself also reviewed the client website access, credit or debit cards, interest on delinquent accounts, and negotiated settlements. We thought that the client website access should be Cindy Schroeder from Finance and myself. We also thought that it would be best to accept credit/debit cards and to charge the convenience fee for their use. He also recommended we go with charging interest on delinquent accounts and to accept negotiated settlements. Negotiated settlement collections would exceed any amount that we normally collect through a collections agency. All of these enhancements have the possibility of increasing our revenue. Finally I would recommend we join the North Central EMS Cooperative for purchasing. We already belong to a couple of buying groups and another alternative for purchase supplies at a cheaper price would be to our benefit. have filled out the questionnaires according to Barry and Ken's recommendations. I request you forward this on to the City Manager for his signatures. I will then forward them to Lifequest. ~n _ r ~:' ~' nT T Z, CT 1-888-777-4911 • www.lifequest-services.com Billing, Collection, & Data Management Services N2930 State Road 22, Wautoma, WI 54982-5267 Value Added Service Enhancements As you know, LifeQuest is continuously striving to improve the services that we provide to our Clients. In an effort to continue on this path, the following information identifies several areas we are introducing that will streamline our processes as well as provide you with several value added services and enhancements. Client Website Access LifeQuest has developed a secure web access location on our website located at www.lifequest-services.com. To give you a sampling of some of the features that the website will have, you can go to our website and find the Client login area, which is on the top right hand corner of the website. Click on the login link and enter the username: sample and password: demo. Access to the Client Only general area will be open to the service director and/or any members of the service that are authorized by our primary contact person(s) for the service. The general access area will contain archived access to our newsletter series, access to WebEx training sessions, streaming video training, streaming audio training, as well as other general information. In addition to the general access area, in the near future we will have restricted access to the area that will contain the Client's monthly reports, which can be downloaded, printed, viewed, or stored at that location. The restricted area will also contain service-specific forms as well as other service related tools and documents. Access to this area will be limited to the Service Director and/or other primary service contact. At this point, we need your input to provide us with a primary and/or secondary contact that would have authorization to setup other users for access to the general area of the website. LifeQuest will setup, maintain, and make any appropriate changes to the restricted area to ensure the security of the site. 2 Please complete the attached Client Website Access questionnaire to advise us who should have access to the restricted area and have authorization to setup other users for the general site area. ACH (Checks by Phone/E-Checks This enhancement requires no input from you our Client; however, we would like to advise you that we have rolled out a value added service that will not involve any cost to you or your service. Our in-house programmers have recently completed a new software program that will allow us to accept checks by phone. As you are probably aware, more and more people are paying their bills using multiple forms of payment, including ACH (checks by phone). With this new enhancement, LifeQuest will be able to accept ACH (checks by phone). We are now rolling out the checks by phone portion of this with our intent to roll out the ability to accept checks by website sometime in the near future. As we accept checks by phone, we will be able to deposit these checks directly into your individual account located for the majority of you at Hometown Bank in Wautoma. This will enable patients to be able to pay their bills without going through the trouble of writing the check, paying postage, and, of course, the delay that is experienced when the payment is dropped in the mail. Credit or Debit Cards LifeQuest has been working for some time to find the right solution for our Clients so we are able to accept credit cards and debit cards on your behalf. We believe we have found that in a company called ACH Direct. ACH Direct has been in business for many years and is utilized by many agencies throughout the United States. After diligently negotiating with this company for some time, we have achieved what we believe is an excellent package for our Clients. How this will work is that we will be able to accept Master Card, Visa credit cards, and debit cards from patients who wish to pay their bills with this method. As you are aware, more and more people today are using credit and debit cards to make purchases and pay their bills. Due to the additional costs involved, we would not recommend accepting American Express, Diner's Club, or Discover Card. The cost for this service is very 3 competitive and we believe it will come close to paying for itself by following the recommendations that we have for you. Studies have shown that companies who accept credit and debit cards are typically paid in a timelier manner for bills that involve private pay. Any enhancements that make it easier for patients to pay their self-pay balances will help increase collection rates. Each of our Clients will have their own merchant account established on their behalf so that money can be directly deposited into their account and the cost for the credit and debit cards can be deducted on a monthly basis automatically from their account. Your costs for participating in this program are as follows: Setup Fee: $24.95 (One time) Monthly Fee: $ 9.95 MCNisa Transaction Fee: $0.24 per transaction IDVerify Fee: $0.35 per transaction (Only used if verification cannot be established using call number and other criteria) Discount Rate (Visa1MC): 2.17% - 3.5% (Master Card/Visa Card -depending on the type of credit card) Per Day Batch Fee: $0.25 (This is only charged if a transaction actually takes place on that day and it is a one time charge per day for the batch that will be sent.) Although rare, there are other fees that may apply to the account such as a $25.00 charge back fee if a patient disputes the charge to their credit card, a $20.00 non-sufficient fee if the account is over extended, a $20.00 account maintenance fee if assistance is requested from ACH Direct to hand calculate the account, and a $0.95 voice authorization fee, these fees would rarely be implemented but certainly could be if any of the circumstances listed above occur. There is an option that can be utilized with this process to recoup what we believe will be the majority of costs involved with credit and debit cards and we would recommend that you consider utilizing this mechanism. A transaction or convenience fee for credit/debit card usage is not uncommon today, especially because the patient does have the option of using paper checks or check by phone as an alternative for paying their bill, which would be at no cost. We would recommend a convenience fee of 3% or $25.00, whichever is less, on credit cards for patients who wish to pay their bill using this form of payment. 4 By law, we cannot charge a convenience fee on debit cards. This transaction or convenience fee will show up on the patient's credit card statement as part of the total paid. Please complete the attached Credit or Debit Cards questionnaire to initiate the acceptance of credit/debit cards by LifeQuest on your behalf. Interest on Delinquent Accounts As you are probably aware, we recently surveyed all of our Clients as to whether they would be interested in charging interest on delinquent accounts. Over 95% agreed that charging interest on delinquent accounts would be authorized by their service. As a point of clarification, what we mean by delinquent accounts are those accounts that have not been paid in the billing phase, which is Phase I of our process, and have gone into the later phases of Phase II and Phase III. We would recommend that once our new collection software is in place (which will be on January 1, 2008) that you allow us to charge a percentage not to exceed 1.5% per month on any open balance that exists in the collection portion of our processes. We believe that by charging this interest that in many cases it will prompt individuals to pay their bills on a timelier basis. In the past, we have had to restrict this capability because federal law does not allow agencies such as ours to add iiterest on to both interest and principal but with our new collection software package, the interest is segregated and calculated separately based only on the principal. Again, our recommendation is going to be to initiate this process to help generate additional funds to offset other costs such as credit/debit cards and the cost of billing services. Please complete the attached Interest on Delinquent Accounts questionnaire and have the appropriate person sign and date. This project will be initiated once the new collections package is put in place, which will be on January 1, 2008. LifeQuest Phases With the installation of our new collection software package, we will be making several changes to our internal processes. The major difference that you will see is that rather 5 than having four Phases of billing and collections, we have reduced that number to three. For our existing customers, this will ultimately save you money in that we are combining our current Phase II and Phase III work process into one Phase called Phase II. The cost for this Phase will be at the lower of the two Phases, which is currently what you are being charged for Phase II. This will ultimately save you costs in the fees that we charge for collecting on these delinquent accounts. The current Phase IV will become Phase III. The primary reason for changing this structure is that as a result of expanding our collection services to ambulance providers, we have found and studies show that when you change the appearance of the collector on a delinquent account, that the debtor views that as taking the account to new level. As an example, during our Phase I Billing and Phase II Initial Collections processes, we will continue to bill and collect from your patients as "`Your Ambulance Service Name' Billing Office". Once the account reaches Phase III, we will begin collecting on that account as "LifeQuest - A Licensed Collection Agency". As mentioned previously, we believe that this will take the account to a new level for the debtor and in some cases prompt the debtor to pay their delinquent accounts more readily than if we continue to collect under "`Your Ambulance Service Name' Billing Office". We will still have the same customer friendly collectors dealing with your patients and, as in the past, there will continue to be a seamless transition from Phase II to Phase III. This change will occur on January 1, 2008 when our collection software is fully integrated with our existing system. In addition to the change mentioned above, we would also like to make you aware of the other enhancements. When accounts move between Phases, for example from Phase I to Phase II, we will zero balance adjust those accounts that have moved to Phase II to reflect a true aged receivable report, which will then be balance reported as delinquent in Phase II. Starting with the January reports you will receive in February, you will notice a significant decrease in your aged receivables as, again, it will only be reporting Phase I aged receivables. Your Phase II report will reflect the accounts that are being collected as delinquent in that Phase. Once the accounts have passed through Phase II, there will again be a seamless transition to Phase III collections and the Phase II accounts will be adjusted. These will allow us to report more accurately, for your review, the accounts that are current, delinquent, and in Phase III of the collections process. For any accounts that remain delinquent in Phase III, we are allowed by law to continue to 6 collect on those accounts for up to six (6) years. There are other options available beyond our attempts to collect on those accounts such as debt purchasing, third party placements, or other alternatives. If you are interested, we would be happy to discuss these with you in further detail. Although the new fee percentages will take affect with your January revenues and reported in February, sometime during the first part of 2008 we will forward an addendum to you for signature officially combining Phase II and Phase III into the lower percentage rate. When you receive the addendum, please sign it and return it to our office as soon as possible. We believe that these changes to our process will not only streamline but also make for more accurate reporting to your service. Additionally, our new collections software will allow web access to your data 7 days per week, 24 hours per day via the worldwide web to evaluate the status of any delinquent account you choose. There are many other features that will assist us in collecting delinquent accounts that include enhanced reporting to the credit bureaus, skip-tracing capabilities, as well as address verification and validation. Negotiated Settlements Recently, we had an opportunity to evaluate a new procedure for use by us on behalf of our Clients. This is a negotiated settlement process. With the implementation of our new collections software package we previously mentioned, we will be changing our Phase structure. Rather than having four Phases, we will be changing our process to include three Phases. As of a result of this change, in Phase I and Phase II, we will be collecting on your accounts as "'Your Ambulance Service' Billing Office" and in Phase III as "LifeQuest, a Licensed Collection Agency". As such, when an account enters Phase III, which will be between 150-180 days, we would recommend that you allow us to negotiate settlements with the debtors. Our collectors are trained to negotiate these types of settlements with debtors based on the response they are getting to the collection call where we have made a right party contact. Our collectors are trained to begin negotiations on settlements at a smaller percentage than the total maximum allowable that is authorized by your service. We would recommend that you allow us to negotiate up to a 25% discount on the total amount due. Unfortunately, our hands are tied under the Fair Debt Collection Practices Act (FDCPA) where we are not able to tie a deadline onto the negotiated settlement. However, after testing this process with some of our Clients, we have found it to be effective in negotiating settlements and receiving payment based on those negotiations. Please remember, accounts that reach the new Phase III have low collection rates and any money received in Phase III is considered successful and we would highly recommend that you allow us to negotiate these settlements, again, because we will start at the smallest percentage of discount possible to the maximum allowed by your service. Please complete the attached Negotiated Settlements questionnaire which includes our recommendation that we are proposing to allow those negotiations to take place. Buying Group As a value added service to our Clients, LifeQuest has negotiated a membership to the North Central EMS Cooperative (NCEMSC). This is a multi-state EMS buying group that has negotiated pricing on items such as EMS supplies (Boundtree), ambulances, gasoline, radio equipment, and other EMS necessities. Please complete the attached questionnaire if you are interested in participating in this purchasing group to experience significant savings in your supplies and equipment budgets, all you need to do is sign below that you would like to be a member of the NCEMSC through LifeQuest and we will sign you up. Once we receive your acknowledgement, we will forward you additional information regarding the buying cooperative. Membership into the cooperative is being provided at no cost to you by LifeQuest. For more information on the NCEMSC and the added benefits of membership, please go to their website located at www.ncemsc.ora. We hope that you will view the enhancements and value added services as a benefit to you and your service. We believe that these enhancements will not only streamline the billing and collection process but also provide you access to several opportunities that we have not previously been able to provide. 8 We are also working on several other enhancements that we hope to be rolling out sometime in the next several months. One of those that should be out soon is our ImageTrend Service Bridge. We have upgraded the Bridge to include fire reporting capabilities. We will also be adding staff education tracking capabilities. The site has been re-branded as LEADERS (LifeQuest Technologies Emergency Ambulance and Fire Data Electronic Reporting System). We hope to provide more information on these as well as other value added services in the not too distant future. ; As always, we truly appreciate having you as a Client and we look forward to serving you long into the future. Should you have any questions regarding the enclosed, please feel free to contact either Chip or myself directly. Please return the questionnaires with the information requested at your earliest convenience. Si y, .Miller, NREMT-P President/CEO =~' ii:=.'rnT T~ CT Billing, Collection, & Data Management Services 1-888-777-4911 • www.lifequest-services.com N2930 State Road 22, Wautoma, WI 54982-5267 Value Added Service Questionnaires Credit or Debit Cards The following is required to initiate the acceptance of credit/debit cards on your behalf. Q Yes, our agency authorizes LifeQuest to move forward on our behalf in preparing an agreement that will allow LifeQuest to accept credit cards and debit cards for payment of ambulance claims. ^ No, we would not like to accept credit or debit cards at this time. dubu ue Fire De artment ~'~1 ~ ~/~_ q P Signature Service Name Mike Uan Milligan, City Manager Printed name and title ~~ Date Person authorized to sign credit/debit card agreement: Name: Mike Van Mi 11 i gan Title: Ci ~ Manager ® Yes, we would like to charge atransaction/convenience fee of 3% or $25.00, whichever is less, for all transactions paid by credit cards. (Recommended) ^ No, we would not like to utilize the option of charging a 3% or $25.00, whichever is less, convenience fee for the use of credit cards. We understand that this cost will be absorbed by our agency. Signature Mike Van Milligan, City Manager Printed name and title Dubuque Fire Department Service Name ~~~ -~-~ Date Interest on Delinquent Accounts ® Yes, we would like to begin charging interest on delinquent accounts that have not been paid in full in Phase I of the billing process. We authorize LifeQuest to charge a fee not to exceed 1.5% per month until the account is paid in full or adjusted. ^ No, we would not like to begin charging interest on delinquent accounts. U Q~ Signature Date Mike Van Milligan, City Manager Dubuque Fire Department Printed Name Service Name Negotiated Settlements X© Yes, our service authorizes LifeQuest to negotiate a settlement for any accounts that are delinquent in Phase III of the billing and collection process. We authorize a total discount of X© Up to 25% (recommended) ^ Up to 20% ^ Up to 15% ^ Up to 5% ^ No, we would not like any negotiated discounts made on behalf of our service. V Sign ture l U~ Date Mike Van Milligan, City Manager Printed Name Dubuque Fire Department Service Name Buying Group ®X Yes, our service authorizes LifeQuest to provide membership to the North Central EMS Cooperative on our behalf. We understand that there is no cost to our ambulance service for joining the NCEMSC. ^ No, our service does not wish to join the NCEMSC at this time. V ~ ~~ ~~ ~~ Signature Date Mike Van Milligan, City Manager Printed Name Dubuque Fire Department Service Name w Client Website Access Please complete one or both for your service. These individuals will have access to the restricted area of the website and have the ability to set up users for the general area. #1 Signature Wayne Dow, EMS Supervisor Printed Name 12/18/2007 Date Dubu e Fire Department Service Name Title: EMS Supervisor Email Address: wdow@cityofdubuque.org #2 Signa Cindy Schroeder Printed Name 12/18/2007 Date Title: Account Clerk Email Address: cschroed@cityofdubuque.org