R-3704-9-19 RESOLUTION NO.3704-9-19(R)
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF ALLEN, COLLIN
COUNTY, TEXAS, APPROVING THE ALLEN FIRE DEPARTMENT CHARITY
CARE POLICY; AND PROVIDING FOR AN EFFECTIVE DATE.
WHEREAS,the City of Allen Fire Department provides ambulance services to the City of Allen; and,
WHEREAS, the City of Allen Fire Department has been participating in the Texas Ambulance Services
Supplemental Payment Program(TASSPP) since 2015; and,
WHEREAS, the Centers for Medicare and Medicaid Services requires a charity care policy to continue
participating in TASSPP; and,
WHEREAS, the City Council has determined that it is in the best interest of the City to have a charity care
policy.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF ALLEN,
COLLIN COUNTY,TEXAS,THAT:
SECTION 1. The City Council hereby approves the City of Allen Fire Department Charity Care Policy as
attached.
SECTION 2. The recitals contained in the preamble hereof are hereby found to be true, and such recitals are
hereby made a part of this Resolution for all purposes and are adopted as a part of the judgment and findings of
the City Council.
SECTION 3. All resolutions, or parts thereof, which are in conflict or inconsistent with any provision of this
Resolution are hereby repealed to the extent of such conflict, and the provisions of this Resolution shall be and
remain controlling as to the matters resolved herein.
SECTION 4. This Resolution and the Supplement adopted hereby shall become effective upon passage as
required by law.
DULY PASSED AND APPROVED BY THE CITY COUNCIL OF THE CITY OF ALLEN, COLLIN
COUNTY,TEXAS,ON THIS THE 10TH DAY OF SEPTEMBER 2019.
APPR D:
ephen errell, AYOR
ATTEST:
Shelley B. George, TY ECRET Y
CITY OF ALLEN FIRE DEPARTMENT CHARITY CARE POLICY
CHARITY CARE POLICY:
The Allen Fire Department may provide healthcare services to patients without the expectation of reimbursement
(charity care services)if the patient meets the charity care guidelines below,and is determined to be eligible to be
a charity care patient. Charity care services do not include bad debt,payment shortfall(s), insurance allowances,
courtesy allowances,or discounts given to patients who do not meet the provider's charity care policy or financial
assistance policy.
Charity care services become effective as of October 1, 2019, and will only be available as long as the State of
Texas provides reimbursement for charity care services through the Texas Ambulance Services Supplemental
Payment Program/Medicaid 1115 Waiver,or similar means of reimbursement.
The Allen Fire Department may change the charity care determination criteria under Section 2. II. on a regular
basis and will maintain the current criteria.
CHARITY CARE POLICY GUIDELINES:
1. The Allen Fire Department must determine each patient's ability to pay for the ambulance services provided
before classifying the patient as a charity care patient. If the patient does not have the ability to pay for the
ambulance services,the Allen Fire Department may determine the patient as a charity care patient.
To determine a patient's ability to pay,the Allen Fire Department shall:
I. gather patient information during and/or after the services are provided, as applicable given the patient's
condition.This may include the issuance of one or more requests for information with the patient to obtain
information necessary for the Allen Fire Department to determine the patient's ability to pay for the
ambulance services provided. During communication with a patient, the Allen Fire Department shall
include information about its charity care services;
II. undertake an insurance discovery process to identify if the patient has third party insurance including
Medicaid,Medicare,or other forms of insurance; and,
III. undertake reasonable collections efforts to verify and/or yield essential information about the ability of
the patient to pay for the ambulance services provided.
2. The Allen Fire Department may classify the patient as a charity care patient if the following occur:
I. The current revenue cycle process results in one or more of the following:
a. the patient does not provide evidence of insurability, or the Allen Fire Department is unable to obtain
information from the patient during the requests for information in 1. I.within a 30-day period. The lack
of a response by the patient may be considered an affirmation that the patient does not have third party
insurance and does not have the ability to pay for the ambulance services provided;
b. the insurance discovery process in 1. II. determines that the patient does not have a third party insurance
product that will pay for the ambulance services provided. The lack of insurance or having an insurance
product that does not pay for ambulance service may be considered by the Allen Fire Department as a
determinant that the patient does not have third party insurance and does not have the ability to pay for
the ambulance services provided; or,
Resolution No.3704-9-19(R),Page 2
c. the collections effort in 1. III. results in no payment,or minimal payment, from the patient over a 30-day
period. Receiving no payment or minimal payment from the patient may be considered by the Allen Fire
Department as a determinant that the patient does not have third party insurance and does not have the
ability to pay for the ambulance services provided;
II. The payment predictor model indicates that a patient does not have a high likelihood of payment as
identified by the following classifications:
a. results indicate a low,medium,or non-classified designation
1) low designation results are identified as"L"
2) medium designation results are identified as"M"
3) non-classified designation results are identified as"NC"and indicates that there is insufficient patient
information to adequately determine likelihood of payment, thus indicating a low likelihood of
payment
b. for patients outside of the low, medium, or non-classified designations, results indicate a "Payment
Advisor Score",PAS,or similar,of 650 or below
3.The Allen Fire Department may also classify the patient as a charity patient if:
I. The service to an insured patient is denied by the insurance provider as not covered;
II. The Allen Fire Department is notified that the patient has been granted charity care by the sending or
receiving hospital;or,
III. The Allen Fire Department is notified that the patient is deceased and there are no additional remedy
options that may be pursued.
4. Once the Allen Fire Department determines the patient is a charity care patient,the Allen Fire Department will
make no further attempts to collect from the patient.
5.The ambulance services provided to the charity care patient shall be valued at 100%of the net cost of providing
those services by the Allen Fire Department.
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Resolution No.3704-9-19(R),Page 3