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Address Info: 1150 O Street, P.O. Box 758, Greeley, CO 80632 | Phone:
(970) 400-4225
| Fax: (970) 336-7233 | Email:
egesick@weld.gov
| Official: Esther Gesick -
Clerk to the Board
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20133343.tiff
RESOLUTION RE: CANCELLATION OF 2013 OUTSTANDING ACCOUNTS RECEIVABLE FOR THE WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, a list of 2013 Department of Public Health and Environment accounts has been submitted to the Accounting Department of Weld County, Colorado, and WHEREAS, said accounts have been deemed uncollectible in accordance with guidelines adopted by the County of Weld, a copy of said list being attached hereto and incorporated herein by reference, and WHEREAS, the Accounting Department has recommended the cancellation of said list of uncollectible debts due and owing the Department of Public Health and Environment, in the amount of $10,143.63. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the aforementioned list of uncollectible accounts, in the amount of $10,143.63, be, and hereby is, approved for cancellation. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 9th day of December, A.D., 2013. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: Weld County Clerk to the Board BY: Deputy Cler APPRAS uhty orney Date of signature: DEC 1 9 2013 arbara Kirkmeyer Cie,: Au*, 19.-3-2?- It 2013-3343 HL0040 WARNING This report can make data changes in your system. Please read these instructions carefully. This report gives you the opportunity to write-off old patient balances in your database. When you close this window you will be prompted by the system to update your database. If you select Yes the balance write-offs will occur. If you are not sure you want to proceed with the write-offs then select No. Criteria used for the write-off: Write off the patient balance for all visits where the visit date is before: Create these write-off transactions as conveyances for the payor: Create these write-off transactions in the batch: Create these write-off transactions as adjustments of type: Company: Weld County Dept of Public Health and Environment - Last Payment Date before: 07/01/2013 Patient Name ii Last Payment 07/02/2012 08/27/2012 11/16/2012 06/24/2013 12/20/2012 06/21/2013 04/29/2013 10/10/2012 05/09/2013 08/07/2012 03/14/2013 09/19/2012 10/04/2012 04/29/2013 10/30/2012 03/01/2013 12/20/2012 01/07/2013 Last Payment FPN042810 FPN041583 FPN045755 $20.10 IZCN017389 $20.00 FPN041481 $10.00 FPN042662 FPN041872 $50.00 FPS002668 FPN042527 IZCS001937 $14.70 IZCS002062 $14.75 FPN043050 FPN045700 MDN002505 $5.00 FPS002645 $50.00 FPN042119 STDN000358 $10.00 FPN045134 $14.70 IZCN017520 IZCN017592 IZCN017619 FPN043153 IZCN017978 $37.50 FPN042966 FPN043363 FPN044314 IZCN018131 $12.00 FPN041807 IZCN017706 $30.00 IZCN017767 $40.00 IZCN017830 IZCS002028 IZCS002006 IZCN018519 IZCN018055 $20.00 IZCN017903 $25.00 IZCN018049 $20.00 IZCS002057 IZCS002055 IZCS002088 IZCN018193 IZCN018222 $20.00 FPN043299 07/01/2013 Old Balance Write -Off tgeiser 20131203 Write Off Ticket Number Patient Balance $27.00 $14.50 $19.50 $24.00 $42.25 $16.00 $40.25 $61.50 $62.00 $73.50 $14.70 $16.25 $15.50 $59.00 $21.00 $9.25 $44.00 $31.25 $14.70 $73.50 $117.60 $64.00 $73.50 $35.00 $66.00 $42.00 $73.50 $5.25 $88.20 $28.80 $18.80 $58.80 $88.20 $14.70 $58.80 $38.80 $4.40 $38.80 $29.40 $44.10 $73.50 $14.70 $21.00 2013-3343 Patient Name Last Payment 06/10/2013 01/16/2013 01/17/2013 01/17/2013 03/08/2013 02/08/2013 02/21/2013 04/04/2013 01/14/2013 01/04/2013 11/07/2012 11/19/2012 11/06/2012 03/12/2013 10/22/2012 01/07/2013 06/24/2013 12/03/2012 11/15/2012 12/17/2012 03/05/2013 04/01/2013 06/21/2013 06/26/2013 08/10/2012 11/20/2012 12/17/2012 11/27/2012 05/10/2013 Last Payment Ticket Number $322.25 IZCN018265 $20.00 IZCN018277 IZCN018278 $29.40 IZCN018283 IZCS002098 $30.00 IZCS002099 IZCS002182 $60.00 STDN000428 IZCN018407 $23.00 FPS002606 $14.70 IZCN016466 $9.00 IZAS000331 FPN045557 IZCN018645 IZCN018666 FPN045284 NNHVHO 12565 IZCS002246 $60.00 STDN000381 $40.00 FPN043245 FPS002601 IZCN018520 IZCN017905 IZCN017906 $15.00 IZCN017943 FPN043099 $5.00 FPN036939 $35.00 IZCN017936 $1.00 MDN002778 $50.00 FPN042303 $20.00 ZCN018225 ZCN017583 ZCN017609 ZCN017646 $33.00 FPN045706 $30.00 ZCN018062 ZCNO 18143 ZCNO 18396 ZCN018442 ZCN017624 ZCNO18810 ZCN017656 ZCN017938 $40.00 ZCN017990 $30.00 ZCN018142 ZCN018453 ZCN018615 FPN041155 $5.00 ZNA005199 MDN002858 $26.00 FPN044594 FPN040818 $138.00 MDN002349 $10.00 MDN002866 $65.00 FPN035913 $12.00 FPN042689 $14.70 IZCN018139 FPN042438 FPN042038 $14.70 IZCN018040 $25.00 FPN036262 Patient Balance $122.25 $38.80 $14.70 $29.40 $58.80 $28.80 $44.10 $10.00 $29.40 $10.00 $14.70 $5.70 $66.00 $44.10 $29.40 $41.50 $36.00 $14.70 $21.00 $47.50 $21.00 $29.40 $14.70 $29.40 $43.80 $11.00 $19.00 $38.50 $9.00 $52.00 $24.10 $44.10 $58.80 $14.70 $29.25 $43.50 $14.70 $58.80 $29.40 $29.40 $14.70 $44.10 $58.80 $18.80 $14.10 $29.40 $29.40 $64.00 $9.70 $57.50 $68.25 $80.50 $42.00 $82.00 $18.50 $179.00 $44.10 $8.00 $38.00 $14.70 $36.75 Patient Name Last Payment 05/02/2013 10/05/2012 02/27/2013 03/13/2013 12/13/2012 09/07/2012 07/19/2012 02/20/2013 04/18/2013 07/13/2012 09/20/2012 05/02/2013 04/04/2013 04/23/2013 11/19/2012 07/20/2012 02/01/2013 05/13/2013 07/26/2012 09/19/2012 09/14/2012 08/17/2012 02/13/2013 01/22/2013 08/27/2012 01/18/2013 03/14/2013 09/21/2012 06/11/2013 08/16/2012 08/06/2012 01/04/2013 Last Payment Ticket Number FPN041046 FPN042136 $10.50 FPN045034 FPN042060 $24.00 FPN036007 $21.00 FPN044099 $198.00 FPN044284 FPN043496 $3.00 FPN035828 FPN044556 FPN042344 FPN045466 FPN041762 $19.00 FPN040256 $10.00 FPN040949 FPN043107 FPN044262 FPN045405 FPN042391 FPN045579 IZCN017585 $1.75 FPN044011 $30.25 FPN044871 FPN044081 FPN045317 FPN040898 $20.00 FPN039676 $5.00 FPN041826 $4.00 FPN043906 MDN002645 FPN044620 $13.00 FPN044638 $196.00 MDN002802 IZNA005302 $3.00 FPN042673 $8.00 FPN040989 $33.00 FPN043737 $20.00 FPN045187 $43.75 MDN002156 $1.00 FPN041796 $3.00 FPN041725 $57.00 STDN000250 $1.00 MM0000004 FPN043934 $191.00 MDN002626 IZCN017703 $14.70 IZCN017638 IZCN0 17535 $15.00 FPN043501 FPN044446 $10.75 FPN044326 $20.00 IZCN017718 IZCN017719 $20.00 MDN002849 IZCN017827 $5.00 IZCN017595 $5.00 FPN041191 IZCN017462 FPN043513 FPS002505 $11.00 FPN043266 Patient Balance $74.00 $13.75 $83.25 $109.50 $34.75 $10.00 $80.00 $35.00 $7.00 $21.00 $30.00 $12.75 $100.00 $16.00 $76.25 $41.25 $15.00 $15.00 $13.00 $57.50 $58.80 $36.75 $26.00 $59.75 $16.50 $55.75 $11.00 $16.00 $52.25 $43.75 $49.00 $8.00 $82.00 $14.70 $22.00 $23.00 $26.00 $60.00 $24.25 $25.00 $5.00 $6.00 $43.00 $19.50 $79.00 $14.70 $14.70 $29.40 $9.25 $73.50 $45.25 $24.10 $29.40 $106.75 $58.80 $39.10 $8.00 $14.70 $80.50 $16.00 $13.00 Patient Name Last Last Payment Payment Ticket Number Patient Balance 01/07/2013 $10.00 FPN043296 $9.00 FPS002486 $37.00 IZCS001921 $58.80 IZCS001874 $14.70 IZCS001977 $14.70 IZCN017610 $44.10 FPN044270 $10.50 FPN045639 $23.50 FPN041183 $54.75 FPN042967 $31.00 12/14/2012 $27.00 MDN001998 $9.00 01/18/2013 $31.00 FPN043546 $18.50 FPN045437 $40.00 05/02/2013 $77.00 MDN002608 $103.00 02/06/2013 $196.00 MDN002717 $94.00 05/13/2013 $20.00 FPN041143 $57.75 FPN042857 $35.50 02/14/2013 $10.00 FPN043942 $11.00 03/22/2013 $21.00 STDN000444 $9.00 10/02/2012 $25.00 FPN041993 $34.00 FPN042612 $21.00 04/15/2013 $10.00 FPN044807 $98.50 09/26/2012 $10.00 FPN040136 $54.00 02/05/2013 $20.00 FPN042592 $17.00 01/28/2013 $21.25 FPN043658 $1.50 06/20/2013 $31.00 MDN002425 $59.00 FPN043180 $37.00 FPN046326 $66.00 FPN043615 $13.00 07/23/2012 $15.00 FPN041002 $15.00 FPN044478 $21.00 02/15/2013 $20.00 FPN043969 $82.75 MDN002840 $84.25 05/28/2013 $20.00 FPN044857 $1.00 01/29/2013 $40.00 FPN038507 $44.00 FPN044722 $21.25 05/30/2013 $25.00 FPN045401 $32.25 FPN041217 $12.25 IZCN017790 $14.70 FPN042982 $8.00 FPN045451 $9.00 FPN041378 $21.00 01/04/2013 $17.00 FPN036960 $6.00 MDN002217 $7.00 FPN041311 $82.50 10/09/2012 $3.00 FPN035486 $12.00 FPN043525 $35.25 02/04/2013 $5.00 FPN043784 $77.50 MDN002844 $188.00 STDN000448 $46.00 08/06/2012 $25.00 IZCN017518 $33.80 FPN045412 $9.00 06/26/2013 $10.00 FPN038224 $54.00 03/20/2013 $14.50 FPN044432 $12.50 FPS002515 $64.00 10/15/2012 $30.00 FPN042192 $50.00 12/19/2012 $2.25 FPN039864 $52.50 12/20/2012 $7.00 FPN037740 $13.25 FPN043084 $27.50 FPN041811 $57.50 FPN041370 $16.00 Patient Name Last Payment 06/04/2013 01/11/2013 04/12/2013 09/07/2012 02/25/2013 09/10/2012 06/14/2013 07/05/2012 03/13/2013 04/30/2013 06/10/2013 03/29/2013 04/23/2013 01/16/2013 06/28/2013 04/18/2013 04/02/2013 Last Payment $3.44 FPN036629 $3.00 FPN043365 $45.00 FPN044632 IZNA005258 $5.00 FPN041633 $20.00 FPN036606 $20.00 IZCN017682 $21.25 FPN045609 $20.25 FPN040772 IZCN0 18406 FPN044320 IZNA005511 $17.00 FPN044306 $196.00 MDN002796 IZCN017704 $10.00 FPN045558 $15.00 FPN044550 $18.00 MDN002546 MDN002547 FPN044933 MDN002563 FPN042722 NNHVH012117 $87.00 IZNA005040 IZCN0 18319 $14.70 IZCN018243 $110.00 FPN043301 FPN044761 IZCN0 18194 IZCN018167 FPN044695 FPN043866 FPN042654 FPN040977 FPN045807 FPN044209 $10.00 FPN039257 FPN042728 FPN044150 Ticket Number Patient Balance $31.06 $63.00 $31.00 $29.40 $16.00 $17.50 $24.10 $6.25 $24.00 $29.40 $21.00 $92.27 $13.00 $174.00 $14.70 $5.00 $46.50 $30.75 $47.00 $41.00 $47.00 $19.00 $36.00 $29.40 $29.40 $14.70 $26.00 $27.00 $88.20 $44.10 $13.50 $17.50 $46.50 $31.00 $62.00 $129.50 $34.00 $30.00 $38.00 $10,143.63
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