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HomeMy WebLinkAbout20082798.tiff CORRESPONDENCE RESPONSE DEPARTMENT OF 141/11(3 * * * PLEASE RESPOND WITHIN THREE DAYS.* * * IF RESPONSE WILL BE DELAYED, PLEASE NOTIFY "CTB GROUP" BY E-MAIL OF EXPECTED DATE FOR RESPONSE. RECOMMENDED AC?ION: Narrative: BOARD ACTION: (Initial by Approval) DL BJ RM DR BG AGREE WITH RECOMMENDATION - V ✓ \) WORKSESSION - METHOD OF RESPONSE: - Board Action Work Session Letter (Attached) - Telephone Call - No Response (explain) Department Head Signature M:\CAROL\OPMAN\RDCOM P2 �[ /y ,� Iq oig_e C4 ya,°<� ;�(` f��_'� 2008-2798 d OFFICE OF BOARD OF COUNTY COMMISSIONER 915 Street 1 P.O.. Box 759 TT GREELEY, CO 80632632 ig WEBSITE: www.co.weld.co.us WIPHONE: (970) 356-4000, EXT. 4200 C. FAX: (970) 352-0242 COLORADO October 3, 2008 Tracy Chapman 8474 E. Jamison Cr. N. Centennial, CO 80112 Dear Tracy Chapman: Thank you for contacting the Board of County Commissioners with your concerns regarding your daughter's bill for services she received from the Weld County Paramedic Services. As part of the review of your concerns, the Weld County Paramedic Services ("WCPS") was contacted for additional information. It is important to note that the rate your insurance carrier uses to reimburse health care expenses and the billing rates for services provided by the Weld County Paramedic Services are actually two entirely different rates, and are established based upon different criteria. The process insurance companies use to arrive at their level of reimbursement varies with the type of coverage and plans purchased. Insurance carriers charge premiums and reimburse health care expenses based upon rates that they have determined to be effective for their particular insurance services. Different insurance companies pay different amounts for reimbursement on the same standard billings. These are a result of the contracts they have with their clients. Insurance obtained by patients consists of a contract solely between the patient and the insurance company. The terms used by insurance companies to define the amounts they will reimburse based upon the tables they have adopted, are"usual and customary" or"reasonable and customary, or similar wording. How various insurance companies determine what is reasonable, customary or appropriate for ambulance and emergency medical service reimbursement has never been disclosed by any of the insurance companies to the ambulance and paramedic service providers, and such amounts vary among the different insurance providers. WCPS is not a party to the insurance contract, and cannot enforce the contract. The billing statement from WCPS is for services performed by WCPS, and is independent from the agreement you may have with an insurance company. While WCPS may be reimbursed by an insurance company on your behalf for all or a portion of a bill, the insurance company is answerable only to you, the insured, pursuant to the contract you have with the insurance company. You, however, are responsible for payment for services provided by WCPS, not any insurance company you may have contracted with for reimbursement services. Even though Weld County Paramedic Services is a depailment of Weld County Government, it does not receive any funding from tax dollars to support the cost of providing emergency medical services. The cost for providing emergency medical service is billed to the persons receiving such services. The fees for such services are set once a year during open budget meetings with the Board of County Commissioners for Weld County. The fees are set based upon the customary and appropriate costs for such services in Weld County. Weld County makes every attempt to maintain fees for ambulance and emergency medical services as low as possible. The bill your daughter received was for the services provided to her, and is a standard bill for patients who receive that service. Your insurance company has paid the portion of the bill for the service that was covered by your insurance contract, based upon their reimbursement tables. Your daughter has been billed only for the balance not reimbursed by your insurance. That balance is due and owing. If you or your daughter are interested in arranging for a monthly payment plan for the amount due, the office billing staff is willing to assist you with that. If you have any additional questions or concerns about this matter, please feel free to contact the Director of the Weld County Paramedic Services, Dave Bressler, at 970-353-5700, extension 3211. Sincerely, Rob Masden Weld County Commissioner September 29, 2008 Rob Masden 915 10th St. P.O. Box 758 Greeley, CO 80632 Dear County Commissioner Masden, My daughter is a senior at UNC in your fine city of Greeley. Last October she had an accident at her home, and her roommates called 911. The incident report is enclosed with this letter. We submitted the Weld County Paramedics bill to our insurance company, Anthem Blue Cross, and they paid them $350.00. This is an amount that insurance companies consider reasonable payment for ambulance service. Weld County sent us an invoice for $1,638.00, saying that they have no contract with insurance companies and Claire is responsible for the remainder of the balance. I called them and they were not willing to reduce the balance. A couple weeks ago, Claire received a call from a collection company, saying she owes them the money, in the form of a voicemail on her cell phone. I told her I would call them. The collection company would not speak to me regarding the bill as I am not the patient. They did say they would send a bill to my address, and I have not received any further bill or communication from them, including a paper bill, nor has my daughter. I strongly disagree with this high charge for your county ambulance service. I cannot find any insurance that pays more than $300- $450 for service, and in fact a friend of mine had service from the City of Aurora and they accepted payment of $190.00 from insurance and nothing else from the patient. I don't know if you are familiar with the finances of college students, but Claire had to work most of the summer to clear $1,600. The involvement in a sorority does not indicate wealth; in fact her rent is $425 a month, including food, which is very reasonable and not terribly high living. I spoke again with Weld County Ambulance on September 23, 2008. They had no idea what the balance owed is, and stated that it had been turned to collections. I asked them what reasonable payment is from insurance and they continued with the mantra of "we don't work with insurance", I told them "you certainly were willing to enter a contract with Anthem when you cashed the check they sent". Her attitude in response to that was poor. My insurance company said they have no control over these companies. The agent said that the payment Anthem made was indeed reasonable payment. The customer service representative I spoke with was shocked at the high price we were charged. Actual insurance payments are always lower than the charged amount, all of the providers involved in this incident, the hospital, doctors, lab; everyone accepted the payment rendered with no further bill to us. This is similar to the agreement Weld County has with Medicare, they have to accept the fixed amount. Their unwillingness to do the same with insured individuals seems like they have a racquet going It is my impression that people do not complain because of fear that maybe next time they won't pick me up or take good care of me if I complain, medical providers have a lot of power over people. How much does Medicare reimburse Weld County Paramedics for service? How much is paid if an illegal is picked up? My request to you is that you contact Weld County Paramedic and have them reduce Claire Chapman's bill to reflect the cost that the above two groups pay. This would be a better reflection of her financial status. Weld County can then contact the collection agency and work it out. As you know, if she doesn't pay the collection agency, her credit will be damaged. Recently, one of her friends fell and broke her leg — all of the girls said "don't call 911, they charged Claire almost $2,000." They took her in a car. Maybe the girls need to write a letter to the student newspaper and Greeley Tribune and warn others of this serious problem. Let me reiterate — insurance paid what is considered reasonable. And from my research, it was more than reasonable. The collection company told me they would mail a bill, it has been three weeks and we have not received anything. In light of that I am enclosing the Weld county bill, which is the price before the insurance payment. Please, please do not shuffle this off — it is a problem not only for us, but I believe for others who do not know what to do or how to complain. When brought to light, it could prevent patients who are truly in need of an ambulance not to use it. I will await your resolution to my daughter's problem. aiiirs. Thank you, Tracy Chapman 8474 E. Jamison Cr. N. Centennial, CO 80112 303.770.9879 tracyachap@comcast.net ALPHA OMICRON PI CHAPTER INCIDENT REPORT This report is to be completed WITHIN 48 HOURS of the occurrence of an incident OR of your obtaining knowledge of an incident. Any Chapter President,AAC member,Network Specialist Team member,Network Director Team member,or International Officer or visitor may complete this form. All chapter incidents must be reported. Completion of this form is NOT optional. DISTRIBUTION LIST (Please check who has received a copy of this report.): o Chapter Adviser o Network Specialist o Network Director o XB Director o International Headquarters Today's Date 10/16/07 Revised by Amber Robinson 02/25/08 Chapter Name Epsilon Gamma Date Incident Occurred 10/16/07 Date Reported to Chapter Adviser 10/17/07 College/University I lniversity of Northern Colorado Chapter Adviser Name Cassidy Langowski Phone Number 720-208-6395 Chapter President Name At time of incident Amanda Visscher As of 01/01/08 Claire Chapman Phone Number Visscher 303-579-4791 Chapman 303-907-2930_ INCIDENT TYPE: (Please check one.) o Hazing Policy Violation o Out of Town Event Policy Violation o College/University Policy Violation o AOH/College/University Alcohol Policy Violation o Any other violation of The Governing Documents o Other(Please Specify)_Claire Chapman-Accidental fall on Alpha Omicron Pi Property_ Describe the events leading up to the incident- including dates,times,and names of those involved. Please estimate number of people involved if specific names are not known. (Use additional paper if necessary) Claire Chapman was walking down the back stairway,when she fell at 10:45am.When she fell She yelled for Amber Robinson to come to her.Claire stated to Amber that she hit her head on the wall and complained of back pain.At this time her speech began to slur and was confused. About a minute after her fall she began to lose consciousness.Amber witnessed her begin to possibly seize and called for help from the other girls living in the house.Amber also checked Claire's breathing after loss of consciousness.With in a few moments of her fall Stephanie Nixon called 911,and EMS responded.Amber Robinson,Stephanie Nixon,and Amanda Visscher stayed with Claire until EMS arrived.Amber Robinson spoke to dispatch the entire time.Amber was advised to not move claire off the stairs.At 10:52 EMS arrived. Upon arrival Claire began to regain consciousness. EMS advised Claire betaken by ambulance to Northern Colorado Medical Center.Amanda Visscher,Chapter President,rode with Claire to the Emergency Department. 8/05 Describe the incident including date,time,location,and names of those involved. Please estimate number of people involved if specific names are not known. (Use additional paper if necessary) No one actually saw Claire Chapman fall down the Stairs.Amber Robinson,First one to respond to Claire,Checked Claire's breathing,and spoke with 911 and EMS,and called Claire's family after incident occurred. Stephanie Nixon Called 911,and stayed with Claire until EMS arrived. Amanda Visscher, stayed with Claire and rode with Claire to NCMC. Shannon Wadsworth, stayed with Claire until EMS arrived. Describe any action(s) taken at the time of the incident- including date,time,and names of those who took action (if applicable). Stephanie Nixon called 911,Amber Robinson Spoke to Dispatch.Amanda Visscher rode with Claire to the hospital. Describe action taken since this incident,including dates and names of those involved. While in the Emergency Department,Hospital took Head and Chest X-Rays of Claire Chapman. Diagnosed with a Concussion,and possible bruised or broken tail bone. Claire was released a few hours after the incident,she was taken home by her father for one day. Hospital gave discharge instructions stating,that she is to be watched for any nausea or vomiting,and headache. She is also to be checked when napping and sleeping. She is not to sleep for long periods of time.If any of these were to happen she was to be brought back into the Emergency Dept. Stephanie,Amber,Shannon and Amanda also watched for any of these signs when Claire came back to Greeley.They also drove her around for a few days after the incident. She showed no signs and did not need to be brought back to the Emergency Dept. Describe future plans made to address this incident,including dates and persons involved in the development and execution of these plans. There was nothing on the stairs that caused Claire Chapman to fall. She was monitored by her Parents and Roommates as ordered by the doctor. Originally signed and dated by Katie Youngren vPrint Name and Title of erson Completing This Report_Amber Robinson Vice President of Standards_Z Today's Date 7' - ce Originally signed and dated by Katie Youngren on 10/16/07 revised by Amber Robinson 02/25/08 Signature of Person Completing This Report Cgoe, Cws:_\_. This form may be faxed to the chapter's Network Specialist,Network Director, and Headquarters (attention Collegiate Operations). The Headquarters fax number is(615) 371-9736. 'Please note: This form may not be submitted via e-mail. 8/05 \ WELD COUNTY PARAMEDIC SERVICES � \ 1121 M Street • Greeley CO 80631-9587 (970) 353-5700 Ext. 3200 (970) 304-6408 Fax COLORADO Billed To: Bluecross Blueshield Of Colorado Origin 1838 8th Ave, Greeley, Co 80631 Patient Name: Claire Chapman Run Number: 07-11429 Destination Date of Service: 10/16/2007 North Colorado Medical Center Claire Chapman 8474 E Jamison Cir N Centennial CO 80112-2754 Total Charges: $1,638.00 Dear Claire Chapman: Our records indicate service was provided to you on the above date of service. This account balance is ultimately your responsibility, however, as a courtesy we have billed the insurance referenced above on your behalf. If we do not receive payment within 45 days, we will bill you directly. It is your responsibility to follow up with your insurance company. If you have any further questions, please contact our office. Thank you for your cooperation, Billing Office Weld County Paramedic Services PLEASE NOTE-AN 8% APR FINANCE CHARGE WILL BE ASSESSED ON ALL ACCOUNTS OVER 60 DAYS OLD. CPPWELD019 *"Detach Lower Portion and Return with Payment in the Enclosed Envelope"' 1121 M Street Greeley CO 80631-9587 ADDRESS SERVICE REQUESTED October 18,2007 REMIT TO: WELD COUNTY PARAMEDIC SERVICES 1121 M Street #BWNHRMD 0414231 0047716 Greeley CO 80631-9587 #1018 1932 0047 7165# 07-11429-9 Ilrrlrllrrrrllrrrrllrrrrlllrlrrrlrlrlrrlrlrrrllrlrlrrrllllrrrl Huhn IIurIIrrLlrrlrllrrrLlrLJr,IIrrrlrLrllJrrl Claire Chapman 8474 E Jamison Cir N Centennial CO 80112-2754 Patient Name: Claire Chapman Run Number: 07-11429 Amount Enclosed: $ Hello