HomeMy WebLinkAbout20052878.tiff CORRESPONDENCE RESPONSE
DEPARTMENT OF 7/77 LAI" 2ti
* * * PLEASE RESPOND WITHIN THREE DAYS* * *
IF RESPONSE WILL BE DELAYED,
PLEASE NOTIFY "CTB GROUP" BY E-MAIL
OF EXPECTED DATE FOR RESPONSE.
RECOMMENDED ACTION:
Narrative:
BOARD ACTION: (Initial by Approval) MG RM BJ L GV
Agree with Recommedation
Worksession
METHOD OF RESPONSE:
- Board Action
Work Session
A. Letter (Attached)
- Telephone Call
- No Response (explain)
1
Department Head Signature
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BOARD OF COUNTY COMMISSIONERS
PHONE (970) 336-7204, Ext. 4200
FAX: (970)352-0242
I P. O. BOX 758
GREELEY, COLORADO 80632
C.
COLORADO
September 8, 2005
R. Mark Richards
P.O. Box 388
Hudson, CO 80642
Dear Mr. Richards:
Thank you for contacting the Board of County Commissioners with your concerns regarding
your wife'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.
The records at WCPS indicate that your first letter was received June 17, 2005. In response to
your requests, the billing staff telephoned your residence and left a message. Unfortunately,
although a message was left at your residence, you apparently did not receive the message.
Your inquiry as to how the rate at which your insurance carrier reimburses health care
expenses relates to billing rates for services provided by the Weld County Paramedic Services
actually attempts to compare two entirely different rates.
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. What various insurance companies feel is reasonable, customary or
appropriate for ambulance 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. WCS is not a party to the insurance contract,
and cannot enforce the contract.
The billing statement from WCS is for services performed by WCS, and is independent from
the agreement you may have with an insurance company. While WCS 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 pursuant to the contract you have with the insurance company. You,
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however, are responsible for payment for services provided by WCS, not any insurance
company you may have contracted with for reimbursement services.
Even though Weld County Paramedic Services is a department of Weld County Government, it
does not receive any funding from tax dollars to support the cost of providing emergency
medical service. The cost to provide 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.
The bill your wife 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 wife has been billed only for the balance not reimbursed by your insurance. That
balance is due and owing. If you 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 353-5700, extension
3211.
" /�
Sincerely,
•
William H. Jerke, Chair
Weld County Commissioners Office
R. MARK RICHARDS
PO Box 388
Hudson Colorado 80642
303-536-4117 (H)
720-934-4080 (M)
teamroping(kmyway.co m
August 15, 2005
Mr. William Jerke
C/O Weld County Commissioners
915 10th Street
P.O. Box 758
Greeley Colorado 80632
Dear Mr. Jerke:
In June 2005 I sent a correspondence to Weld County Paramedic Services (WCPS)
requesting written explanation of the charges for Run 05-3876. Specifically, I
requested justification and/or basis for charges significantly higher than usual and
customary rates paid by my health insurer. I never received a response to this
request.
In July 2005 I sent another written correspondence to WCPS requesting the same
information as my June correspondence. Again, WCPS failed to respond.
I recently received another billing from WCPS for Run 05-3876. Unfortunately, no
response to my previous requests was included with this most recent invoice.
The basis for my request is that I challenge all medical charges that exceed my health
insurer's reasonable and customary rate. My health insurer devotes considerable
resources to controlling costs and I am not willing to accept significantly higher rates
without appropriate and sound justification. In fact, over the past several years, I
have challenged several medical service providers. On every occasion, rather than
justify their exorbitant rates, each provider accepted the health insurer's reasonable
and appropriate rates as payment in full.
As a consumer my request is not unreasonable, unless there is no basis for the higher
rates/charges. That being said, what I find even more inappropriate and unacceptable
is failure of WCPS personnel to respond to a citizen and taxpayer.
At this point contacting your office appears to be the only path forward for me to
achieve a satisfactory resolution of this issue.
Sincerely,
R. MARK RICHARDS
PO Box 388
Hudson Colorado 80642
303-536-4117 (H)
720-934-4080 (M)
teamroping(n,myway.com
September 18, 2005
Weld County Central Collection Agency
915 10th Street
Greeley Colorado 80631-1117
To Whom It May Concern:
Today, I received an invoice from your office for Weld County Paramedic Services (WCPS)
Run 05-3876.
It is beyond my comprehension how you could state "Since the validity of this claim has not
been disputed, it is now assumed to be valid."
I have been disputing the"validity of this claim" since the initial invoice.
For your review and edification I am providing a short summary of my efforts to resolve my
dispute with this claim.
• June 2005, 1st written correspondence to WCPS, requesting an explanation why
charges are as much as 84% higher than my insurance carrier's"usual and customary"
rates. No response from WCPS.
• July 2005, 2nd written correspondence to WCPS requesting the same information as the
June correspondence. Again, no response from WCPS. (Attachment 1)
• August 2005, 3m written correspondence to Mr. William Jerke (Weld County
Commissioner-in case you do not know that) requesting his assistance in resolving my
dispute with WCPS (Attachment 2). As a result of this correspondence a representative
of Mr. Jerke's office advised me that my concerns would be addressed in writing by
WCPS management.
For the record-this is your 4th correspondence disputing the validity of this claim.
At this point the only conclusions I can reach are:
• WCPS management is totally incompetent and your office is complicit in this
incompetence.
or
• WCPS management has chosen to ignore Mr. Jerke's instructions, which constitutes
insubordination.
From my perspective both of these behaviors are totally unacceptable and are grounds for
termination of the responsible manager at my company.
As a final note, I am forwarding a copy of this correspondence to Mr. Jerke so he is aware
WCPS management has not complied with his instructions and ensure your office does not
proceed with collection. (Cceyeel
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