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from Non-Residents for applicable co-pays and deductibles unless covered by <br />secondary insurance. <br />PLEASE ATTACH COPY OF ORDINANCE/LEGISLATION. <br />Definition of Resident <br />Client will be responsible for determining the Resident and Non Resident status before submitting the trip <br />to Life Force, obtaining documentation to substantiate residency status, and selecting the informational <br />statements received by Residents. In some cases, the information obtained from the receiving hospital <br />may be used by Life Force to determine the patient's residency. Client will include the following <br />individuals in its definition of Resident status: <br />(PLEASE INITIAL ALL APPLICABLE) <br />X Individuals with a permanent legal residence (residence of record) within the <br />jurisdiction of Client. The residency category of a minor is determined by the <br />residency of their parent or legal guardian. <br />Individuals employed bytax-paying Employers within the jurisdiction of Client. <br />For mutual aid calls, Client elects to have Life Force do one of the following: <br />treat the patient as aNon-resident. <br />X follow the billing procedures established by the community in which the person <br />transported resides as instructed by Client on the trip report. <br />Billing ofNon-Residents <br />X Pursuant to Section 1(C)(4), Client directs Life Force to handle Non-Resident <br />"insurance only" billing and collections as follows: <br />a. Generally. Life Force will send Non-Residents a request for insurance letter <br />indicating that Life Force will submit the claim to the Non-Resident's Payor and <br />that the Non-Resident need NOT directly pay the submitted amount. Life Force <br />will accept the covered reimbursement from the Payor for the fee charged as <br />"Paid in Full" regardless of the Non-Resident's outstanding co-pay and <br />deductible. If the Non-Resident does not have coverage or the Payor does not pay <br />the invoiced amount, Life Force will submit the information to the Client for <br />further instruction. If the Non-Resident does not respond to the communication _ <br />^~a ^°~~^^~~^^ ^~*°^~^~^ from Life Force the Non-Resident will be considered _ _ _ _ _ _ - Formatted: Strikethrough <br />non-insured and the account will be submitted to the Client for further instruction <br />---- <br />ed_ _ Life Force is_ not authorized to automatically adjust Non-Resident_ _ _ _ _ _, . - - Formatted: Strikethrough <br />accowtts according to this Non-Resident collection policv but is required to <br />provide Client with a listing of those accowtts and ask for further insG~uction <br />from the Client. Life Force is authorized to automatically adjust Non-Resident <br />accounts according to this Non-Resident collection policy and provide Client <br />with a listing of these accounts each month. <br />