2009 008 Ordinance - Laserfiche WebLink

Home Browse Search

\. 2. Motor Vehicle Accounts. If Ambulance Services result from a motor vehicle accident and an auto insurance carrier disputes the claim and/or the claim is in a legal dispute, Life Force will attempt to obtain a letter of protection from tHe appropriate individual (attorney or insurance company representative for the responsible party) stating that payment will be sent directly to Client once the matter is settled. If an attorney is not involved or the appropriate individual does not provide Life Force a protection letter, then Life Force will seek monthly payments on the account from the responsible party in accordance with the Client's elections for Responsible Party billing in Appendix B attached hereto and incorporated by reference. 3. Medicare and Medicaid Accounts. Life Force will bill Medicare and Medicaid directly for the Ambulance Services provided by Client. Medicaid payment will be obtained directly from Medicaid, and recipients will not be billed for services covered by Medicaid. 4. Responsible Party Billing: Life Force shall bill responsible parties for any amounts not covered by Payors unless otherwise directed in Appendix B. Client shall be responsible for investigating and following any federal, state and third-party payor guidelines regarding the waiver of responsible party responsibilities and the application of taac revenue or fees toward the co-pay and deductible as payment in full for the out-of-pocket expense for Residents. D. Life Force shall notify Client if it becomes aware that additional documentation is necessary to substantiate a claim for the Ambulance Services either on initial submission of a claim or upon further inquiry by a Payor or responsible parly. If requested by Client, Life Force can assist with the development of documentation suff'icient to file a claim. E. Based on the information supplied by Client, Life Force shall complete special forms for the Ambulance Services reasonably required by Payors, including, but not limited to, such items as requests for provider numbers, address changes and fee schedules. The foregoing does not include Payor requests for authorizations or certifications, which shall be the responsibility of Client. F. Life Force shall post payments it receives for the Ambulance Services to the individual responsible pariy accounts and shall report overpayments according to refund procedures pursuant to Appendix B. G. Life Force shall provide telephone support during reasonable business hours to assist Payors and responsible parties who request information about their bills for Ambulance Services. Life Force shall process all written and oral requests for information received by Life Force pertaining to the Client's accounts in a timely manner and forward all requests concerning matters beyond the scope of Life Force's _ services (clinical matters, policy issues, Client complaints) to Client's Authorized Liaison. 2 22068/513664-1