The Government Collection Triangle

1. The Government Collection Triangle NC Debt Setoff Garnishments Collection Agency Summer 2008 Angela E. Munsie Forsyth County EMS

2. What is the relationship of Local Government to the State?

3. Relationship of Local Government to State • The State Constitution gives the North Carolina General Assembly the power to organize local government: the power to establish or to abolish counties and cities. • The General Assembly also determines the scope of county and city government: local governmental units must have legislative grant of power before dealing with any particular issue. • Counties operate as the second tier of government, administering and delivering many programs to city as well as rural county residents.

4. In other words… You have the power!

5. What makes the Government Collection Triangle legal?

6. Legal Collection Boundaries for Ambulance in North Carolina • Ambulance debt is treated as if it were tax due to the county or municipality. § 44‑51.4 • Tax Law establishes the period of time a county or municipality may maintain and action or procedure to enforce collections. (10 years) § 105‑378 • Enforcing collections by attachment and garnishment with wages and bank accounts. § 105‑368

7. Daily Collections Medicare, Medicaid, and Health Insurance Attorney’s EMS Subscriptions Private Pay (during billing) Delinquent Collections NC Debt Setoff Garnishments > Wage > Bank Account Collection Agency > Credit Report > Additional billing statements Resources for Collecting Ambulance Debt

8. NC Debt Setoff Withholding NC tax refunds and Lottery winnings over $600

9. North Carolina Local Government Setoff Debt Clearinghousewww.ncsetoff.org • Patients must be notified in writing 30 days prior to submission an allowed a hearing/appeal process if requested. • Establish a Hearing Officer • Minimum Debt Requirements for Submission: • Delinquent at least 60 days • Must be an individual debt, not corporate, etc. • Must be $50 or greater • Debts can be combined to meet the $50 minimum (same debtor, SSN, and debt type) • Submission of accounts can be unlimited • Accounts must remain on file with $0.00 balance • Patient will be charged a $20 garnishment fee. ($5.00 NCDOR and $15.00 NCDCH)

10. Attachment and Garnishment Wages and Bank Accounts

11. Attachment and GarnishmentWages and Bank Accounts • Wages > Verified through Employment Security Commission (ESC). > Withholds 10% of employee gross pay (amount before taxes). > Served one time on employer and garnishment remains active until account is paid in full. • Bank Accounts > Freezes bank account for 10 business days. > Fees imposed by bank charged to account holders, not to County. > At the end of 10 business days, the account is emptied to clear the amount sent in for garnishment. > Served one time on financial institution, and garnishment is for a one time payout.

12. Collection Agencies

13. Collection Agencies • Follows the Fair Debt Collection Practices Act as written by the Federal Trade Commission. • Ability to submit debt to Equifax, Experian, and TransUnion credit bureaus. • Extends a patients private pay billing time. • May acquire information not known about patient. (employer, insurance, demographics) • All fees imposed are charged back to the County. • Account is active on credit file seven years from date of last communication efforts from patient.

14. Now what?

15. Game PlanKnow your opponent… Patient have an identity? Patient have assets? BAD DEBT ACCOUNT (Your opponent) Patient employed? Self or Company? Patient NEW to EMS? Patient NEW to area?

16. Utilize your resources COLLECT! COLLECT!

17. Outside of EMS some resources available to you might include… • Tax Office • Social Services • Utilities Division • Local Hospitals • Department of Motor Vehicles • Employment Security Commission • Accurint for Government (Lexis Nexis) • Law Enforcement • Other counties…

18. Let’s review… One account can be collected by…

19. Questions? Thank You!