BCC: Ambulance Billing - Dated May 28, 2026
Summary
The Pasco County Clerk & Comptroller's Department of Inspector General engaged Forvis Mazars, LLP to conduct an end-to-end review of Pasco County Fire Rescue's (PCFR) ambulance billing and accounts receivable reconciliation process, covering the period October 1, 2024 through September 30, 2025. The engagement examined bill creation, cash receipts posting, reconciliation controls between RescueNet, the AR ledger, and the general ledger, and write-off authorization practices, testing a sample of 24 transactions drawn from roughly 60,000 transactions and $26 million in billing activity.
No findings or control deficiencies were identified, and PCFR's procedures and controls were found to support agreement between the billing and financial systems. However, auditors noted two opportunities for improvement: heavy reliance on manual processes due to limited system integration between RescueNet and Munis, and a lack of formal policy documentation for existing write-off, AR aging, and governance practices. Management agreed with both observations and committed to pursuing system integration solutions and updating standard operating guidelines.
2 findings
- Opportunity 1lowother
Manual data entry due to limited system integration
RescueNet, the ambulance billing system, does not interface with the County's financial system (Munis), requiring significant manual effort to input, record, and reconcile data between the two systems. This increases complexity and elevates the risk of errors.
Recommendation: Management should evaluate opportunities to enhance system integration or leverage automated reconciliation solutions between the billing and financial systems to improve efficiency, reduce manual processing, and minimize the risk of errors.Management response: Pasco Public Safety Ambulance Billing agrees that current software and equipment create risks of errors due to manual data entry and stated readiness to purchase software that would integrate the various systems to reduce the need for manual entry. - Opportunity 2lowpolicy
Write-off and AR governance practices not formally documented
Key write-off, AR aging, monitoring, and governance practices were observed during walk-throughs, but these practices were not consistently or explicitly documented within formal policy.
Recommendation: Update the policy to formally document existing practices, including segregation of duties for write-off activities, monitoring of write-off trends and aging, AR aging review and reporting responsibilities, and consolidated governance and controls in a clearly defined section.Management response: Management will update the policy to formally document existing practices, including segregation of duties for write-off activities, monitoring and analysis of write-off trends and aging, AR aging review and reporting responsibilities, and consolidated governance and control structure. These elements will be added to the current production list of the newest SOG update team.