ORDER NO.29678
BUDGET AMENDMENT
LATE BILL
INDIGENT HEALTH CARE
Came to be heard this the 8th day of May, 2006, with a motion made by
Commissioner Letz, seconded by Commissioner Nicholson, the Court
unanimously approved by vote of 4-0-0 to transfer the following expense
codes and issue a hand check in the amount of $1,043.03 to Vericlaims, Inc.
for May 3, 2006 and May 5, 2006 Fee on Paid Claims.
Amendment
Expense Code Description Increase/QDecrease
50-641-486 Third Party Administrators + $1,043.03
50-641-200 Eligible Expenses - ($1,043.03)
COURT ORDER # act ~ -~ ~
# 2
(05/08/06)
BUDGET AMENDMENT REQUEST FORM J7~ i1 y ~0 -v
DEPARTMENT NAME: INDIGENT HEALTH CARE

CURRENT CURRENT
EXPENSE CODE LINE ITEM DESCRIPTION BUDGET EXPENSE	UNEXPENDED
BUDGET
BALANCE		REQUESTED
AMENDMENT
INCREASE/QDECREASE
50-641-486	Third Pa Administrator	$24,119.57	$1,043.03	$0.00	+	$1,043.03
						
50-641-200	Eli ible Ex enses	$736,880.43	$24,844.96	$173,370.01		($1,043.03)
						
						
						
						
						
						
						
04/28/06
DATE
FOR AUDITOR'S OFFICE USE ONLY
LATE BILL FOR 05/08/06
WILL NEED A HANDCHECK
2741
VENDOR #
INVOICE #
PAID TO: VERICLAIMS, INC.
AMOUNT: $353.65
EXPENSE CODE: 50-54786
DESCRIPTION: VERICLAIMS/Fee on 5/3 paid claims
INV. NUMBER	5/3/06-fee
INV. DATE:	04/20/06
RCVD DATE:	04/20/06
DUE DATE:	05/08/06
207 Meadowg	rove
Houston, TX	77037-4303
	

AUDITOR VERIFICATION DATE
FRJM ~-L'E~:C-~RIf~S FfiX t~1D. 281-0472404 Rpi~: t0"~~6 a5: 23PM Pl
VeriClaims, Irrc.
4/20106
Kerr County Auditor's Office
Attention: Mindy Wffiiams
700 Main Street
Kerrville, Texas 78028
Indigent Health Care
~.? ~1
~~~~ ~~
0 ~ ~QR ~ p Zp~6
OS/3/2006 Claims Payments $8,479.35 ~' 4.5°./0 ° 5381.5''
Please remit to address shown above. Thank you - 27.92
$353.65
Less adjustment for refunds received
during March 2006
- 620.36 (Sid Peterson for
F. Aranda-Guzman)
7,859.00
x A.5~
353.65
207 Meadowgrove
HoustCn, Texas 77037-4303
w
~'~~1~~
FOR AUDITOR'S OFFICE USE ONLY
LATE BILL FOR 05/08/06
WILL NEED A HANDCHECK
2741
VENDOR # INVOICE #
PAID TO: VERICLAIMS, INC.
AMOUNT: 5689.38
EXPENSE CODE: 50-641-488
DESCRIPTION: VERICLAIMS/Fee on 5/5 paid claims
INV. NUMBER 5/5/06-fee
INV. DATE: 04/20/06
RCVD DATE: 04/20/06
DUE DATE: 05/08/06
207 Meadowgrove
Houston, TX 77037303
~- ~-~~
AUDITOR VERIFICATION DATE
FRCM t;~, {r_~,.'. MS Ff~ < N0. : 2B94J584L~9 Ror. 2G`~i0~"b5: 23PP1 P2
VeriCl,~ims, Inc
4/2D/06
Kerr County Auditors Office
Attention: Mindy Williams
700 Main Street
Kerrville, Texas 78028
Indigent Health Care
207 Meg+dowgnave
Houston, Texas 77037-4903
0~/5,~2006 Claims Payments $ I6,3G5.60 * 4.5'io =
Please remit to address shovm above. Thank you.
Less adjustment for refunds received
in April 2006
~~ ~~
~~~~~~~~
'SE APR 2 0 2006 ~~~II;;;J///j
$736.45 !,
- 47.07 ll(,
$689.38 ~~" ~~\~~
~/
- 215.23 (Sid Peterson for G.E. Thomas)
- 180.32 (Sid Peterson for G.E. Thomas)
- 614.34 (Sid Peterson for G.E. Thomas)
- 36.04 (Sid Peterson for S. Franz)
15,319.67
x 4.5$
689.38