How Does Your Service Support Itself?

[letmesleep]

There has been some discussion over on another thread (CCEMTP what does it mean) that has taken us a little off the OP. I thought i'd bring it to a new slate and ask all of you....How does your service support itself? In this day and age billing has taken control of a lot of what we (as medics and EMTs) do in the street. The increased cost to an ambulance service each year continues to grow, your pay and benefits, Fuel cost, supplies, station maintainance, etc. So how does it get done where you work? how involved are YOU with your billing process? Do you even know?

At my District we have a property tax at a rate of 18 cents/ assessed $100 value, We also have a communication tax at 3 cents/ assessed $100 value. Recently we were able to pass a sales tax of .25 cents per sales dollar. We also bill for our services.

The sales tax is bringing in money to the district and allowing us to lower our property taxes, we have already cut it down from 29 cents to the 18 cent rate, and with increased growth and retail headed this direction we will continue to drop it. This sales tax is not allowed to be charged against Fuel/ food/ or prescribed meds.

The communications tax pays for any and all means of communicating from dispatch/ computers/ phones and the service/ cable tv in the station.

Finally billing, we have taken on the job of retrieving the information for the bill by getting a facesheet at the hospital or copies of the insurance cards (auto insurance if it was an MVC). This information is then turned over to the bill department for processing and collection.

So how do you do it?

[itku2er]

Well the Volunteer service I run with we get grants for the equipment, the county pays some of the bills. The rest we do events like yard sales, stand by for the rodeo fair etc, bingo, pictures, poker runs with motorcycles. And the citizens of our community help out alot with donations.

[spenac]

A couple of services I have been involved with are partially supported by a $5 assessment on the water bill. The citys and countys still have to include more. Of the $400,000+ it costs to run one ambulance a year less than 25% is actually covered by collections in a 911 system.

[CBEMT]

FT: As we are under the University Health Services umbrella, we are funded by the Student Health Services Fee assessed with tuition. We do not bill.

PT: Tax dollars, $400,000 a year for the whole department including us. We bill, but revenue goes to the General Fund. We probably average close to $2,000 in donations per year, most often from patients or families of patients.

[strippel]

We rely on fee for service.

We are non-profit. A subscription drive is sent out every year, obviously it does not raise that much.

I'm not exactly sure, but I would bet we receive less than $40,000 in municipal support.

This year, we will do more than 30,000 events, about 60% of them are 911.

[Chief1C]

We bill the patients; and run a subscription drive. But mostly, the fee for transport pays the bills.

[Spock]

My service is an Authority that covers five communities. We run a subscription drive every year and bill for calls. We also run a capital fund drive every year to raise money above what the subscriptions bring in. The communities do not fund the service but have always been helpful with services in kind when possible. Money has been in short supply with the cuts in Medicare so we have been tightening our belts as much as possible. I'm not sure what the future will bring but we can't sustain ourselves in the long run as we are currently constituted.

Live long and prosper.

Spock

[Richard B the EMT]

FDNY EMS bills the 3rd party insurers of the patients first, as in Blue Cross, GEICO, Medicaid, Medicare, or other private and public health insurers, then goes after the difference, if any, from the patient or their family. If no insurance, the bill goes directly to the patient or their family. If they cannot pay, or fell off the radar, NYC taxes handle it. (We have some kind of allowances for paying on time)

NYC usually does not do direct from the scene to hospital Medevacs. If the patient is flown anywhere using New York City equipment, specifically the helo, the transport is done with an NYPD helo, and an FDNY EMS EMT or Paramedic riding along. NYPD does NOT bill for medevac services provided, but I don't know if FDNY EMS charges for the ride along EMS member.

[Ridryder 911]

Mine is set up as a non-profit trust. They do receive a minor county 911 tax revenue (about $30,000 or so a year) as well as we have a membership that does not generate much anymore. The main payer is the usual billing which is Medicare/Medicaid and the usual Insurance payers. We have an above collection rate, especially in comparison being of the urban/rural setting.

I have to admit my administrator and the billing people try to stay abreast of the daily changes. It is hard to make it in EMS and most EMS Administrators lack healthcare administration education and background.

R/r 911

[andrean678]

I work for a non-profit town service. The town does not pay through tax dollars, but we do a subscription drive every year. Also, through billing (as little as that may be). One thing that holds us down is our service bears the town name and some residents do not realize that they are not paying through tax dollars.