Another FD realises the hard way that EMS isn't a cash cow

[Dustdevil]

Idiots.

http://www.ems1.com/ems-management/articles/807425-Maine-officials-write-off-delinquent-ambulance-fees/

Maine officials write off delinquent ambulance fees

Residents who can't afford medical services urged to contact fire chief to discuss hardship waiver

By Melanie Creamer

Portland Press Herald

WINDHAM, Maine — Town councilors decided Tuesday night to write off some of Windham's $224,125 in unpaid bills for ambulance service and hire a collection agency to chase down delinquent accounts dating back to 2006.

The fees are owed by nearly 500 people who have not made payments. Councilors debated whether to write off the entire sum, send it all to a collection agency or send a portion of it to a collection agency.

Some of the accounts go back as far as 1998, said Brian Wolcott, the town's finance director. He questioned whether it would be fair for a resident to be billed for services after 10 years with no communication from the town.

The council voted 7-0 to send all unpaid bills dating back to July 1, 2006, to a collection agency. The rest will be written off.

Town Manager Tony Plante said people who can't afford to pay their bills will be able to fill out hardship waiver forms.

''There hasn't been a consequence for not responding'' in the past, Plante said after the council's vote. ''We need people to respond with insurance information, a payment, or a hardship request.''

The town has a contract with Medical Reimbursement Services in Windham to bill insurance companies and collect any unpaid fees. Company Vice President Shawn McPherson said in an interview Monday that patients who don't have health insurance can make payments of as little as $5 a month toward ambulance fees.

The company sends patients six billing statements, including a hardship request form in the last statement. Following Tuesday's vote by the council, the company will send unpaid bills to a collection agency if patients fail to respond.

Former Town Councilor Liz Wisecup spoke against the proposal to send unpaid bills to a collection agency. Wisecup was on the council in 2006 when it cleared another $227,000 in unpaid fees from the books.

Wisecup argued that if unpaid bills were sent to a collection agency, residents would likely take a car to the hospital instead of being charged about $400 to be transported in an ambulance. She told councilors that it's unfair to change the rules on residents.

Council Chairman William Tracy urged residents who can't afford medical services to contact Fire Chief Charlie Hammond to discuss a hardship waiver.

''We would be happy to help people work through that process with dignity,'' Tracy said. ''I wish no one had to use an ambulance. I also wish we had all sorts of money to pay for this. The reality is that this costs money . . . and we need to do something to make sure that we have the essential services to cover the town.''

Edited April 16, 2010 by Dustdevil

[Kaisu]

Wisecup argued that if unpaid bills were sent to a collection agency, residents would likely take a car to the hospital instead of being charged about $400 to be transported in an ambulance.

Required reading for fire chiefs everywhere looking to increase revenues. We have idiots here in the BANKRUPT FD bragging how in 2 years us private ambo gurney jockies will be out of jobs because "we don't even have to challenge the CON - we are the FD and we will get it just by requesting it."

[Medic One]

we are the FD and we will get it just by requesting it."

Unfortunetly depending on the town or city that statement is close to true....the justification for the "20Year" plan or what ever to replace equipment always seems to pass on a "10Year plan". Most FD's do get what they want but having a collection agency go after people after 7 years can happen but after 10years you don't have to pay if there is no contact from the original billing agency.

The other thing is you can still get harrassed for the money but if I remember Medical Bills will not show up on your credit report. I think the town just needs to raise taxes then to cover the costs and not charge at all. There are ways around the funding issues...threaten to cut school costs or raise fees to play sports and see what an uproar they can create.

Its too bad that the service is loosing money but once again it is a medical service and you can NOT refuse to transport someone because they can't pay.

One other issue is are these medical calls only or MVA calls. 90% of all MVA calls the drivers have car insurance...spend the 3 minutes to get the car insurance info and it will be paid in full if they have medical coverage on the auto policy. Standard practice for us is get auto info our billing submits it and we get paid in full 90% of the time.

[Richard B the EMT]

FDNY usually doesn't charge for members injured or sick while on duty, but somehow I must have slipped through the cracks. I was contacted by a collection agency after a year and a half. A month and a half of debate, and the issue was finally resolved.

[Dustdevil]

Here's another bit of news for any city/county thinking they can make money if they give their EMS to their firemonkeys:

http://www.ems1.com/legislation-funding/articles/814599-EMS-costs-far-exceed-revenues-in-Fla/

May 02, 2010

EMS costs far exceed revenues in Fla.

Jumps in property tax rates for emergency medical services range from 18 to 47 percent

By Anne Lindberg

St. Petersburg Times

PINELLAS COUNTY, Fla. — The Pinellas propery tax rate will almost certainly go up next year to pay for increased costs of emergency medical services.

That's the one common factor in four options staff members are scheduled to present to the County Commission during a Tuesday workshop. The proposals show the jumps in property tax rates for emergency medical services ranging from 18 to 47 percent. The lesser tax hikes would be offset by increases in ambulance fees, a reduction in reserves, or both.

The proposals are designed to make up an estimated $13.6 million shortfall between revenues and the expenses of the EMS system.

Option 1: This would maintain four months of reserves and leave ambulance fees at their current level, which average $473.73 for the county. But the EMS property tax rate would jump by 47 percent, or add $39.99 to the tax bill for a home with an assessed value of $170,000 with a $25,000 homestead exemption.

Option 2: Would maintain reserves, increase ambulance fees by 10.15 percent, or about $48, per ride. Taxes would go up 43 percent, adding $35.93 to the tax bill of the $170,000 home.

Option 3: Would reduce the county's EMS reserves to a three-month cushion, leave ambulance fees as they are and increase taxes 22 percent, adding $18.97 to the tax bill of the $170,000 home.

Option 4: Would reduce reserves to the three-month level, increase ambulance fees by 10.15 percent and property taxes by 18 percent. That would add $14.91 to the property tax bill on the $170,000 home.

A tax increase to pay for EMS has been a likelihood since last year, when the county dipped into reserves to pay for higher costs without raising taxes. Officials said then that could not be done a second time. And earlier this year, Pinellas County Administrator Bob LaSala told the St. Petersburg Times editorial board that an increase was likely.

An increase in taxes seems to be almost unavoidable now with property values expected to decline by about 12 percent from last year. Budgets submitted by the county's 18 fire districts had an increase of about 5 percent, or $1.9 million.

The requested increases included no new positions or units, but came mostly from higher salaries and benefits for paramedics. County figures show the average EMS-funded paramedic will earn 4.3 percent, or $2,098 more, next year than this year. The average increase in benefits will be about 12.12 percent, or $3,803 more than this year. That makes for an overall increase in compensation of about 6.3 percent, or $5,901.

At least one county commissioner said he is willing to look at a tax increase to fund the county's EMS system.

"In the context of falling property values it is not a tax increase," Welch said. "I think at some point you have to look at do you have a sufficient revenue base to fund services at a sufficient level?"

Referring to requests for funding increases, Welch said that each would have to be individually vetted and that necessary streamlining would have to take place.

But, Welch said, "the question becomes, if those are legitimate requests, how are we going to fund it? At the end of the day, though, with a reduced property tax base in the county, we're going to have to look at what to do on the revenue side of it."

That's a solution for the short term, he said. The longer-term solution could involve a revamping of the entire system.

"Some sort of consolidation," for example, would "have a lot more efficiencies," Welch said.

That's a topic that has been much talked about throughout the years but has never taken root. But now might be the time, Welch said.

"At some point, the economics drive us to looking at the system with a fresh pair of eyes," he said.