Volunteer squads billing patients

[PRPGfirerescuetech]

You CAN bill and not lose your not for profit status. Just set your rates as high as Medicare standards will allow. Then, bill the patients' insurance. Once the insurance has paid what it will, write off the rest and don't agressively bill. That way you can still bill and not lose Non Profit Status.

Um, why?

Fact: You can bill patients under and keep your non profit ststus.

Fact: You can bill insurances and keep your non profit status.

Fact: You can bill patients for refusals and no move calls, and maintain your non profit.

EMS hit the nail on the head. Non-profits are measured by fiscal year on profit and loss, and cannot show a profit bigger than (insert varies by state figure here)

Now that the silliness is out the way...next post.

[PRPGfirerescuetech]

Let me warn you.

You can !!!!!NOT!!!!! start billing.

Let me explain why.

You are in NJ so your situation is unique. What the other posters don’t understand is that here in NJ there is something called the volunteer training fund. That is what enables you to get your free training/CEU's. You can only get this if your squad does not charge at all. Not even just insurance.

There is also allot of legal benefits and protections written into NJ law that protects a volunteer FAS, but you lose them as soon as you bill anything.

There was an article in Gold Cross about 2 issues ago listing what you stand to lose by switching. I will try to find it and post it.

So if you want you can start billing, but you lose allot, and the amount of money you gain usually wont be worth it. What your town could do is what allot of other town do (mine included): Have a two tiered system. During the day there is a paid squad. It has to be a separate squad (in our case, it belongs to the local PD) they can charge, and they aren’t eligible for all the protections. At night the vollys run, and they dont charge.

Where are you getting this information? The reason EMS is failing in NJ is because of tainted views like yourself stopping people from being able to set up bundle billing agreements and get paid.

Please clarify as well your statement about how its not worth billing patients upwards of 60k per month or more of billable transports because in NJ, they will give you free CEU's?

Are you CEU courses in NJ expensive enough to warrant losing 60k in billable monthly calls?

Get the volunteer wanker out of your head and get real. This is a business, and without billing, you fail.

[Just Plain Ruff]

What about seeting up a membership program. There are lots of those out there. I'm sure you can find the information you need or just call MAST Ambulance in KC MO they have a membership

the citizen pays a set amount a year for his family. Thsi covers every ambulance call they require. The insurance or membership covers the cost of the ambulance.

What I find funny is that we think healthcare is free. It aint. But we think it should be.

you can maintain non-profit status if you put the money gained back into the service and not put it as a profit.

that's the extent of what I know about non-profits.

New Jersey is a different animal if I read it right in the past posts on this forum.

There has got to be a way to find this information out for y ou all.

[Rescue0ne]

Virginia...

Our squad is going to begin billing patients' medicare/medicaid, & private ins. w/in the next year or 2, in conjunction with our squad becoming part-paid. The plan is to not bill aggressively. Our county is small enough where everyone knows if someone comes from a family that can afford to pay out of pocket...so no, we aren't going to bill aggressively to the family on public assistance that lives in the projects...but we aren't going to take a loss and not aggressively bill the multi-millionaire down the street either. That's the plan, anyways.

Yeah, that's not a uniform approach. Hey, I'm an operations manager. that'll be left up to the folks in sharge. My billing experience is limited to paying for my kids prescriptions at RiteAid, CVS, Walgreens, or WalMart. Sue me.

[medic001918]

Virginia...

Our squad is going to begin billing patients' medicare/medicaid, & private ins. w/in the next year or 2, in conjunction with our squad becoming part-paid. The plan is to not bill aggressively. Our county is small enough where everyone knows if someone comes from a family that can afford to pay out of pocket...so no, we aren't going to bill aggressively to the family on public assistance that lives in the projects...but we aren't going to take a loss and not aggressively bill the multi-millionaire down the street either. That's the plan, anyways.

Yeah, that's not a uniform approach. Hey, I'm an operations manager. that'll be left up to the folks in sharge. My billing experience is limited to paying for my kids prescriptions at RiteAid, CVS, Walgreens, or WalMart. Sue me.

Sounds like a fair system to me...penalize the people who actually work for a living. Since everyone knows my family situation, that means that they also truely know my financial situation as well; right? Agencies that bill like that amaze me. The people who use the system more than anyone else when they tend not to need it end up not having to pay and this allows them to continue the abuse. You say you're not going to "take a loss" and not bill families that can pay for the ride. What if the call from the family on assistance or in the projects doesn't warrant an ambulance transport? Should the ride still be free? Now is all you've done is turn your service into a free vehicle for the family.

If your service isn't going to bill aggressively, then don't bill aggressively across the board. Don't make it a case by case situation. That's discrimination plain and simple. Just because someone's family appears to have money, doesn't really mean that they do.

One suggestion that was proposed at a service I work for is to bill patients insurance companies, and then request some form of donation in the amount of whatever they are willing to spend in order to take care of the balance. So if insurance will cover 50% of the cost, and you have a balance of $250...you can send a donation for $50 (if that's what you can afford) and the bill will be taken care of. If you choose to pay nothing, the bill stays in collections.

EMS will never further itself while be willing to give away it's services. This is true on both a personnel, and a service issue. Volunteers give their services away for free hurting the progression of the field as a career choice. And services that don't bill aggressively end up giving away their services which hurts their profitability and more important survivability since there are many day to day operational expenses that need to be covered.

Just remember that you can't walk into a car dealership and receive a reduced price because you can't afford the car you want. The price of the car is the price of the car. Why should EMS be any different?

Shane

NREMT-P

[Rescue0ne]

I didn't say it was perfect, now did I? ](*,)

There's no doubt in my mind that that issue will be addressed when the reps come to sit down with them. The whole billing concept is brand new to them, for the last 37 years they've been receiving donation/grants only. There's still tons of bugs to be worked out, before they can transition to career staffing.

[Medic716]

This sounds like a law- suit waiting to happen. Billing needs to be the same across the board regardless of whether a person has money or not.

If you have two folks being treated for the exact same thing and charge one person $5 because he is poor, but charge the next guy$30 because he has money, it might be considered in some states as price gouging and can have stiff fines attached to it.

[katbemeEMT-B]

I agree this could bring forth a law-suit. Discrimination based on economic ability. The way you get around that is to charge all patients the same but offer financial assistance with specific economic guidelines based on yearly income and number of people in the family. This is how the government determines who qualifies for assistance so it is definitely legal. You can set your qualifying rate at whatever you want.

I also am not from NJ, but it's sounds ludicrous to me that if you bill patients you lose your non-profit status. I think I would be investigating that a little (no, actually a lot) more. There has to be a way to maintain your status and still bill for services as long as you are not posting large profits.

[NNJEMT]

Some lower Bergen county (NJ) towns just implemented a third party billing process that generates revenue for the town to offset the town's funding a portion of the service. Sounds similar to others already reported in that insurance companies are billed, along with bills being sent directly to uninsured patients - however, there is virtually no follow up on unpaid, non insured bills. It was explained to me that if they only billed insured patients it would be considered some type of insurance fraud.

The ambulance "corps" remains not for profit and the members who are not being paid (paid day crews, volunteer nights and weekends) are still eligible for ceu training via the training fund ...

[EMT*Sweet]

OK I know about this. I implemented an insurance program for a Volunteer Service about a year ago. This service remains non-profit by stating that it is simply covering its running cost. We bill a persons insurance group and we accept only what the insurance pays. This is in every case. Once the insurance has paid its part of the bill the balance is set to zero so our patients or their families do not pay any out of pocket fees. We have to take a loss on PRT's due to the fact that we have to transport since we are paid by the distance from the scene to the ER. For those persons who present no insurance at the time of the run- our billing company sends a statement asking for insurance information. That is as far as it goes on that. Also, we accept donations for which we provide receipts. My intent is to make every transaction accountable.

For those who are just now in the talks of how it all can work PLEASE keep in mind that your system has to be one way for every case. May it be a resident, a family member of the resident or an out of town passerby. You cant make changes by the case. If you do then someone somewhere will figure it out and you will be up for discrimination.

Beside this we pay our EMS personell a certain "per run fee" This, as well, is legitimate and they are paying taxes on any money earned.

This facility struggled for years with financial matters. There simply aren't enough grants passed out or donations made to keep an EMS Facilty running. We have gone from the red to the green and it sure is a comforting feeling. My next big feat is to change this Volunteer Service into a Paid and competing service. It can be done but it will be a challenge. Even so I think our Guys/Ladies will step up to the plate and Make It Happen !! After all, The money in the bank is a direct reflection of the hard work all of the members contributed.

Put the right people in place and anything is possible. If there is a vision there is a way.

If I can help anyone with this let me know.