Funding for EMS services

[Janmarie3]

Hi :-)

It's been awhile since I have been here. I think the last time I was here I was an EMT basic. Well now I am an EMT-Intermediate. Yea!!! But I currently quite my Ambulance service and moved to a bigger city. Still in Northern Idaho but finally out of Podunkville :-)

I took a different career path. I love EMS and it is truly in my heart and blood. I love being able to give back to the community for the so many of my teen years where I took from it. Long story but very interesting non the less. I am in the process of writing a book about that.

Anyway......I took on a different approach in the EMS world. After being in this field for 4 years, working my butt off 96 hours a week and working very closely with the ins and outs of it. (Not that I know everything) but what I did experience was the hardship of trying to keep an Ambulance service in operation. Especially small, rural, private ambulance services. Trying to get grants are a pain in the arse and so many that we applied for were denied for what ever reason....not a good enough reason as far as I am concerned. Trying to staff volunteers was a challenge because they all wanted paid. Not that I blame them at all. This industry is in such high demand that one should get paid for doing what they do. Putting up with what they put up with. But we all do it anyway....God bless the volunteers out there.

I saw and still see this hardship and the many challenges that all aspects of EMS is faced with on a daily basis. Funding is the big one and it is hard for a volunteer service to get a bank loan, which only solves the short term problems such as buying equipment, if one should be so lucky and be approved for a loan. But it doesn't solve the ongoing recurring problems that we face.

Lack of funds.......

When I was researching grants for EMS and what was actually given out to this priceless service, I was appauled. Very little was given to us. Guess where most of the government grant money was given to? It makes me to mad to even say.

Not only that but having to wait 60 to 120 days to get any kind of money from Medicare, Medicaid and 3rd party insurance companies is bogus. Plus these insurance companies have put into place strict compensation guidelines. Basically telling us that we will recieve less money for our services and we have to wait longer to get it. That just totally sucks!! Some Ambulance services can't afford to wait that long. Operating expenses remain the same or become higher especially when fuel prices sky rocket. We still have to pay our employees, office rent, electricity, phone, etc... Plus our medical suppliers. For some EMS services this threatens thier ability to stay in business.

Since EMS is my life and I know some of the needs and concerns that we face, I wanted to do something to help keep this much needed service running strong.

So what I have done is involve myself with helping the EMS service with funding problems and found a solution. Yes there is this awesome solution to keep our EMS service in business and growing. :-) Many services have already taken advantage of this funding solution and are growing. I wanted to let you all know about it because I can't find any other way that I can be of more help to the industry that I love so much.

I have access to "UNLIMITED" money for EMS, trauma centers, medical offices, medical supply companies and so on and I want to give this money to Emergency services who need it and need it now.

Have you ever heard of factoring?

Factoring is a very simple process of selling your invoices or account recievables. What this does is provide you with advanced payment on your outstanding accounts, medicare, medicaid, etc. You get the funding you need and we wait for the insurance companies to pay us. We can afford to wait. This provides the EMS services with an ongoing financing and relieves the stress of a struggling EMS service of not knowing when or how much they will get paid.

Medical recievable factoring allows your EMS service to sell their claims and recievables to me. I buy them at a small discount and pay with emmediate funds to help EMS meet their business expenses. By giving this money to you, you can concentrate on expanding your service and never have to worry about waiting for your money ever again or trying to write the perfect grant proposal and get denied anyway. You can factor or sell as much revenue as you can generate making this a great financing tool to grow with this extremely high demand industry month after month.

I hate calling it an industry because it sounds so impersonable but that is what it is..

This is the best funding solution that I have found, and believe me I have researched for some time now for funding for my own service. This was the one that we didn't have to worry about getting loans that have to be paid back, or get denied for grants. We had such a hard time getting a grant for those hydraulic stretchers. We were only granted one and we needed two. It's just not right...EMS deserves better then that.

If you would like to comment on this I wouldn't mind...if there is a need in your service, please let me know. Share the challenges that you face in your funding research. I want to help in anyway that I can to see to it that EMS is properly funded.

Just call me the "Human ATM machine." I have unlimited funds to give to EMS. If you think this could help you, just leave me a message with your email address and I can explain a little more about my new venture in the world of EMS :-)

Oh and Admin, if this was inappropriate to write this here, please let me know and maybe you can give me some insightful ideas as to how I can get the word out that I have money...lots of money...unlimited amounts of money to give to EMS.

Thanks,

Janmarie

[flight-lp]

I would caution using terms such as "human ATM machine" and "unlimited funds. They are a little misleading..............

Factoring is not the miracle answer. Especially in a rural environment. In fact, I personally view it as another financial venture out to make a quick buck. Why would you pay someone to get today what you could have in less than 3 months? Most of these agencies charge up to 10 % and require a repay within 90 days. If your current billing practice does not allow for a less than 90 day return, then factoring is going to cause you even more problems as you will then not have the funds to repay. AND THEIR LATE FEES AND PENALTIES ARE OUTRAGEOUS! A quality and efficient billing company can generate a better return, for less money, with less risk and liability.

A pose another question for you.........

How are you going to pay back the advance when you have a higher percentage of uninsured, underinsured, or government assisted (M-care / M-caid) patients in a rural environment? It is prohibited by Congress to factor Medicare or Medicaid payments. The lenders get around this by taking assignment of the rights of payment (very risky and has the potential for M-care and M-caid to deny your agency any future claims as you are no longer taking primary assignment). Some states do not even allow this to occur. I strongly urge any agency to retain the services of legal council to determine whether or not your state regulation allows this.

In short and summation, there are too many "shady" individuals out there trying this and people are bound to get burned....

Please do not take this personally Janmarie, I in no way mean to implicate or insinuate your intentions, but this is not an answer for all.............

I still hold solid the belief that funding can and should be generated through community taxation. There is no reason whatsoever why EMS services should be free. Generate some funds from your community, then pay your medics. Show the community the level of professionalism that you can offer them through solid tax funding, paid professional employees instead of unhappy volunteers who devalue themselves and, as an old wise man recently stated , devalue their service. Tax funds are predictable and solid, no risk is required, and it will also help generate some "cushion" funds in the case of the uninsured / underinsured. Tax 'em, period end of story.

[flight-lp]

Here is an interesting article concerning factoring.................

http://www.allbusiness.com/business-financ...e/260966-1.html

[Janmarie3]

Understanding your concerns and we all have asked these questions. We have licenses in all states to fund the medical health industry. There is no problem there. I do encourage your research though. I have done plenty of it.

No offense taken...

Unlimited funds is the ultimate truth that is why I claimed it....I have over 160 financiers who are wanting to help the health care industry. So when I say unlimited....it truly is unlimited.

The thing about buying account receivables is that it isn't a loan, it isn't something you have to pay back like you would if you received a loan from a bank or lending institution. The accounts have been bought, you have been paid up to 85% of your total accounts within 24 to 48 hours. This is a one lump sum check that allows you the ems agency to do as needed to build it up and keep it running strong. We take your accounts upon ourselves and our billing company takes over. We can afford to wait 60 to 120 days, most agencies and private health care providers can't. My main goal is to help EMS and the medical industry because I feel we are taken for granted and not just by the government but county and state do not realize how important we are to our communities. Where I worked as an EMT we were cut $25,000 in grant money from our own county. That put a huge strain on keeping us going. That was when I took it upon myself to search out different ways of getting the funding that we needed. I found so very few and unless you have an excellent, creative grant writer, trying to get any kind of grant from other sources outside ems is next to impossible. Check out how much money was granted to ems by your own state. It is sad.

Now a state run EMS service is much different then a private or non for profit agency as far as what they allow and what they don't. An agency who does their own billing and has to wait 60 to 120 days for payment is very hard. The monthly expenses for that agency are paid late, the agency may have a line of credit with a supply company which is good, but also has its limits as to how much credit they give to an agency. So when there is a bigger demand for the agencies services....the line of credit remains the same.

There are many types of factoring available to many types of contracts and notes out there. From morgages to life insurance policies. We love to help finance the small business owner because they are the heart of America. We see it dieing as more big corporations move in and shove the little guys out.

It is no different for the health care industry.

Thanks for your comment though, I encourage more input. Especially from those who have taken advantage of factoring account receivables.

[Janmarie3]

Here is a website grfundingsolutions.com

This is pretty much about the whole wide world of what we finance. The medical health care portion is not so detailed at this time because no one else had a passion for health care the way I do. I am currently working with them to add more to that portion of the site.

But they still have a heart of gold and want to help finance the EMS and health care industry.

A lot of things have changed since the 1970's, mostly the legal aspect of it and we abide by all state legal aspects. And like I said we are licensed to purchase and finance.

This isn't for everyone and some agency may not need our help. That is great. But some do and that is why we are here.

[flight-lp]

Example ALS transport - $1,000

15% fee to lender - $150

Loss after 100 claims - $15,000

--OR--

You could keep your $15,000

--PLUS--

get tax money to infuse into your budget.

Take the $.03/$100 taxation which is common here in the Houston area.

For example, if you have 20,000 people in your county / city / whatever and the average home is $100,000 (low ball figure), then their tax would be $30 per year. There is no reason in the world why someone cannot pay $30 / year if they own a home. Take your total from all 20,000 residents and you now have a budget of $600,000.

Not too shabby........................

Beats losing 15%...........................

[medic001918]

If you're able to collect on these accounts in 60-120 days, what's preventing a service from being able to collect themselves and saving the 15%? Once a service is established, their collections are always 60-120 days behind which should lead itself to be a steady cycle. I personally don't really see the benefit of this service other than not having to handle the collections process on their own. I think the service would have a better financial result using a true billing service instead of selling their accounts for a 15% discount so someone else can make 15% a 15% profit on the billing. I'm just not seeing where the benefit lies in this operation other then to the people buying the accounts to make the extra profit. Either way someone has to collect on the bill itself, and in this case it should be the serivce that collects the full bill. Not someone else who bought the account at a significant discount (which 15% or so is significant).

Just my two cents.

Shane

NREMT-P

[Janmarie3]

That is all great if an agency can wait for what drizzles in after 60 to 120 days. But if you have worked closely with your billing dept. You can see Insurance companies are giving you less pay. Not to mention the complexity of the billing process, the coding and rules that create very long payment cycles. An Agency takes what they can get, they have to, there is no choice in the matter when dealing with insurance companies. But also one thing I have come across is that when dealing with the coding. It doesn't match up with what is actually in your books. What I mean is....you could be getting less from the insurance companies then you actually think you are getting.

Insurance companies are designed to protect the patient. Which is great, at least there is something coming in for the agency. But sometimes it isn't enough or it isn't when you need it the most.

You have to except what they will give you....where is the rest of your due money going to? The government? The insurance companies pocket? And for what? What has the insurance company done for you that you should pay them the percentages that they take away from you? And then turn around and make you wait for it? You are basically financing the insurance company.

What drizzles in from the insurance companies could be given to you in one complete payment. You don't have to guess when you will get it....you don't have to guess at how much you will be getting. And it isn't something you have to do every month unless you need to.

Most cities and counties have a 911 tax, or a percentage of their property taxes going toward EMS. But here again you fall under the waiting game and you only get what your county allows you to have, that is split between every other agency in that county. Not one Agency is getting that $600.000. There are the hospitals and trauma centers, Dispatch centers, police, fire, Air transport companies, etc...and if its a big city with many ems agencies....there really isn't a whole lot going to the ones that need a new Ambulance, a new stretcher, more supplies, fuel bills and so on.

Ever see one of those shabby looking ambulances coming through your town on their way to the ED? Yeah, those are the ones I am talking about....the forgotten ones.

There are counties around here that a paramedic is forbidden to go into because that county won't pay or grant anything for EMS. The County the Paramedic is coming out of won't pay him to go into the other county. So what does that do for the people who need a paramedic in that county? They suffer for it.

But just as there are many financing potentials out there. You have to pick the one that fits your need the best. If you don't need it...then there isn't a need for it for you. Those that do need it....it is here. :wink:

[flight-lp]

Actually the $600,000 figure is for the one and only EMS agency. Fire is taxed separately at a rate up to $.10/$100. I can understand your frustration with money issues, but it sounds like your experiences were within departments with little or no budget savvy knowledge. Regardless of your revenue, an annual budget should be in place for operating costs, including payroll. Bills shouldn't be late, and there are many proactive methods to prevent such a thing. Having to lose money to "get it immediately" is not good business, period. Enough said from me, good luck with your new business, I hope it brings you the return you are looking for.............................

[Janmarie3]

There should be better budgets put into place and in most cases there is. But even with a good budget there are still many challenges. The rural and private operations face many different challenges then a state run agency, or bigger city with higher volumes. It would be hard for one to totally understand these challenges if not directly related to it. And believe me, the bake sales and boot drives really don't make up for a whole lot of the expenses. Just as with being an EMT, I was never in it for the money...what money? But for the people just as I am with this.

Thanks for your comment though :-)