Budget a little tight? Looking for extra revenue? Do you bill for EMS transport? Many fire departments or districts have historically done EMS transport without charging a service fee. I know of one community where there is no charge for residents and a $50 transport charge for non-residents. Insurance companies certainly love these fire agencies. In most cases, a citizen's private insurance benefits provide for EMS transport. Not collecting is merely making the insurance company richer. At the minimum, fire agencies should at least be billing an ALS or BLS base rate and mileage. Unsure what you should be billing? Get a copy of your area prevailing profile from your Medicare carrier.
Am I advocating turning fire agencies into for-profit organizations like the commercial providers? No, to the contrary, I am merely advocating placing the cost of your services provided back to the end user and lessening the burden on the taxpayer. In essence, this constitutes cost-shifting and shows that fire agencies can be cost-effective and efficient. And unlike our commercial counterparts who send the proceeds to the shareholder, fire agencies traditionally revert the funds back into our organizations for new equipment and better salaries to retain quality people.
The Annapolis Fire Department (MD) is looking into the possibility of charging for the EMS services they provide. Captain Dale Crutchley who heads the department's EMS tells me, "if you look at it objectively, the citizens are paying for the service twice. First, they either pay premiums to insurance companies or taxes for Medicare and Medicaid, plus they pay taxes to support the fire department." Conservatively, AFD is expecting to collect over $100,000 a year if the proposal is accepted by the city fathers.
Last year in a column I mentioned that Lufkin Texas Fire Chief Fenton (Pete) Prewitt was not only doing emergency transports, but had also entered the routine transport market. One year later, the report card is in. Chief Prewitt reports that his department generated $1.2 million in revenue and turned $175,000 back to the city to be put into general revenue for other city services. Chief Prewitt can be reached at 409-633-0367.
To accept or not accept assignment! Medicare Part B! All inclusive or flat-fee structure! Are you worried about the different rules, applications and criteria from more than 1,200 possible payers? Just contract it out to a collection agency that specializes with medical payments and sit back and open the envelope with the check. Many of these collection agencies can also help you to negotiate managed care contracts. In essence, you need to position yourself with the managed care of the future.
In a bizarre story, two AMR paramedics in California were suspended from their jobs for trying to market trading cards with grisly photos of battered corpses. The paramedics had 3,000 nine-card packs called "Cards of Death" which sold for $8.95. As reported by the Associated Press, Chuck McFadden, a spokesman for AMR-West said, "Paramedics are in the business of saving lives, not profiting from death. This just flies in the face of what this company and its paramedic employees are all about." Ironically, a week earlier AMR announced record profit earnings of $24.5 million for their shareholders on $483.8 million gross revenue in 1995.
Mr. Ed Crandall of California would also beg to differ. He claims the bill from AMR is what made him sick. As reported in the San Jose Mercury News, AMR was called to the Morgan Hill medical office building when Crandall felt woozy. The AMR medics rolled him in a wheelchair next door to the emergency room of Saint Louise Hospital. The next day, another AMR ambulance crew transferred Crandall to O'Connor Hospital. The cost from AMR for the 5 minute wheelchair ride was $596.25 and $1,119.11 for the 30 minute ambulance transfer. Maybe Mr. McFadden would like to rethink his statementract his statement about what AMR is really all about.
(Ed. Note: the views and opinions expressed in the above article are those of the author or the International Assn. of Fire Chiefs. They are not necessarily those of the EmergencyNet News Service or the Emergency Response & Research Institute. Please refer all comments, suggestions, or questions to Mr. Ludwig at the addresses listed below.)
Gary G. Ludwig is on the Executive Board of the EMS Section of IAFC and is the EMS Chief for the St. Louis Fire Department. He can be reached at 314-533-4175; fax 314-289-1977; AOL at GaryLudwig; or LUDWIGSTLFD on ICHIEFS.