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EMS to continue billing out services

Rick Patrick

Greene Publishing, Inc.

During the Wednesday, Sept. 14 regular meeting of the Madison  Board of County Commissioners, a discussion took place regarding billing for Emergency Medical Services (EMS). Currently the County EMS responds to approximately 300 calls every month. Of those calls, 200 patients are actually transported to a medical facility. Of those 200, about 150 are patients who have insurance, either Medicare, or another insurance carrier. That leaves roughly 50 patients who are what are considered private pay patients. Of those 50 patients, about half will attempt to pay something toward the EMS bill and about half will never pay anything on their bill.

The county has had a contract with the company, Intermedix, to provide billing services for the EMS system. For a fee of 7.5 percent of the EMS charges, Intermedix bills the patient’s insurance company and related administrative duties. In the past, there has been dissatisfaction with the level of service provided by Intermedix. So, the county commissioners decided to explore options regarding finding another company to do the work of billing for EMS. The county’s contract with Intermedix is set to expire on Friday, Sept. 30. The board also considered the option of doing all billing “in house,” by using local EMS personnel.

At a specially called meeting of the Board of County Commissioners on Monday, Sept 19, the Board heard a proposal from a representative from EMS Consultants, another company that provides billing services for EMS systems. The EMS Consultants representative informed the board that his company be able to provide full billing services for a fee of 5.25 percent of the EMS charges. If the Commissioners decided to move billing “in house,” EMS Consultants could provide the necessary software and hardware for an up front price of approximately $25,000. One drawback to this option would be the time needed to complete training of local personnel. It would take longer than the time remaining on the Intermedix contract to adequately train the local personnel. At the end of this meeting, commissioners asked that a contract be drawn up for EMS Consultants. The board would consider the two options of having EMS Consultants take over EMS billing as a third party or the board opting to move the EMS billing back in house. Another special meeting was called for Wednesday, Sept. 21 at 5:30 p.m.

Details for the two options considered by the Commissioners were:

A: EMS Consultants would provide

ambulance billing and collection.

5.25 percent fee vs. 7.25 percent currently with Intermedix.

Cost for services decrease from $67,500 to $47,250. A savings of $20,250 (30%) based upon $900,000 collections.

Services may include patient charge for non-transport.

Contract includes legal support.

Adherence to healthcare billing laws and regulations.

No up-front costs or fees for software and equipment.

Supports transition from Intermedix.

Customer friendly with many satisfied customers (including several counties like Madison).

Everyday billing.

Less chance of revenue loss with a professional team.

B: County EMS in-house billing.

$25,000 up front cost for software and equipment.

County assumes all liability.

Additional postage/office supplies.

Probable longer period to achieve acceptable collections after Intermedix contract expires.

Add charge for non-transport.

One employee dedicated exclusively to billing and collections.

After consideration, the board voted 4-1 to sign a contract with EMS Consultants to provide billing services for the Madison County EMS system. The dissenting vote was cast by Commissioner Justin Hamrick, from District 1.

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