Fire companies weigh ambulance billing plan County would collect cost of emergency services from health insurers


Carroll County's volunteer fire companies will meet tonight to discuss a county proposal to bill insurance companies for ambulance services routinely covered by health insurance providers.

If members of the county's 14 volunteer companies agree, Carroll could collect $2.1 million or more a year from insurance companies for providing emergency medical services, according to county budget supervisor Ted Zaleski.

The seven-point proposal calls for the county to administer the program and pay each company "dollar for dollar" the revenue generated from emergency calls.

The Carroll County Firemen's Association, which represents the companies, will meet at 7: 30 p.m. at the former emergency operations center in Westminster to discuss the issue.

The firefighters are scheduled to meet with the County Commissioners Thursday.

Residents would continue to receive free ambulance service, but their insurance companies would be billed.

No one seeking emergency service would be turned away for lack of insurance or ability to pay.

If the program does not generate sufficient revenue to cover each company's ambulance service costs in the coming fiscal year, the county would make up the difference.

Currently, the county funds 90 percent of fire company operating budgets; the departments make up the rest through fund-raisers. Fire companies also raise money for buildings and equipment.

The idea of billing for ambulance service is not new, and some fire departments began billing insurance companies last year, said Art Frotton, president of the Carroll County Ambulance Association.

"It's done in many places, and there are some nearby counties that do countywide billing," he said. "It's part of a person's insurance, and people don't know it. Ambulance service is expensive, and it gets more expensive as the technology improves."

When looking for additional funding, Frotton said, it is logical to look to insurance companies, because ambulance service is typically included in health-care benefits.

Four companies -- Union Bridge, Westminster, Pleasant Valley and Winfield -- charge for ambulance service, working through a billing company that sends a bill to an individual's insurance company, Frotton said.

Some companies that don't charge send letters asking users for donations.

In 1997, emergency medical service units responded to 8,150 calls, which would have led -- counting multiple persons injured -- to 14,000 billings, Larry Wiskeman of the county Office of Performance Auditing told the County Commissioners last week.

The cost per call ranges from $600 for advanced life support to $250 for basic life support, he estimated.

Revenue projections for the county are based on a 60 percent collection rate; administrative costs could range from $75,000 to $104,100.

Frotton said he hoped there would be set fees established for ambulance calls, but that hadn't been worked out.

"This hasn't been fully researched yet," Frotton said. "There is a billing committee working on this to make sure that whatever occurs would be the best for the citizens and the responding fire company."

An independent committee has been looking at how the county provides ambulance service, especially advanced life support (ALS). One idea is to add paid ambulance crews at all stations nights and weekends.

"We have so many calls, and it gets to be a drain on the volunteers," Frotton said. "There are times when we might need additional help, so we're looking at paid people other than from 7 a.m. to 5 p.m. weekdays."

Currently, all stations except Harney and New Windsor have paid ambulance crews weekdays. Westminster and Sykesville have some night crews that are paid by the companies, Frotton said.

The weekday paid ambulance crews are paid from the money the county gives the companies for operating expenses.

One study recommendation was to pick out several "hot spots" around the county to provide 24-hour coverage based on the number of calls received and the times when they were received, said Bob Alexander, Firemen's Association vice president.

The association used four locations on a trial basis for 24-hour coverage -- Sykesville, Westminster, Manchester and Taneytown.

"The reason was to try to cut down on the amount of time it takes to get ALS to the patient in situations when a station doesn't have an ALS provider," Alexander said.

For instance, if Union Bridge received a call for ALS and didn't have a paramedic available, Taneytown would be alerted. Alexander said during the trial period, response times were cut. The association would like to continue with the plan, he said.

It was suggested that the extra funding for the 24-hour ALS providers could come from the insurance company billings.

Another issue for the Firemen's Association is reviving the position of liaison between the county and the firefighters on a contractual basis. The position was cut about three years ago.

"That was cut about three years ago, and we want it back on a contractual basis with us, not as a county employee," Alexander said. "The association voted unanimously last month that they wanted that position back."

Pub Date: 5/04/98

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