City Council expands EMS billing

Published 11:46 am Wednesday, April 25, 2018

Franklin’s Department of Emergency Services will now bill for incidents in which a person is treated on-site by EMTs but declines transport by ambulance to a hospital. This policy change was enacted following a 6-1 vote by the members of Franklin’s City Council on Monday evening.

The request to change the city’s EMS billing policy came from Emergency Services Chief Vince Holt on behalf of the department. The reason Holt cited for his request was so that the department could take advantage of a recent policy change by Anthem/Blue Cross, one of Virginia’s major health insurance carriers. Anthem had announced in late 2017 that it would begin covering EMS bills for treatment without transport effective Jan. 1.

“Insurance companies are starting to realize that that type of call, it makes sense for it to be billed,” Holt said. “They don’t want to penalize the local EMS agencies because the patient refused to be transported.”

Holt added in 2017 the department had billed a total of $458,150 for ambulance services. Based on the call volume Franklin Fire and Rescue received that year, the new “treat without transport” billing option could bring the department an additional $48,640.

“That’s still a lot of money we’re letting get away,” Holt said.

Holt also recommended that the city increase what it charges for basic life support, advanced life support and the per mile fee for transport by ambulance. He recommended increasing the basic life support fee from $300 to $400, the advanced life support I fee from $400 to $650, the advanced life support II fee from $575 to $800 and the transport fee from $8.25 per mile to $10.25 per mile. The reason he cited for this recommendation was to put the city more in line with neighboring localities and to bring in more revenue for the department.

The revenue from these changes and the new charge for treatment without transport, he said, would total around $278,190. He argued that this would help the city be able to pay its EMTs salaries that were more competitive with neighboring localities.

“Suffolk is offering a salary of $40,328 for a recruit firefighter, no training,” Holt said. “And all they will come out with is an EMT-basic [certification.] Our advanced life support providers, who have been through Firefighter I and II and EMT-basic, and have spent 18 months as an EMT-intermediate, we’re paying $39,802.”

The council’s vote on Holt’s request to increase the cost of treatment and the per-mile ambulance fees also was 6-1. The dissenting vote on this and billing for treatment without transport came from Councilman Greg McLemore, who said he could not in good conscience vote for anything that would increase costs to citizens.

To address the potential increase in costs to citizens, Holt also discussed the possibility of implementing an EMS subscription service for Franklin residents, similar to what Isle of Wight and Southampton counties already offer their residents. The subscription would allow city residents to voluntarily pay $60 annually and in exchange, not have to pay for any subsequent EMS services they might need that year. The $60 would cover every member of the subscriber’s household.

Following Holt’s presentation, the council voted unanimously to direct him to draft a proposal for the subscription program and to bring it back to the council during a future meeting.

Holt also suggested that the city become more active in pursuing the collection of unpaid EMS bills. Currently, the city only pursues “soft collections,” this meaning that it sends up to three reminder letters to those who have outstanding EMS bills but takes no action beyond this. The council took no action on this suggestion.

The final action the council took that evening with regards to the city’s EMS department was to fund a salary increase for paramedics — the highest level EMT certification.

Currently the average salary of a certified paramedic in Franklin is $43,606. The raise will cost the city approximately $69,558 and result in a new average salary of $51,855.

City Manager R. Randy Martin estimated that the additional revenues the city would gain from the new EMS treatment rates and per mile ambulance rates would be sufficient to cover this cost for the coming fiscal year. He added that since only about two months remain in the current fiscal year, the cost to the current year’s budget would be minimal.