The cost of living: 9-1-1 calls aren't cheap

Posted: January 08, 2013

THE FIRE DEPARTMENT sends emergency responders to nearly every 9-1-1 call - without asking whether callers can afford the services.

So who pays for that costly ambulance ride and that timely medical attention?

If you have insurance - and paramedics correctly record your information - your insurance company does. If you are enrolled in Medicare or Medicaid, the federal government pays a certain amount, but city taxpayers cover the rest. And if you don't have any coverage, you get the bill - but taxpayers sometimes end up paying it.

City Controller Alan Butkovitz released a report in March detailing inefficiencies with how the city collects payments for emergency medical services. His office found that of the $179.7 million in EMS charges the city reported in the 2011 fiscal year, it collected only $34 million.

The biggest reason was a low reimbursement rate from Washington: Medicaid pays $200 for advanced medical services or $120 for basic runs, and Medicare pays $628 and $365, respectively - far less than what many trips cost the city. The state sets those rates, and Butkovitz's report urged city officials to lobby in Harrisburg for a change. But until that happens, the city will foot the bill for the difference - which costs $68 million in 2011, according to the controller.

Another factor was "inaccurate and incomplete" patient-billing information collected by paramedics.

Since the report, the Fire Department has equipped paramedics with a more advanced computer system for collecting billing information, which it hopes will cut down on mistakes.

- Sean Collins Walsh

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