By Benjamin Joe
Lockport Union-Sun & Journal
LOCKPORT, N.Y. — Revenue collected from Lockport Fire Department’s ambulance service nearly matched its operating cost, including start-up costs, in 2023.
From mid-February, when the service was launched, through the end of December, the total of revenue collected is approximately $800,000, and some bills are still in collection.
Fire Chief Luca Quagliano and Wendy Mancuso, president of MedEx, the third-party billing service retained by the city, went over the numbers with members of the city Fire Board and the Common Council earlier this week.
According to Quagliano, the cost to launch and operate the ambulance service, from mid-February through December, was $872,000. That total includes the purchases of medical supplies and necessary equipment, three used ambulances and one new ambulance, vehicle repair expenses, a service consultant and overtime for paramedics.
Overtime, estimated at $245,000, was the single-largest expense of the ambulance service in 2023, according to Quagliano. All overtime generated by LFD during the year added up to $760,000.
The overtime associated with the ambulance service should be lower in 2024, the chief said.
Last year was an unusual year in that the closing of Eastern Niagara Hospital caused the out-of-town hospital transport rate to rise to 80%, from 50%, for about four months until Lockport Memorial Hospital opened. When an LFD ambulance and personnel are on out-of-town transport duty, tied up for an hour or longer, additional firefighters and paramedics are called in on an overtime basis to be ready to respond to other emergencies, Quagliano said.
Of note: While Lockport Memorial Hospital is located in the town, not the city, transports there are not considered “out-of-town” per a Memorandum of Agreement between the city and the firefighters union, Quagliano said.
Since the opening of LMH, the out-of-town transport rate has fallen back to 50%, the chief added.
Mancuso, the billing company president, said the total of LFD ambulance billings in 2023, before insurance markdowns, was $1.61 million.
“There are a lot of agencies — Medicare, Medicaid, Medicare Advantage — that do not pay what we bill. They do what’s called an ‘allowed amount’ depending on whatever the fee schedule is. If we bill them $500 and they only allow $300, we can only (charge) $300,” she said.
The conservative estimate of revenue from ambulance transport service is 70% of gross billings, according to Mancuso.
To offset the operating cost of the ambulance service going forward, Quagliano said, LFD is planning an annual increase in transport rates and introducing a minimum fee for the dispatching of an ambulance whether emergency medical service is utilized or not. The department also is mandating electronic paperwork, he said.
Based on first-quarter averages, and assuming trends in call volume hold, the ambulance revenue projection for 2024 is $1.9 million, Quagliano said.
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