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Tenn. county considers paying company to collect ambulance bills

Officials say it's worth spending $200,000 on the new computers, and a 4.25 percent fee for a company to manage debt collection, to improve finances in the long run

Louie Brogdon
Chattanooga Times/Free Press

HAMILTON COUNTY, Tenn. — Nearly 20-year-old computer systems have left Hamilton County's ambulance service's bill collection on life support — and they are a time drain for paramedics to boot.

So commissioners Wednesday will consider spending $200,000 on new computers for the county fleet and contracting with an outside service to help capture an estimated $20 million in annual write-offs.

The current computer systems in county hospital wagons are relics that don't keep up with the fast-paced job of providing quick rides to hospitals, County Emergency Medical Services Chief Ken Wilkerson said Friday.

"The old system is so antiquated and user-unfriendly, the paramedics are having to put reports in multiple times. That takes up a lot of time," Wilkerson said.

The county is considering a contract with National Reimbursement Group, a company that will sell new ambulance computers to the county and manage its debt collection -- for a 4.25 percent fee.

Wilkerson doesn't handle billing, but the new computers would be a great benefit for EMS workers. The new computers will be able to send patient information to the hospital wirelessly while en route, and they will be much easier for paramedics to use for reports, he said.

"The information will get to the hospital before the patient will," Wilkerson said.

The $200,000 price tag for the new computer systems will be well worth it -- if the company makes good on its collection job.

A county-run ambulance ride can cost anywhere between $1,000 and $1,400, depending on what level of care a patient needs, Wilkerson said.

But Finance Administrator Al Kiser said a vast majority of those bills never get paid. After 180 days, unpaid balances get written off.

"Our write-off rate is 66 percent on ambulance fees," Kiser said. "About $9.5 million is about what we collect on about $30 million gross."

Not all of that is actually bad debt, he said. About 41 percent, or $12 million, is the so-called contractual allowance -- the discounted price given to insurance companies and Medicare.

But 25 percent is purely bad debt, Kiser said.

"That 25 percent is a better sounding number, but it's still a lot of money," Kiser said.

Hamilton County Mayor Jim Coppinger said Friday the fee collection would be good for the budget, but improved care for residents in need would be the most important benefit.

McClatchy-Tribune News Service

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