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SC county mulls new strategy for collecting unpaid EMS bills

The plan includes collecting smaller amounts from poorer patients and using a collections agency to pursue out-of-state debtors

By Charles D. Perry
The Sun News

HORRY COUNTY, S.C. — With unpaid EMS bills continuing to mount, Horry County officials on Monday rolled out a strategy for recouping some of that outstanding debt.

The plan encourages officials to try to collect smaller amounts from poorer patients and to use a collections agency in pursuing debtors who live out of state.

Horry County Council’s Public Safety Committee supported the proposal, but it must be approved by the full council before taking effect. Council members stressed that they should receive biannual progress updates if the program passes.

“Let’s come back and evaluate these efforts that you’ve done and say, ‘OK, this is how successful it’s been; this is how unsuccessful,’ and we need to tweak it,” said councilman Johnny Vaught. “Too many times we make plans and don’t follow up on them.”

Each year, millions of dollars in Horry County EMS bills go unpaid. After three years, county officials write off a portion of that debt, acknowledging there’s little chance they will collect the money.

But the amount of unpaid bills has skyrocketed in recent years. Transport billings rose from $8.4 million in fiscal year 2007 to nearly $20 million in 2015. The number of calls for service also jumped by nearly 12,000 over the last five years, topping 49,000 in the fiscal year that ended June 30.

In 2010, EMS billing rates were increased in an effort to boost revenues, yet that didn’t solve the problem. Earlier this year, county leaders wrote off nearly $5.7 million in 2012 EMS bills.

During Monday’s meeting, Assistant County Administrator Justin Powell recommended the county create a “hardship policy” that would allow the county to write off some of the bills for impoverished patients.

Under this plan, the county would require that a patient provide income verification to receive the reduced rate. The amount of the write off would depend on the person’s income relative to the federal poverty guidelines.

Officials have said many of those who don’t pay have no health insurance, and Powell pointed out that a $900 EMS bill amounts to a significant portion of a minimum wage worker’s annual pay. By lowering that amount for eligible patients, he said, the county could at least bring in some revenue.

“While it’s a little counterintuitive, what we believe is by allowing some level of hardship assistance to get some of the money paid, we may be able to get more of the bill paid to us than none of it,” Powell said. “We’d probably get more than we have gotten before.”

Another key part of Powell’s program involves increasing collections from out-of-state residents, who account for nearly 30 percent of the overdue notices.

Unlike South Carolina residents, whose state income tax refunds can be garnished to pay the unpaid EMS bills, those visiting from outside the state live beyond the reach of the S.C. Department of Revenue.

County officials recommend that any delinquent accounts (those more than 120 days past due) for out-of-state residents be turned over to a collections agency.

“There’s an incentive to the vendor to make these collections because they’re getting a percentage of what they collect,” County Administrator Chris Eldridge said. “The whole idea is to get somebody that this is what they do.”

Earlier this year, the county started using an outside vendor to assist in collecting some unpaid EMS bills. Although county officials have seen some improvement, their hope is that the collections company’s efforts and an updated policy will help bring in more money to county coffers.

(c)2015 The Sun News

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