(April 19, 2013) Ocean City is anticipating a windfall — currently projected at $300,000 — from a move this coming budget year to outsource its ambulance service billing to a private collector, and to consolidate its fee structure.
City Finance Administrator Martha Bennett said this week that billing for emergency medical services was becoming and increasing burden on her department, which has been able to collect less and less of what the city actually charges due to the complexity of Medicare claims adjustment.
“This company comes with outstanding recommendations from Hagerstown, Cumberland, Cambridge, and Salisbury,” Bennett said. “They have 11 employees who are certified medical coding specialists. We don’t have any.”
More stringent and specific Medicare claims processing, Bennett said, has meant that the federal government now has more than 65,000 different billing codes for different injuries.
“There’s a lot more detail now on each injury or medical call,” Bennett said. “I only have one employee that does this and I’ve had to back them up with another accountant. It doesn’t make sense to take a CPA off other duties for that.”
The outsourcing company will be able to pull the city’s medical service records from the state database, reducing any clerical work on the city’s end.
“They don’t have to do the uploading, it can be pulled online,” said Ocean City Fire Department Deputy Chief Chuck Barton. “I’m familiar with the company that Martha is recommending. They have an excellent reputation, and they specialize in EMS billing.”
Barton also noted that the contract company is recommending that the city eliminate its two-tier system for in-town and out-of-town calls. Currently, ambulance fees range from $325 to $550 — depending on the level of life support given — for in-town calls. Calls originating outside the resort, which account for roughly 17 percent of the OCFD’s work, are charged considerably more.
The recommended change would be to up the in-town rate by roughly $100, and charge the same for both in-town and out-of-town calls. The city was somewhat reluctant to accept this, however, given tension with the county over its lack of support for the OCFD’s out-of-jurisdiction workload in West Ocean City.
“I accept the fact that the billing rate in and out may be the same to Medicare and the insurance companies, but it’s not the same to the taxpayers,” said Councilman Dennis Dare.
However, in a pragmatic sense, it is of little use for the city to charge more for out-of-town calls when it knows it will not be reimbursed by Medicare.
“You may be charging it for West Ocean City calls, but you’re not collecting it,” said Budget Manger Jennie Knapp.
“There may be other ways to skin that cat [with county funding] other than with the ambulance billing,” Barton said.
According to Bennett, the change in rates, as well as the anticipated increase in the percentage collected by the private billing company, could net the town an extra $300,000 next fiscal year.
