Ambulance fees boost revenue projections

A slightly more aggressive approach on collecting fees for ambulance services appears to be paying off for the town.

“We’re looking at $100,000 favorable on revenues,” Controller Kevin Redmond told the finance board’s Feb. 18 meeting — and the bulk of the revenue boost is coming from ambulance fees, he said.

Ambulance fees range from $758 to $1,238 per ride, depending on the level of medical service provided, with extra charges possible based on factors like miles traveled and waiting time.

An extra $100,000 in ambulance revenue isn’t a huge number in the context of a $148 million town and school budget for 2019-20. But it doesn’t hurt.

On the spending side of the budget, Redmond told The Press it’s early to project where things stand — half way through the fiscal year that runs July 1, 2019, to June 30 2020.

“So far no major red flags in expenses, other than trees,” he said, referring to the mounting costs of the emerald ash tree borer’s attack upon ash trees in town.

Income from ambulance fees was budgeted at $800,000 for the 2019-20 fiscal year that ends June 30, and Redmond reported that he’s now expecting ambulance fees would total about $900,000 by the end of the fiscal year.

“Up $100,000 there — that’s what I’m projecting,” Redmond told the finance board.

The ambulance income through the end of January was just over $524,000, representing neary 66% of the budgeted revenues. Last year, at the fiscal year’s halfway mark, ambulance income was a little over $413,000, or 51% of the budgeted amount.

Getting tougher

In recent years ambulance revenues haven’t gone up much, Redmond said, even though the fees charged have been going up annually, reflecting the state’s approved level of charges — the charges for ambulance rides increased 2% on Jan. 1. 2020.

“They’ve been relatively flat,” Redmond said of the fees. “Activity has not gone down.”

Redmond said the town asked the firm that handles collections, CAG or Certified Ambulance Group, what the problem was.

“You’ve got a very soft collection effort,” was CAG’s response, Redmond told the finance board.

Town officials have long kept the collection effort on ambulance charges low key, largely out of concern that people worried about paying the fees might hesitate to call an ambulance when one is needed.

In August, when the selectmen approved a 2% rate increase in ambulance fees, Fire Chief Jerry Myers told the selectmen that the town does try to collect ambulance fees, but isn’t overbearing about it.

“If a person has insurance, we get permission to bill that,” Myers told the selectmen.

“As rule, the billing company sends out a bill,” he said.

People who don’t pay are reminded of the obligation — but not chased for payment, he said.

“They would send out a bill for that, and we send out two additional reminders — that’s all we do,” Myers said

The ambulance charges, based on state-approved caps, are: Advanced Life Support Level One Non-ER: $762; Advanced Life Support Level One ER, $1,198 ; Paramedic Intercept, $851; Basic Life Support Helicopter Assist, $496; Advanced Life Support Helicopter Assist, $771; Advanced Life Support Assessment, $445; Specialty Care Transport, $1,646; Waiting Time Charge, $201; Per-Mile Charge, $18.14; Special Attendant Charge, $148.

“What we have is the state’s standard rate,” Fire Chief Jerry Myers told the selectmen.

The ambulances’ 2,203 emergency medical service calls made up 58% of the fire department’s 3,817 calls in calendar year 2018, Myers told the selectmen in August. And ambulance revenues cover approximately 28 percent of EMS expenses, he said.

After hearing CAG attribute the flat revenue to the town’s “soft” approach on collecting ambulance bills, the selectmen agreed to get a little tougher.

“The collection letters are a little more aggressive,” Redmond told the finance board’s Feb. 18 meeting. “And out-of-town individuals they’re actually going to go after.”

Now, ambulance fees are looking like they’ll be about $100,000 for the year.

“It’s working,” Redmond told the finance board.