Supervisors discuss charges for non-transport ambulance calls

LEE COUNTY - A move to potentially charge residents who call for ambulance assistance, but turn down transport to the hospital, came up again Monday at the Lee County Board of Supervisors meeting.
Lee County EMS Director Dennis Cosby said he was approached by the EMS billing services company who said other ambulance services do charge for those runs.
But PCC Ambulance Billing, out of West Bend, Ind. gets paid by the county on a percentage of the billing it collects.
Cosby brought the issue up at a Lee County EMS advisory committee meeting last week.
Fort Madison Fire Chief Joey Herren was on the call as a member of the committee and said many times the fire department will get to the calls first and they have been dealing with many of the repeat callers.
Herren said it's just something the fire department handles.
"Its just something we have to deal with. If we see a pattern of people calling for assistance, we call the families and let them know they may need other assistance," Herren said.
Cosby said there are many occurrences where people are calling two and three times per day.
"I think there might be some abuse there," Cosby said.
He said he didn't have hard numbers on those calls, but could start tracking those. Patients are required to sign waivers of transport if they don't want to go to the hospital.
Lee County Supervisor Garry Seyb said at last week's meeting, he would be supportive of some type of charge for a non-emergent call.
"Correct me if I'm wrong, but once that ambulance is dedicated to a non-emergent call, it takes emergent response time away from that ambulance."
He said there seems to be a large amount of calls going out  with no transports that were not emergent.
Seyb said there has been some negative response to the potential charge when it was brought up.
"Dennis brought that up not that he wanted to move forward with it, but wanted to look at it," Seyb said.
"The discussion was that we do see it happening, but we're not sure of the impact of it. Dennis suggested, and I agree,  that we need to look at it and pull some data to see how often we're getting reccuring calls to the same address in a short amount of time and is that impacting emergent calls in the area."
Seyb said he's not motivated by the increased revenue, but more of a concern about having ambulances that are needed for emergent calls being tied up in non-emergent calls.
"Is there an ambulance that's being displaced to emergent calls because there's an ambulance in the area that's responding to a non emergent call," he said.
When that was heard, it was thought that we were going to start charging for it, but nothing has been brought forward.
Cosby said he wanted to bring that to the full board before that decision would be made.
Charles Holmes said Monday in general in the health care industry, if there is a service provided, there is a charge associated with it.
"If you go to the emergency room and you die of a heart attack, believe me, you're still going to get billed. If you die on the operating table you're gonna get a bill no matter what. To be consistent with how billing is done in the health care industry, you would be billing no matter what."
Holmes asked if Medicare or Medicaid would be picking up the bill in those instances.
Cosby said if there is no transport under EMS industry standards, it's very difficult to bill for those trips.
He said those laws are changing slowly and if there are medications administered, but no transport, they can bill for the medications provided.
"This charge would not be billable to insurance now. That could change in the future," Cosby said.
Seyb said he wanted to take a closer look at the data.
"We'll take a look at that and see where it goes," he said.
"If it bares out statistically that we're sacrificing care of someone in an emergent call for someone not in an emergent call, then I think we have a duty to absolutely do something to address it."