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Shenandoah supervisors OK seeking biller for ambulance fees

By Sally Voth -- svoth@nvdaily.com

WOODSTOCK -- The Shenandoah County Board of Supervisors on Tuesday gave County Administrator Doug Walker the go ahead to hire a company to handle billing for ambulance fees.

The board voted 5-1, with District 1 Supervisor Dick Neese voting against the proposal, to hire EMS/MC, of Lewisville, N.C., to bill insurance companies and Medicare and Medicaid for ambulance rides.

Neese said after the meeting he was concerned the practice could lead to higher premiums.

County residents won't have to pay any out-of-pocket expenses, the county has said.
Under the current system, Shenandoah County rescue squads do not charge fees for ambulance rides.

"No co-pays, no deductibles, no out-of-pocket," Walker said.

Patients from outside of the county would be billed, though, he said.

Also during Tuesday's meeting, the supervisors voted 5-1 to hire an EMS billing technician.

Chairman Conrad Helsley cast the only dissenting vote because he didn't agree with the pay grade that would accompany the position.

The job is being advertised as a grade 13, with a pay range of $27,000-$40,000. District 3 Supervisor David Ferguson asked where that fell position-wise, if it was like a clerk's or secretary's level.

Walker said it was equivalent to the current services coordinator position in the county Department of Fire and Rescue.

"We see this more as a finance technician type of position," he said.

The person hired will be a liaison between EMS/MC and the patients, Walker said.

"I haven't heard anything yet that tells me or leads me to believe that this position is a grade 13 because of what I'm hearing so far," Ferguson said. "They're not interfacing with the public. They're not interfacing with insurance agencies. They're taking data from an EMS provider and making sure that the data is correct. It sounds very clerical in nature, and it does sound very redundant in nature."

Shenandoah County Department of Fire and Rescue Chief Gary Yew said whoever's hired would need to have some EMS background to know what level of service is provided so the bill would correlate to that.

"So, you're telling me [there are fees for] more than just transport?" Ferguson said.
Yew said transport fees are based on what's performed in the field, whether it was basic or advanced life support.

"There could be a minimum of four or five different levels of billing," he said.

Helsley said he didn't question the need for the position, but the grade it was assigned. Assistant County Administrator Mary Beth Price said county secretaries are at grade 11, while Yew said EMTs are at grade 17.

"It's a formula," District 4 Supervisor Sharon Baroncelli said.

A few years ago, Springsted did a salary study to create a reliable formula, she said.

"I really hate to question that formula and that data now because then you go back and you question everything and every position," Baroncelli said.

The county has researched billing for ambulance rides for years, she said.

"It's in the millions that we've been missing out on," Baroncelli said.


And who gets the money when Middletown ambulances cover Shenandoah County, which happens frequently?

When will people understand that paid Fire/Rescue is nothing but a bottomless pit to throw tax-dollars into? Hopefully my BOS member, Steve Baker, will understand in Nov when he is without a position on the ShenCo Good Ol Boy Committee.

Rusty, you can't be serious. Steve Baker and Daivd Ferguson will have a free ride (for another 3 years) in office because no one stepped up to the plate in their districts, to oppose them. 27-40k for a EMS billing technician!!! The spending continues. shruntzm

You can thank those who just call 911 for a band aid. Those calls waste time, money, and resources but our EMT's and ambulances still have to go out. Also, you have to realize that gas and overhead is no less expensive for our emergency services and the funding they get from the government has also been cut, just like it has for everyone. It costs money every time they go out on a call. But of course, you probably aren't going to be so concerned when your life is on the line and need a ride to the hospital.

Rusty, would you rather not have fire and rescue services, I'm sure your neighbor would haul you to the hospital when you need to go, and sit in the waiting room for two, three, four or more hours. Unfortunately the days of volunteers are over, the amount of training required by law is tremendous and time is scarce for most people. I and a lot of others I'm sure wish it wasn't this way but it is.


Im not sure people are understanding whats going on here. This isnt a move to spend more money by the board of supervisors, this is to help off set some of the cost by the so called "bottomless pit" of fire/rescue. This does not cost the tax payer anything, only the people who use the service. As for Middletown running calls into Shen Co, the patients that they transport will not be charged because Fred Co has not implemented a fee for service yet.

I would rather invest that money in recruitment, retention and improvement of the volunteer system. The complete salary (compensation, training, benefits, union dues, equipment) for one paid fireman is often equal to the entire operating budget of a volunteer fire/rescue agency.

Rusty, how wrong you are. The salary and benefits you talk about in no way EQUAL what it takes to run a volunteer agency. It takes millions of dollars to run a volunteer agency by the time you count the upkeep on the equipment, the purchase of new equipment and apparatus, training of the VOLUNTEERS who run are not paid, and the normal utilities and such. The calls that come in where someone wants an opinion of whether or not they should go to the hospital or just want to EMT to patch them up drain those resources and dollars. Our guys, paid or volunteer recieve great training on the newest techniques and equipment, so tax dollars are being spent well there. I fail to see the problem with charging for running. It may cut back on the number of non-emergency calls.
Of course, you have you opinions, as everyone does, but come fill out an application and see what it is like. Maybe your opinion might change a bit when you have to make the nonsense calls and waste resources and money.

Skidplate, I wish you were right and the days of volunteers were over. Just take a look at the disgusting situation in the Shenandoah Farms Volunteer Fire Department in my neck of the woods. Check the articles and posts here in the nvdaily. As you can see, the old adage is true, you get what you pay for. I wish they would triple my taxes, if that's what it would take to get a paid fire department that understood what accountabiliy means. Instead, we're stuck with people who get their nose bent out of shape when the County, the State police, or the public wants to know why the heck is gasoline disappearing and more than $1,000 missing from bingo money. Yep, they think they should be allowed to "make it right" behind closed doors. Well, I for one know that "lemme make it right" is old-time Virginia code for "I'll do whatever I want, harm to others be daggoned, and sweet-talk my way out of it later." I'm sick of hearing that sorry refrain in my neighborhood. Do you want to rely on that type of person to come to your aid in an emergency, when you or your property are vulnerable? Let's pony up and pay what we and our property are worth... please, powers that be, raise my taxes and provide a professional, paid fire department that doesn't think it's too special to receive well-warranted criticism.

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