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Frederick County to join region with ambulance fees

By Alex Bridges -- abridges@nvdaily.com

The days of free ambulance rides to area hospitals are numbered.

But localities have had to turn to "revenue recovery" as a way to pay for needed firefighters and to help fund volunteer stations.

Frederick County doesn't charge a fee for ambulance service but officials continued this week with plans to implement "revenue recovery." Winchester may raise the amount it charges for the service.

Shenandoah County began billing "revenue recovery" in February, according to Fire and Rescue Chief Gary Yew. After the department worked on the initial steps of the program by billing on behalf of the career ambulance services, the agency started to do the same for the volunteer companies, Yew said Thursday.

"EMS is most of what we do now and has been for a number of years now," Yew said.

Rates across the region differ among localities, though they do try to bring the fees in line with each other.

"There is a goal for all the jurisdictions in the Valley to be very close with our rates so as not to confuse people," Yew said. "Sometimes Shenandoah County ambulances pick up Frederick County patients; sometimes Frederick County ambulances pick up Shenandoah County patients, so we're trying to be as consistent as we can with the rates."

Frederick County doesn't charge patients a fee for ambulance transport in emergency medical services call. That will change in the near future as a panel of fire and rescue officials and elected leaders discuss how the county would implement "revenue recovery," charge patients for ambulance trips and divide the proceeds collected from the fees.

Winchester several years ago became the first of the region's localities to start charging patients a fee for the service. This week the Department of Fire and Rescue proposed the city increase the fees charged to the patients. Chief Scott Cullers explained Thursday the city has not raised the fees and mileage charges since Winchester implemented the program. The city currently charges slightly below the average levy for the service, Cullers said.

The city department looked at what Medicare allows as a rate for ambulance service and then studied the fees charged by neighboring jurisdictions, according to Cullers.

"So we're sort of following the model of Shenandoah County which they just put in," Culler said.

Localities with a revenue recovery program charge for three types of ambulance service, each of which depends on the level of care required for the medical situation. Localities also charge patients a rate per mile the ambulance crew must travel for the service.

The city department has proposed Winchester raise its rates to be more closely aligned with the average levies charged in the region. The rates as proposed for basic life support and advanced life support II would exceed the average while advanced life support I falls below the average, according to information provided by Cullers.

The proposed increase to the per-mile fee also would fall just below the average by less than a dollar. In determining the proposed rates Cullers said the department looked at levies which are 25 percent over what Medicare will cover.

But as Cullers indicated most patients pay little money out of pocket for the ambulance service. Insurance often covers most if not all the cost of an ambulance trip. Less than four percent of the revenue collected through the fees came as out of pocket expenses for the patients, Cullers said.

Like most localities which charge for ambulance service, Winchester uses a "soft billing" approach and if a person doesn't pay the city does not go after the patient for the money, Cullers explained.

Localities use the revenue from ambulance services not only to fund the salaries for paid firefighters hired to meet the growing number of response calls in the region but also to augment funding to the volunteer stations, Yew explained. The chief noted stations face other expenses such as ambulance maintenance and replacements.

"It's revenue that comes back to the system to prop it up, whatever needs exist," Yew said.

The Shenandoah County Board of Supervisors on Tuesday approved agreements with four of the county's volunteer rescue companies that provide ambulance transport. Fort Valley Fire Department and Woodstock Rescue Department have decided to not participate in the county's revenue recovery program and thus not charge patients for the service.

"It's not forced upon any company," Yew said.

Companies may participate in the county's revenue recovery program at any time, according to Yew.

Opposition to charging for ambulance service remains among some volunteer fire and rescue stations which argue that imposing a levy against patients would spur residents to stop contributing to the companies. Such opposition remained vocal in Frederick County where officials brought up the issue more than once, only to see it fail move forward.

Statistics throughout the region

Shenandoah County
Basic life support - $424.80
Advanced life support I - $504.45
Advance life support II - $730.13
Travel fee per mile - $13

Warren County
Basic life support - $425
Advanced life support I - $550
Advance life support II - $775
Travel fee per mile - $13

Basic life support - $400
Advanced life support I - $450
Advance life support II - $600
Travel fee per mile - $9

Berkeley County, W.Va.
Basic life support - $400
Advanced life support I - $700
Advance life support II - $700
Travel fee per mile - $9 (approximate)

Morgan County, W.Va.
Basic life support - $400
Advanced life support I - $600
Advance life support II - $650
Travel fee per mile - $11 (approximate)

Regional average
Basic life support - $407
Advanced life support I - $550.64
Advance life support II - $697.16
Travel fee per mile - $10.86

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