In the midst of eking out a budget that will make best use of every dollar that can be scrounged up – and dollars are scant – Philadelphia is owed almost $50 million in emergency services fees for fiscal year 2011, a follow-up report of the Fire Department's billing and collection practices released today by City Controller Alan Butkovtiz found.
The Department collected $34.4 million in EMS user fees last year out of a total of $82.5 million billed, putting it at a collection rate of 42 percent. Despite city efforts aimed at increasing revenue – which included taking recommendations from Butkovitz's 2008 report like raising fees for Basic and Advanced Life Support by nearly 100 percent and choosing a new EMS patient billing vendor – the rate is nearly the same as in fiscal year 2006, in which it was 41 percent.
"The collection rate remained virtually unchanged during this five year
period, leaving millions of dollars on the table and not collected," Butkovitz said in a statement. "While there have been
developments during this time to increase revenues, there is still much
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"We’re hopefully anticipating that with the new EMS billing vendor the City will experience a significant increase in its collection rate."
The report also found that, in addition to the $50 million in uncollected fees, the city lost out on $97 million in potential revenue that the Fire Department couldn't collect. $78 million of that was because the bill was considered disallowable through Medicare, Independence Blue Cross or Medicaid, from which, according to state law, the city is mandated to accept only reimbursement amounts of $200 for ALS and $120 for BLS, though their
actual charges are $1,050 and $950.
"I strongly recommend the administration lobby state and federal
legislators to increase Medicaid and Medicare reimbursements rates," Butkovitz said, noting that state Medicaid reimbursements haven't increased since the early 1990s.
The remaining $19 million in potential revenue was written off due to inaccurate or incomplete billings, which Butkovitz said was a result of EMS workers failing to obtain the patient's insurance card, receiving bad or incomplete information about their billing address or making data entry errors. Butkovitz recommended the Fire Department develop a plan to minimize these write-offs.
According to the figures uncovered by his department, Butkovtiz concluded that, for every run in which Advanced Life Support is needed, the Fire Department can only expect to collect 19 cents on the dollar – 13 cents for those that include Basic Life Support.