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Home My WebLink About20070416 - VIII-C-4HASTINGS FIRE DEPARTMENT MARK J. HOLMES, CHIEF 115 West 5th Street Hastings, Minnesota 55033-1815 Business Office (651) 480-6150 Fax (651) 480-6170 V 111-C-4 TO: Mayor Hicks and City Council Memb er s FROM: Mark J. Holmes, Fire Chie~f~~~7 ~ - ' DATE: April 16, 2007 SUBJECT: Request for Adjustment to Ambulance Billing Rates A review of rates and billing practices used by the Hastings Ambulance Service has resulted in the proposed need for an adjustment. The existing billing practices were adopted in 1996 as a result of our upgrade to advanced life support. The system was designed around up to 18 billing codes, which resulted in charges accordingly and applied based on the level of service needed. The current system has become difficult to navigate by staff and fully understand by payors. Health care coverage providers, such as Medicare, have set reimbursement schedules based on general levels of service rather than the specific care given. An example would be if all care given to a patient was provided at the basic life support level we are only being reimbursed at an appropriate assignment rate. Care given at the advance life support level can be reimbursed at one of two rates, ALS 1 routine or ALS 2 critical. The adjustment, as proposed, will be the first major change to ambulance billing rates since 1999 and the first overhaul to our billing practices since 1996. As required by federal law, Medicare will only pay a percentage of the amount billable as determined by their reimbursement schedules. The new rates and billing structure will be consistent with area services and will allow us to maximize reimbursements other than with Medicare. Although at the proposed charges for service appear to be a rather large increase, not all cases will allow for reimbursement at that level. The restructuring of ambulance billing codes and rates will result in approximately a 20 - 25% increase in ambulance reimbursements annually, non-residents will be billed $116.00 in addition to the rates normally charged resulting in a benefit to our citizens and the new rates are designed to help the offset increasing cost of service. If you should have any questions regarding this request, please feel free to contact me at any time. My cellular phone is the best way to reach me at 651-775-5545. I will be attending the April 16, 2007, council meeting, if you should have any questions at that time. Requested Action: Approve proposed ambulance billing rates and restructuring of fee schedule -°ducing the number of charge codes effective May I, 2007. Attachment FIRE SUPPRESSION - FIRE EDUCATION - FIRE PREVENTION - AMBULANCE SERVICE Current Ambulance Billing Charges Code "1" - $391.00 Code "2" - $452.00 Code "3" - $497.00 Code "11" - $329.00 Code "4" - $508.00 Code "5" - $608.00 Code "7" - $631.00 Code "10" - $552.00 Code "8" - $698.00 Code "9" - $810.00 Code "14" - $155.00 Code "18" - $9.60/mile Non-resident fee - $83.00 Proposed Ambulance Billing Charges Code "BLS" - $730.00 Code "ALS-1" - $864.00 Code "ALS-2" - $1,043.00 Code "ALS Treat/No Transport" - $310.00 Code "Mileage" - $12.00/mile Non-resident fee - $116.00. Proposed Code BLS = Non-emergent BLS medical or trauma Basic wound care 02 Transfer with no treatment initiated or maintained Proposed Code ALS-1 = Emergent ALS medical or trauma IV, monitor, CPAP, one medication Transfer with maintaining EKG, 02, and/or IV(s) Proposed Code ALS-2 = Respiratory/Cardiac arrest Intubation, 10, chest decompression, surgical airway Two or more doses of any medication Proposed Code ALS/Treat/No Transport = Treatment no transport with or without medication