Fire companies set standard ambulance rates


All 13 of Carroll County's volunteer fire companies equipped with an ambulance have agreed on a list of standard rates to charge patients for ambulance services, replacing a hodge-podge of charges.

The new rates will begin by June 30, 2007, when 24-hour-a- day, 7-day-a-week ambulance service should be the county norm, according to the Carroll County Volunteer Emergency Services Association (CCVESA).

"We're going to be sure everybody is in the same range, and our recommendation is an average of what all the companies are charging," said Mike Swartzbaugh, 24/7 Committee chairman. "Wherever you are picked up in Carroll County, you'll pay the same. The only difference is mileage."

The new rates are: Basic Life Support 1 (BLS), nonemergency, $300; BLS 1, emergency, $400; Advanced Life Support (ALS) 1, nonemergency, $500; ALS 1, emergency, $600; ALS 2 (highest level of critical care), $700; plus $10 per loaded mile.

The fees were determined by federal guidelines and allowable Medicare rates in five categories, Swartzbaugh said. Ambulance companies use a billing company to charge insurance agencies and Medicare for transports.

If a patient is not transported to a hospital, the ambulance companies cannot charge for services. Mileage is for transport of the patient from the site to the hospital only.

While patients may get a bill for the remainder of their insurance coverage, Swartzbaugh said the fire companies write off the bill if they don't receive payment after sending out two bills. "We don't do any collecting," he said.

The organization, formerly the Carroll County Volunteer Firemen's Association, began charging for ambulance calls in 1998 and set a minimum of $200 per call, but individual stations could charge different rates.

Ambulance billing was implemented at the urging of the county commissioners to help pay for needed paid EMS personnel, though tax revenues fund the costs in some other jurisdictions. Fire companies have had increasing difficulty in recent years in keeping sufficient volunteers on hand around the clock to staff ambulances and other fire equipment.

To combat the same problem, Harford County, with 12 volunteer fire companies, established the countywide EMS Foundation that supports paid personnel for stations that need the help, said Rich Gardiner, spokesman for Harford County Fire and EMS. Money from ambulance billing goes for paid staff and other expenses.

Since ambulance billing was started in Carroll, the firefighters and commissioners have worked to support round-the-clock EMS coverage in all the fire stations, except Harney. For fiscal year 2007, the commissioners provided $2.951 million for EMS coverage in the 13 stations.

Last year, county ambulances ran 13,788 calls, ranging from 383 for Lineboro to 3,301 for Westminster. Lineboro, Pleasant Valley and New Windsor are expected to go to full 24/7 coverage by next year.

Joe Schwartzbeck of Union Bridge was a recent recipient of some EMS care when he had a back problem and couldn't get out of bed. The ambulance ride to Carroll Hospital Center was his first in his 64 years, he said.

"I don't mind paying. They have fuel bills like the rest of us," he said. "And they were really good to me."

The standard billing "is a first step toward what we've been trying to do -- show the commissioners in good faith that we're trying to raise money, so when we go to them asking for more [public] money, we can show we're trying," said Richard Green Sr., CCVESA president, after Monday night's vote at the association's monthly meeting.

Swartzbaugh said "billing fills in a gap left from the county allotment, which does not cover all the costs of EMS. Billing makes up a good percentage of the shortfall," but not all, he said.

"We're still putting out a good bit of money for our paid personnel, but next year we're slated to go to 24/7, even at a cost to us," said Michael Kelly, EMS captain at Lineboro. The station has only 10-hour weekday Basic Life Support staffing, along with 24/7 Advanced Life Support and 24-hour weekend BLS coverage.

Lineboro was charging a flat $400 for BLS and $500 for ALS care, plus $12 a mile for transport, but immediately went to the new rates, Kelly said.

Mount Airy ran 1,272 calls last year, but this year EMS runs are "well ahead of what we were last year," said Doug Alexander, public information officer. "In June, we ran 213 calls, the most we've run, and 197 in July."

With the town's population exploding, including senior housing and care facilities, "We can't do it with volunteers, we hire paid people," Alexander said.

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