No free ambulance service for Key West residents

BY PRU SOWERS – KONK LIFE STAFF WRITER

A lower than hoped for collection rate in the first year of the city-operated emergency medical service has postponed an effort to give Key West residents free ambulance service.

Key West EMS Division Chief Edward Perez presented a first year financial look at the fledging ambulance and emergency services division to city commissioners on May 3. When commissioners voted in 2014 to take over EMS services from a private contractor in the hopes it could reduce the $45,000 a month cost, consultants hired by the fire department estimated a first year cost of $1.5 million, with a 40 percent collection rate for EMS billing, including ambulance transportation to Keys Medical Center.

However, four months after the fire department began offering EMS services, the first year budget was increased to $2.1 million to cover higher than anticipated training costs. And the first year collection rate, as Perez outlined to commissioners, currently stands at approximately 30 percent. Perez said that the EMS division has billed out $3,373,000. Just under $1,017,000 has been collected. After adjusting for mandatory fee reductions required by Medicare and other insurers, the city is owed just under $1,752,000. Of that amount, just under half, $795,000, is past 120 days old.

“So that’s a lot of money sitting there that hopefully sooner than later will be sent to collections and further be collected on,” Perez said.

As a result of the lower than expected collection rate, Perez recommended that commissioners not approve a proposed ambulance fee waiver for Key West residents, something commissioners had hoped for back when they approved setting up the in-house EMS division. Perez said the waiver could be revisited in another year.

“A resident waiver of EMS transport out of pocket fees will most likely significantly reduce the amount of money collected,” he said. “In addition, the process of verifying and administering the resident waiver applications for potentially thousands of residents each year will be labor intensive and staff does not currently have the resources to perform this function effectively.”

Of the 6,427 total EMS calls in the first year of operation, 3,565 were from Key West residents. A representative from Ambulance Medical Billing (AMB) who attended the commission meeting, said that the collection rate should increase in the EMS division’s second year. Not only did it take several months to set up a billing process with Medicare, which delayed payment, a new collection agency has just been hired to go after people who have not paid their EMS bill.

Still, delaying a break for local residents for ambulance transport was disappointing to several city commissioners. Commissioner Billy Wardlow, a former Key West fire chief, promised to bring the issue back next year.

“That is what I’m looking for to give back to the taxpayers of Key West because we paid to get the ambulance service started. It would be a good move to show we’re trying to give back to the citizens of Key West,” he said.

The AMB representative, however, warned commissioners not to promise something that could significantly impact the revenue collected by EMS.

“You’re giving up a lot of funds. Are you ready to give up all those funds,” he asked?

Commissioner Sam Kaufman pointed out that the commission deserved to know all its options in order to make the best decision.

“A lot of us up here want to offer a discount to residents for EMS transport,” he said.

Commissioners voted in June 2014 to take over ambulance and emergency services that had been provided by Care Ambulance, which told the city it would not renew its contract as of March 31, 2015. Commissioners voted to take on the project after being assured it would ultimately save money and provide a more dependable service than an outside agency.

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