Paid EMS transport in Fredonia nears

The implementation of paid emergency transport by the Fredonia Fire Department has been delayed due to red tape, but free services will soon be a thing of the past.

A reimbursement fee schedule for private insurers is close to taking effect in Fredonia, according to Fire Chief Kurt Maytum. Maytum recently informed the OBSERVER that the finishing touches are being put on the contract between the village and the third-party EMS billing company.

“We’ve spoken with the attorneys at Enhanced Management Services Inc. and what they’re doing now is just reviewing everything to make sure we’re compliant and everything is in place,” he explained. “I don’t have an official date as to when it’ll start yet, but I don’t think it will be too far off into the future. Maybe within the next month or so.”

Maytum added the process of implementing paid transport has taken a bit longer than first anticipated, due to negotiations and legal processes, thus cutting into the initial revenues expected for the fiscal year beginning June 1.

Medicare and Medicaid reimbursements still need to be applied for, which Enhanced will take care of for the village. When it comes to retroactive payments, Maytum said he is unsure how far in the past the billing can legally reach, but should get cleared up once everything goes into effect.

The OBSERVER asked Maytum if he still anticipates the amount of revenue placed in the 2014-15 budget, which came to $185,696 in Mayor Stephen Keefe’s proposal.

“It’s not going to happen immediately, so it’s going to be based on from the start date and when things get rolling. Then we have to look at a good, solid year from that point to be able to see what the numbers are going to be and how they come in,” he said. “It also depends on when Alstar Ambulance is out of service, and that’s been increasing more and more, because if they come and show up (at a scene), they will transport. We’ll be billing when they’re not available.”

One person in Fredonia’s fire department has been moved to a full-time position and two part-timers already with paramedic licenses have been added for the current fiscal year. Maytum said these individuals are not exclusively assigned to EMS calls.

“The additions tie out to the people we need for us to be safe and run our operations 24 hours a day, around the clock, whether we’re transporting or not transporting,” he said. “The correlation is not there between having these people to transport; these people are there to make sure we can do everything that we do, including EMS and firefighting. You have to have at least two people on-staff in the hall around the clock, and we didn’t have that before.”

Fredonia is implementing paid transport about three years after Dunkirk’s fire department did the same in mid-2011. Comparing Fredonia’s impending system with Dunkirk’s, Maytum said it should be “very similar.” Both fire departments use Enhanced of Danville, Pa., as their third-party biller.

“The only thing is, because Fredonia is already advanced life support, we’ll be able to bill for those types of calls where those services are provided,” Maytum pointed out. “Dunkirk is not an advanced life support unit; that’s why they call Alstar for assistance when they have an advanced life support case, so they get a little bit lower reimbursement level than we will based on what the types of calls are.”

Advanced life support includes starting IVs, putting in airways, delivering drugs and interpreting cardiac monitors.

When comparing fee schedules between the two, Dunkirk charges $525 for basic life support transport, while Fredonia will charge $600 for basic and $800 or $1,000 for advanced services, depending on if three or more drugs are administered or any of a number of life-or-death procedures are executed.

Fredonia will also charge $100 extra when EMS personnel are called to assist on-board with another agency’s transporting ambulance. Basic life support assessments/on-scene treatments to those who refuse transport should cost $300, with advanced assessments/on-scene treatments at $350.

For every mile Fredonia’s ambulance travels, $20 will be assessed on top of the life support fee.

“These fees are a little bit lower than Alstar’s and are open to changes by the board anytime,” Maytum said at a previous Fredonia Village Board meeting. “Probably within the next few years, you’re going to see a lot more (fire companies) doing this in Chautauqua County.”

Residents in both the Dunkirk and Fredonia fire districts are not responsible for any co-pays since they pay property taxes.

Dunkirk Fire Chief Keith Ahlstrom’s figures show the city received $152,580 in revenue for ambulance transports in 2012. That figure is above both the expected revenue of $120,000 in the 2012 budget and the $125,000 expected in 2013’s budget revenues.

In 2013, expected revenue bumped up to $125,000 in the city; actual revenue came in at $117,030.

As of July 31 for 2014’s numbers, Dunkirk has collected $69,671 in revenues for third-party ambulance billing.

OBSERVER City Editor Gib Snyder contributed to this report. Comments on this article may be sent to gfox@observertoday.com