Oregon is considering `soft billing’ patients’ insurance providers for rescue squad transports to the hospital.
Administrator Ken Filipiak said it would help fund rising costs in the fire department. It will be discussed further at a safety committee meeting Monday at 6:30 p.m.
“It is an interesting issue that I think the public should be informed about,” said Councilman Clint Wasserman, chairman of the safety committee.
Oregon is the only major city in the area that doesn’t bill for transports, said Filipiak.
“We don’t bill for trips to the hospital from an emergency scene. That’s something that’s been talked about for 20 years around here. We would seriously have to look at that as one alternative for funding.”
Wasserman emphasized that there would be no out of pocket expenses to patients, just their health insurance companies.
“Soft bills would be sent directly to a person’s insurance company, Medicare or Medicaid, and would require no out of pocket expense by residents,” said Wasserman. “A hard bill, which some communities have looked at, would require first billing the insurance company, Medicare, or Medicaid, then the balance would be picked up by the individual. In the proposal, there was no mention of hard billing. It was strictly a soft bill.”
“If we had a $400 fee for transport,” explained Filipiak, “and your insurance paid $375 for it, we would accept what they would pay. If Medicare paid $300, we would accept that. And we would cut some provisions for those who would be unable to pay.”
Most people have insurance to cover the expense, said Filipiak.
“If you’re paying an insurance premium and you’re not taking advantage of that, you’re subsidizing someone else’s premium. If you don’t have insurance, you would probably be covered under Medicare. If you didn’t have Medicare coverage, and you had the means to pay for soft billing, you would. If we would be doing this under a soft billing requirement, we’d make some accommodation for someone’s income level and you could get some or all of that forgiven,” he said.
Council would have to approve such a plan.
“The administration is proposing it,” said Wasserman. “We still have yet to meet as council. Right now, it is strictly in an exploratory avenue stage.”
Currently, the fire department has a $2 million annual budget that is funded partly by a .10 mill levy, which brings in about $150,000 annually, and partly by the general budget.
“The amount of money that can be gained to supplement a fire department is very attractive to communities,” said Wasserman.
Soft billing could bring in approximately $300,000 annually, said Filipiak.
“Costs associated with our current level of services are going up at rates that generally are ahead of inflation. We’re going to take a big hit to the funds that our levy brings in, with the changes from House Bill 66,” said Filipiak.
House Bill 66, passed by the Legislature in June, 2005, phases out tax on tangible personal property of general businesses, telephone and telecommunications companies and railroads over a five year period.
Lucas County’s Emergency Management Service (EMS), which provides paramedic service county-wide, is also considering billing for its Advanced Life Support transports.
The city is also considering making changes in the delivery of emergency services, said Filipiak.
“Essentially, what we’re trying to do is get our people on the scene faster, so we want to get our guys to respond from the stations as opposed to responding from their homes or wherever they are when they’re toned out,” said Filipiak.
“Leaving from the station shaves off, on average, five to six minutes. And that is a huge, huge period of time in these emergency situations. So we’re looking for ways to try and cut down on that lag time,” said Filipiak.
“The bottom line is our guys do a great job, they’re well trained. When the call goes off, we have 20 people flying through the streets of Oregon trying to get to the station as fast as they can. There’s a huge risk there. And that’s another concern we want to cut down on as much as possible,” he said.
“There’s no wage scale in place for what we’d be looking to do, so we would have to negotiate that with their union. We’d be looking at accommodations at the station. We would be taking a group that comes in when they’re called to now schedule them to come in. In collective bargaining environments, how do you sign them up? Usually, that’s based on seniority of some type. So those are all things that we would have to sit down with our union and negotiate,” he said.
The city has already talked to the unions on the matter.
“We wanted them to be aware that there is a need here in Oregon to be looking at these things. We’re one of the last communities in the area to go to this. There would be some changes in their terms of employment that we would have to get ironed out before we would implement anything,” he said.
The safety committee is also going to discuss enhancements in the paramedic service, he added.
“Right now, we cannot assure we can get paramedics to the scene of every Advanced Life Support (ALS) call in Oregon, A couple hundred times per year, they’re either on call here or they’re outside the city on a call. Our unit can be called into Toledo or Jerusalem Township if there isn’t another life squad available. In those instances, if someone calls 911 in Oregon, and it’s an ALS call, another unit from somewhere else in the county would have to respond. By the time that happens, you’re 10-20 minutes into a response time. Our basic units are going to get there. But again, there’s limitations on their ability to get there, and they can’t provide ALS service. So we’re also looking at ways to add a few paramedics to try and enhance that,” he said.