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Funding Your Future Establishing Fee-for-Service Programs in Non-Profit EMS Agencies Central Shenandoah EMS Council in partnership with: Virginia Office.

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Presentation on theme: "Funding Your Future Establishing Fee-for-Service Programs in Non-Profit EMS Agencies Central Shenandoah EMS Council in partnership with: Virginia Office."— Presentation transcript:

1 Funding Your Future Establishing Fee-for-Service Programs in Non-Profit EMS Agencies Central Shenandoah EMS Council in partnership with: Virginia Office of Emergency Medical Services

2 Central Shenandoah EMS Council and the Virginia OEMS Billing for Services is Not New But it is new for you – Number of agencies billing in Virginia has increased dramatically in the last ten years. Experience is the best teacher – Especially someone elses experience This is an opportunity to see what others have learned.

3 Central Shenandoah EMS Council and the Virginia OEMS Who Thinks We Should Bill? Joint Legislative Audit Review Commission (JLARC) 2004 Report on Emergency Medical Services Emergency medical service agencies should actively consider billing patients health insurance polices for the services and transportation provided.

4 Central Shenandoah EMS Council and the Virginia OEMS Who Thinks We Should Bill? Citizens Groups – Who want an alternative to tax increases to improve services. Local Governments – Who are continuously being asked to do more with less funding. Our Staff Members – Who want to do a good job for their community – but dont have adequate resources

5 Central Shenandoah EMS Council and the Virginia OEMS Funding Your Future Section 1 – Is Billing For You? Section 2 – Implementation Section 3 – Marketing Section 4 – Results

6 Central Shenandoah EMS Council and the Virginia OEMS Part I – Is Billing for You? A. Define the Problem B. Reimbursable Services C. Look at your Community D. Build your Team E. How Much Does the Solution Cost? F. Make a Decision

7 Central Shenandoah EMS Council and the Virginia OEMS Define the Problem What will the funds from billing enable your agency to do? Increase Staffing Decrease Response Times Replace Equipment Citizens what to know where the money will go - If you dont give them something better will they support Fee-for-Service?

8 Central Shenandoah EMS Council and the Virginia OEMS Terminology – it all means the same thing Billing for service Reimbursement program Fee-for-service Revenue recovery Seeking payments from insurance carriers for benefits that individuals have as a part of their existing policies

9 Central Shenandoah EMS Council and the Virginia OEMS Reimbursable Services Ambulance Transport Fees Generated for the care and transportation of ill and injured persons. Federally sponsored health care insurance programs (Medicare and Medicaid) Most private health insurance policies have a medical transportation benefit.

10 Central Shenandoah EMS Council and the Virginia OEMS Reimbursable Services Rescue Service Fees Submit claims to auto insurance carriers Fire Service Fees Send to homeowner and allow them to submit to insurance company Special Service Fees are Frequently Rejected by Insurance Carriers

11 Central Shenandoah EMS Council and the Virginia OEMS Look at your Community What is the potential financial impact for your agency? Revenue is related to call volume How many ALS? BLS? Who is the Patients Insurance Carrier? -Medicare -Medicaid -Private Health Insurance -No Insurance

12 Central Shenandoah EMS Council and the Virginia OEMS Look at your Community Who within the community will help you present the concept to the public? Local Government Officials Hospitals and Physicians Community Leaders

13 Central Shenandoah EMS Council and the Virginia OEMS Build Your Team Committee Membership Each Local Government Each Hospital or a Community Physician Press Relations – Marketing Community Representative Agency Leadership

14 Central Shenandoah EMS Council and the Virginia OEMS Build Your Team Committee Goals Identify Problem Determine Root Cause of Problem Identify Contributing Factors Provide Potential Solutions

15 Central Shenandoah EMS Council and the Virginia OEMS Build Your Team Committee Goals – Example 1 Problem Slow Responses Times M-F Dayshift Root Cause Inadequate Number of Personnel Contributing Factors Loss of Manufacturing Jobs – Everyone works out of Town Potential Solutions Fee for Service – to provide Supplemental Staffing

16 Central Shenandoah EMS Council and the Virginia OEMS Build Your Team Committee Goals – Example 2 Problem Difficulty Recruiting and Retaining Volunteer Staff Root Cause New Volunteers Arent Interested in Joining Agency with -Antiquated Equipment -Inadequate Support of Educational Needs Contributing Factors Traditional Fundraising not Adequate to Support Squad Potential Solutions Fee for Service – Provide Funds for Training and Equipment

17 Central Shenandoah EMS Council and the Virginia OEMS How Much Does the Solution Cost ? Project Cost = Billing Revenue OK Project Cost > Billing Revenue NOT OK Closely Match Anticipated System Improvement Cost with Anticipated Patient Revenue

18 Central Shenandoah EMS Council and the Virginia OEMS Make A Decision Will the community benefit from planned improvements to the EMS System? Does the estimated revenue match the cost of the improvements? Does the committee support the concept of billing? YES, YES, YES – You have what is necessary to proceed

19 Central Shenandoah EMS Council and the Virginia OEMS Make A Decision What if the answers are Yes, No, and We Dont Know? Reevaluate Community EMS Needs Seek to Promote Understanding and Gain Consensus Explore Other Options

20 Central Shenandoah EMS Council and the Virginia OEMS Part II – Implementation Plan A. Make An Announcement B. Obtain Governmental Support C. Nuts and Bolts D. Fees and Policies E. Insurance Carriers F. Forms & Flow of Information G. Revenue and Cash Flow H. Compliance – Records and HIPAA

21 Central Shenandoah EMS Council and the Virginia OEMS Make An Announcement Letter – notify each group represented on the billing exploration team EMS Agency Local Government Hospitals

22 Central Shenandoah EMS Council and the Virginia OEMS Make An Announcement Press Release – Issued by Committee Chair and Agency Leadership Newspapers Radio Television Be Sure to List Follow Up Contact Information

23 Central Shenandoah EMS Council and the Virginia OEMS Obtain Governmental Support Resolution of Support We Think This is a Good Idea Too Creation of an Ordinance We Formally Authorize You to Do This

24 Central Shenandoah EMS Council and the Virginia OEMS Obtain Governmental Support Resolutions are Easy to Change Ordinances are More Difficult If your local government is involved in setting rates – ask that they set rates using a resolution rather than an ordinance.

25 Central Shenandoah EMS Council and the Virginia OEMS Nuts and Bolts Internal Billing System Collecting Patient Data Billing Staff Billing Software Dedicated Phone Forms and Postage Interact with Insurance Companies Collect, Post and Deposit Payments External Billing System Collect Data Package Information and Forward to Billing Service Deposit Payments It is easy to see why so many agencies chose to use a billing contractor

26 Central Shenandoah EMS Council and the Virginia OEMS Nuts and Bolts Pay Per Claim Flat Fee Per Claim No incentive for accuracy or follow-up Percentage of Net Receipts Incentive to work with patients and insurance companies to receive payments Most agencies pay on a percentage of net receipts basis

27 Central Shenandoah EMS Council and the Virginia OEMS Setting Fees and Establishing Policies Fees – base on Medicare Fee Schedule Dont set fees low now and hope to increase them later. Maintain your fee schedule. Review charges at least annually. Policies – focus on fairness All patients who are transported are billed Establish definition of poverty or medially needy

28 Central Shenandoah EMS Council and the Virginia OEMS Membership Programs Agency accepts a fee as a form of pre- payment for deductibles and non-covered charges. You agree to accept whatever insurance benefits are paid as payment in full. Labor Intensive Membership Revenue should equal what is written off due to the agreement.

29 Central Shenandoah EMS Council and the Virginia OEMS Relationships with Insurance Carriers Medicare – pays 80% of allowable charge. Balance due from co-insurance or individual Medicaid – pays less than 50% of actual charge. No patient billing permitted Private Insurance Carriers – payment is highly variable. Patient responsible for remaining balances

30 Central Shenandoah EMS Council and the Virginia OEMS Relationships with Insurance Carriers Obtaining Provider Numbers – Your agency must be a recognized provider of service In order to bill federally sponsored healthcare programs Also some private insurance carriers Each insurance carrier will have an application process and require copies of various documents

31 Central Shenandoah EMS Council and the Virginia OEMS Relationships with Insurance Carriers In Virginia there is a legal requirement that all ambulance providers be paid directly by insurance carriers. It is no longer necessary to become a participating provider in order to receive payments directly from the insurance company.

32 Central Shenandoah EMS Council and the Virginia OEMS Development of Forms What must be collected for the billing process? Patient Information Insurance Information Clinical Impression / Preliminary Diagnosis Consent to bill patients insurance carrier Authorization to release medical records

33 Central Shenandoah EMS Council and the Virginia OEMS Flow of Information Collect data following transport Verify that information is complete Prepare documents for delivery to billing contractor Establish schedule for timely delivery

34 Central Shenandoah EMS Council and the Virginia OEMS Revenue and Cash Flow Revenue Checks arrive at billing contractor and patient accounts are credited Checks are deposited by either contractor or agency. Cash Flow It takes approximately 12 months to achieve stable cash flow – dont spend too quickly

35 Central Shenandoah EMS Council and the Virginia OEMS Compliance & Records Compliance Even if you use a billing contractor, your agency is still responsible for complying with all laws, rules, and regulations. Records Clinical and billing records are your property and must be maintained. Be sure to recover your records if you change billing services

36 Central Shenandoah EMS Council and the Virginia OEMS HIPAA All staff members need to receive HIPAA training. Provide patients with information on how your agency protects their sensitive information. Enter into business associate agreements with other entities as necessary in order to legally share information

37 Central Shenandoah EMS Council and the Virginia OEMS Part III Marketing the Program A. Common Themes B. Target Audiences C. Opportunities to Share Information D. Providing a Walk Through E. Dispelling Rumors

38 Central Shenandoah EMS Council and the Virginia OEMS Common Themes There are problems with the current EMS system that need correcting Traditional sources of revenue arent adequate to correct the problems Ambulance billing is a way to obtain resources using insurance coverage that most citizens already have.

39 Central Shenandoah EMS Council and the Virginia OEMS Common Themes Services will be rendered regardless of a patients ability to pay The billing process will be sensitive to those who dont have the financial resources to pay their bill

40 Central Shenandoah EMS Council and the Virginia OEMS Target Audience Agency Personnel Our goal has been and always will be to provide the best possible service to the people we serve Funding sources that we have relied on in the past are no longer adequate to meet community needs We intend to preserve the volunteer system by alleviating volunteers from fundraising and supplementing current staffing where necessary

41 Central Shenandoah EMS Council and the Virginia OEMS Target Audience Agency Personnel (continued) Providers must be trained to answer the publics questions or properly direct their concerns They are the day to day face of your agency Create a short list of the most common questions they may be asked and train your providers to answer these questions Give providers a handout with the answers to these questions and contact information for people that have more information about the BFS process

42 Central Shenandoah EMS Council and the Virginia OEMS Target Audience Local Government Officials Our agency has a long tradition of working with local government to service the public in an efficient and reliable manner. We understand that it is difficult to shift tax dollars from other programs. Billing will enable our agency to use insurance benefits that most citizens already have to fund improvements to the local EMS system

43 Central Shenandoah EMS Council and the Virginia OEMS Target Audience General Public When a medical emergency occurs our focus is on responding promptly and providing the best care possible. This care, however, comes at a cost and traditional funding sources are no longer adequate. We will continue to respond to all calls for assistance and provide care regardless of a patients ability to pay.

44 Central Shenandoah EMS Council and the Virginia OEMS Opportunities to Share Information Press Releases Be sure to provide a consistent message and provide contact information for follow up questions Public Meetings Hold meetings where the general public can come and ask questions. Speakers Bureau Offer Speakers to Community Groups - Kiwanis, Ruritan, Garden Club

45 Central Shenandoah EMS Council and the Virginia OEMS Providing a Walkthrough 1.An emergency occurs and someone calls 911 2.An ambulance is dispatched 3.EMS personnel arrive, the patient is treated and transported to the hospital 4.The patient signs a form giving the agency permission to obtain his or her insurance information and file a claim with their insurance carrier.

46 Central Shenandoah EMS Council and the Virginia OEMS Providing a Walkthrough 5.The signed consent form, the insurance data, and a copy of the patient report is forwarded to the billing service. 6.A claim is filed with the insurance carrier. 7.The patient is notified of any remaining balance after payment is received from the insurance company. 8.All statements from the agency will have a telephone number for questions or if additional information is needed.

47 Central Shenandoah EMS Council and the Virginia OEMS Dispelling Rumors - Staff Rumor Loss of Community Support – Some personnel feel that community support for the agency will decrease due to billing Response Most billing programs produce up to 10 times more revenue compared to fundraising. Agency may consider eliminating or reducing fundraising if billing is successful.

48 Central Shenandoah EMS Council and the Virginia OEMS Dispelling Rumors - Staff Rumor Loss of Community Support – (continued) Response With strong public education, citizens will continue to recognize the important work that you do in the community

49 Central Shenandoah EMS Council and the Virginia OEMS Dispelling Rumors - Staff Rumor Increased Work for Field Personnel – Additional paperwork will consume lots of staff time and take staff away from responding to calls Response Billing paperwork requires less than ten minutes per patient. Crews are already completing the pre- hospital patient care report

50 Central Shenandoah EMS Council and the Virginia OEMS Dispelling Rumors – Public and Officials Rumor No Money = No Response Response We respond to all calls for assistance and provide care and transportation without regard for the patients ability to pay

51 Central Shenandoah EMS Council and the Virginia OEMS Dispelling Rumors – Public and Officials Rumor Harassment by Bill Collectors Response Our billing contractor works for the agency and has agreed to accept our direction in terms of the level of collection efforts

52 Central Shenandoah EMS Council and the Virginia OEMS Dispelling Rumors – Public and Officials Rumor Harassment by Bill Collectors (continued) Response Great efforts have been made to make sure that patients who do not have the financial resources to pay their bill are not harassed or intimidated

53 Central Shenandoah EMS Council and the Virginia OEMS Follow Up Train all providers to educate citizens, professionally and courteously Supply agency providers a reference or printed information pamphlets for distribution and/or to assist the public with commonly asked question Provide contact information to be distributed for those persons with further questions or concerns Train providers to visit different members of the community while on duty, answering questions and listening to concerns

54 Funding your Future Lessons Learned Central Shenandoah EMS Council in partnership with: Virginia Office of Emergency Medical Services

55 Central Shenandoah EMS Council and the Virginia OEMS Lessons Learned: Experiences provided by: Giles County Life Saving & Rescue Squad Amherst County Fire & EMS Chesterfield County Fire & EMS Roanoke County Fire & Rescue Regional EMS, Inc.

56 Central Shenandoah EMS Council and the Virginia OEMS Lessons Learned: Giles County Do Use a reputable billing company Submit provider applications early Determine your collection strategy Soft Billing vs. Firm Billing Dont Fail to designate a responsible individual to get paperwork together for the contractor Forget that you must have a federal tax ID number

57 Central Shenandoah EMS Council and the Virginia OEMS Lessons Learned: Giles County Do Submit information to the billing contractor on a regular basis Understand that reimbursement will be less than charges Low 35% - 45% Average 40% - 50% Optimal 50% - 60% Dont Expect rapid payments It generally takes 6-8 months to start receiving payments

58 Central Shenandoah EMS Council and the Virginia OEMS Lessons Learned: Amherst County Seek Consensus Agencies need to agree there is a funding source problem Government and Agencies need to agree how funds will be used. Education – concerning the need for & benefit of revenue recovery Providers – internal Community – external Governmental leaders – external

59 Central Shenandoah EMS Council and the Virginia OEMS Lessons Learned: Amherst County Education (continued) It is all about the patients – providing care is primary focus We take care of patients first – and collect insurance information later Educate early, educate at every opportunity Community groups Newspaper & other media sources

60 Central Shenandoah EMS Council and the Virginia OEMS Lessons Learned: Chesterfield County Planning Determine the need for initiating revenue recovery Explain what the funds will support to: Local Government An ordinance, authorizing the county Fire Dept. to bill for service is necessary

61 Central Shenandoah EMS Council and the Virginia OEMS Lessons Learned: Chesterfield County Local Government (continued) Fee schedules should not be included the ordinance Allows the change of the fee schedule without a public hearing Billing Operations Use an ability to pay scale based on income levels Establish refund procedures for overpayments Use electronic data collection software for patient care reports Allows integration of data directly from a PPCR to the billing software

62 Central Shenandoah EMS Council and the Virginia OEMS Lessons Learned: Roanoke County Planning Determine the reason for EMS billing Does the EMS agency have the legal authority to bill? Determine who (within the agency) has the authority to negotiate contracts Designate an upper level management person as the lead for development of all aspects of the program

63 Central Shenandoah EMS Council and the Virginia OEMS Lessons Learned: Roanoke County Local Government Educate local government & elected leaders at least 6 months prior to implementation Ordinance to authorize billing program Implementation Plan Soft vs. Firm - Will aid in selecting a third party billing company Develop an RFP for selection of a third party billing company

64 Central Shenandoah EMS Council and the Virginia OEMS Lessons Learned: Roanoke County Implementation Plan (continued) Apply for a Medicare number early National Provider Identification (NPI) Process takes 60-90 days Staff Education Develop HIPAA & EMS billing policies together Prevents confusion of providers & duplication of policies

65 Central Shenandoah EMS Council and the Virginia OEMS Lessons Learned: Roanoke County Community Education Present a clear and concise message to the community is a critical step to ensure buy-in Educate anyone who will listen Civic groups, neighborhood associations, local government employees, etc Follow Up and Maintenance Establish an oversight committee within the EMS agency Ensure policies are followed, checks & balances Remember: the program is ongoing! Personnel & resources will be required to maintain operations

66 Central Shenandoah EMS Council and the Virginia OEMS Lessons Learned: Regional EMS Inc. Do Develop and maintain good financial controls Avoid the rich on payday attitude – outputs ($) are only consistent if inputs (call data) is consistent Dont Think that revenue recovery is magic pill that will solve all your financial problems Overspend Overestimate your revenue

67 Central Shenandoah EMS Council and the Virginia OEMS Lessons Learned: Regional EMS Inc. Do Work to obtain support of staff Expect some backlash, be prepared to manage bad publicity - May be political or public displeasure Dont Neglect Staff Education – Make sure that staff are properly prepared to respond to questions from the public Forget to follow up to make sure billing paperwork is completed on all calls

68 Central Shenandoah EMS Council and the Virginia OEMS Lessons Learned: Regional EMS Inc. Local Government Funds from billing should supplement - not replace current local government support No one revenue source is sufficient to maintain EMS operations

69 Funding your Future Frequently Asked Questions Central Shenandoah EMS Council in partnership with: Virginia Office of Emergency Medical Services

70 Central Shenandoah EMS Council and the Virginia OEMS What is revenue recovery? Revenue Recovery Fee-for-Service Insurance Reimbursement Billing All mean the same thing The process of collecting fees for the treatment and transport of patients to the hospital

71 Central Shenandoah EMS Council and the Virginia OEMS How does billing work? Following treatment & transport, field staff collect the data necessary for billing. Bills are sent out for the services rendered Fees are primarily paid through Medicare, Medicaid, private insurance or subscription programs Patients are contacted concerning the remaining balance is one exists.

72 Central Shenandoah EMS Council and the Virginia OEMS Why consider billing for service? Costs are increasing faster than our budgets EMS has faced budgetary cuts from federal, state & local funding Over the years & across the country Concurrently, there has been a marked increase in the costs of EMS expenses operational, training, etc Population increases have strained the resources available to respond to emergencies

73 Central Shenandoah EMS Council and the Virginia OEMS What is the patient population? Who is being transported? Only 5-8% of the overall population Insurance coverage will vary based on location 90% of all patients transported have some form of insurance or governmental assistance in paying their ambulance bill.

74 Central Shenandoah EMS Council and the Virginia OEMS Where does the money come from? Majority of fees are paid through insurance companies Final process of billing is to bill the patient Approximately 5% of the total funds collected are paid by individuals

75 Central Shenandoah EMS Council and the Virginia OEMS How does billing for service work? Step One: Bill the insurance Billing is based on four basic rates, set in accordance with federal allowable charges Bill secondary insurance Step Two: Bill the patient Agencies determine firm or soft billing as the standard for pursuing funds from individuals Step Three: Write-off of uncollectible funds Based on guidelines set by your agency

76 Central Shenandoah EMS Council and the Virginia OEMS How do we handle debt? Each agency determines their bad debt policy Firm billing Strict collections policy Soft billing Write off debt per agency policy Pre- / post-payment plans Uncollectible debt

77 Central Shenandoah EMS Council and the Virginia OEMS What does the patient have to pay? Insured: Co-pay or deductible Uninsured: Responsible for full amount of the bill There are Private Pay Options: Subscription Plans Time Pay Programs Ability to Pay Programs

78 Central Shenandoah EMS Council and the Virginia OEMS What are the private pay options? Subscription plans Pre-payment for ambulance charges not covered by insurance. Patients are not responsible for co-pays, deductibles, or non-covered services The Agency still bills their insurance Time pay programs Payments on a set time table for a fixed amount Usually no-interest, low payments

79 Central Shenandoah EMS Council and the Virginia OEMS What are the private pay options? Write-Off due to Inability to pay Sliding Scale based on household size patients income If a patient has a family size of X and an annual income of Y – all charges beyond the insurance payment are written-off.

80 Central Shenandoah EMS Council and the Virginia OEMS What is the Office of Inspector General? The OIG: Government agency to detect and prevent Medicare/Medicaid fraud Their opinion on waiving fees: Concerns about long-term/routine plans to waive deductibles or co-payments As costs and reimbursement you may have to start firm collections - may affect acceptance of your program later Law permits Medicare patients with financial need to have the cost-sharing amount waived

81 Central Shenandoah EMS Council and the Virginia OEMS Will an ambulance show up? Members of the public must not be afraid to call 911 because of a fee! – EMS providers will always treat and transport to hospital regardless of ability of patient to pay for the transport

82 Central Shenandoah EMS Council and the Virginia OEMS Will insurance premiums go up? No historical data supports the claim that insurance premiums will rise as a result of EMS billing for services Insurance premiums rise annually for many reasons Research reveals it is not related to EMS billing for services Economy (inflation), family size, health status, age

83 Central Shenandoah EMS Council and the Virginia OEMS Will insurance premiums go up? Insurance carriers provide subscribers with ambulance coverage riders Funds are available, cannot be re-directed Ambulance fees account for less than 1% of all health-related Medicare costs

84 Central Shenandoah EMS Council and the Virginia OEMS What are the steps in the billing process? Step One: Patient is given HIPAA rights & must sign a release of information for insurance company to be billed No signed form: Patient gets the bill directly Step Two: Insurance companies are billed, in order by primary, secondary, etc Notice of bill to insurance sent to patient At present, all Virginia agencies have outsourced to a billing agency

85 Central Shenandoah EMS Council and the Virginia OEMS What are the steps in the billing process? Step Three: Patient is billed for the remainder of the balance unpaid by insurance Bills may vary for patients with subscription plans Step Four: Unpaid debt is handled according to the bad debt policies and private pay options Soft billing: usually send at least 3 invoices. Cant automatically write off all bad debt

86 Central Shenandoah EMS Council and the Virginia OEMS How will billing change my agency? Expectations will shift There will be a higher level of accountability across the board There will be both Internal and External changes for your agency Internal – personnel Additional training and documentation requirements Success will require commitment at all levels

87 Central Shenandoah EMS Council and the Virginia OEMS How will billing change my agency? External – government They will give your agency the legal authority to bill Have close ties to the public and will have similar concerns External – public This will change the publics perception of your agency You must ensure that that change is positive Fee for service = higher expected quality of service Dispel the myths

88 Central Shenandoah EMS Council and the Virginia OEMS How will billing change my agency? Expectations will shift Internally – personnel Externally – government Externally – public What does not have to change: 501 c3 status staffing (volunteer, combined, career, etc) non-profit status

89 Central Shenandoah EMS Council and the Virginia OEMS Can Volunteer Agencies Bill for Service? Many volunteer agencies bill for services Yes Personnel management is an agency specific decision No requirement or expectation for career staff Fund use & disbursement is an agency decision No rules, regulations or laws decreeing how an agency will utilize funding

90 Central Shenandoah EMS Council and the Virginia OEMS Can we maintain our 501c3 status? 501 c3 pertains only to the tax-exempt status of a non-profit agency Billing for services does not = for profit! Billing for services is used to fund an agencies operational costs! NOT to fund private shareholders or political campaigns

91 Central Shenandoah EMS Council and the Virginia OEMS Can we maintain our 501c3 status? 501 c3 regulations are designed for: Public safety organizations Organizations chartered for a charitable cause Visit the IRS website for more details: http://www.irs.gov/charities/charitable/article/0,,id=96099,00.html

92 Central Shenandoah EMS Council and the Virginia OEMS How much money should we expect? Varies by agency, region, area, etc. Dependent upon demographics & other specifics of the locality Percentage insured Population Average number of calls Resources & research Billing companies Other agencies that currently bill for service

93 Central Shenandoah EMS Council and the Virginia OEMS What will the money be used for? Varies by agency based on needs: Ambulances Equipment Training & education Supplies Salary & benefits of career personnel

94 Central Shenandoah EMS Council and the Virginia OEMS Will donations drop off? Agencies & billing companies alike have reviewed donations before & after No evidence to support the claim Donations are still deductible as a non-profit Public education programs can explain benefits & costs Address questions & concerns early! Universal goal in billing for service is to improve patient care

95 Central Shenandoah EMS Council and the Virginia OEMS How will BFS benefit the community? Increased availability of personnel More time for running calls Improved response times Hiring of career staff Increased level of education & experience Better provider retention More funds available for training Improved equipment Better patient care Improved QA/QI systems

96 Central Shenandoah EMS Council and the Virginia OEMS Wrap Up Billing for service is becoming a more frequently used method for increasing funds Billing for services is a serious undertaking, requiring significant man hours before, during & after implementation Billing for service should not be considered without considering risks & benefits to the agency, personnel & public


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