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Fire-Rescue Ambulance Transport Cost Recovery

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1. When did Goochland County implement EMS billing?

Goochland County began billing for EMS transports on January 1, 2013.

2. What is Ambulance Transport Cost Recovery?

Ambulance Transport Cost Recovery is a program that allows localities to charge for the cost of emergency medical transport services.

3. Why do we need Ambulance Transport Cost Recovery?

The costs to meet the needs of residents with quality fire-rescue services are constantly increasing. These increases are due to population growth as well as continuous improvements in technology which require equipment upgrades or replacement.

4. How is charging for emergency medical transport service allowed?

Virginia authorizes localities to charge reasonable fees for the use of emergency medical service vehicles.

5. How does Ambulance Transport Cost Recovery work?

Service fees are based on the level of care provided during transport. Advanced Life Support (ALS 1 and ALS 2) are life-saving measures provided by Paramedics. Basic Life Support measures are provided by EMTs or Paramedics. Charges are also generated on “loaded” mileage, which is calculated from the scene to the hospital. Loaded miles are those traveled during patient transport. If there is no transport, there will be no bill for service.

6. Will I be denied service if I can’t prove I have insurance or money to pay the bill?

No person will ever be denied emergency medical service because of an inability to pay.

7. What if I cannot pay my bill?

If you have concerns about paying your bill, you can contact the Goochland County Fire-Rescue Administration for information.

8. What is the process for billing?

The County has a third-party biller which files the claim first with your insurance company. Any portion not paid by insurance will be billed to the patient. You will receive two invoices, and if you are unable to pay, the debt is written off. The County has a “compassionate” policy. No accounts are sent to collections and unpaid invoices do not affect your credit.

9. Why did I receive mail from out of state regarding my transport?

The third-party vendor use by Goochland County uses for emergency transport billing is not local. Requests for insurance information and invoices will come from the vendor, not Goochland County.

10. Why am I sending my payment to Baltimore?

Payments are handled directly by the bank using a secure lock-box account. No payments can be accepted at the Fire-Rescue Administration or Treasurer’s office.

11. How is my insurance information collected?

The hospital collects your insurance information which is then provided to the third-party biller.

12. Does Ambulance Transport Cost Recovery cause health insurance premiums to escalate?

Health insurance premiums will continue to rise regardless of localities billing for emergency medical transports; however, ambulance costs are less than one percent of health care expenditures and have minimal impact on insurance premiums. Less than one penny of every insurance dollar is spent on EMS transports.

13. How much money can counties realistically expect to collect through the Ambulance Transport Cost Recovery Program?

Collections vary by agency and region due to demographics, location, percentage of insured patients, number of calls run, type of billing level, and fee structures. Historically, Goochland has collected (on average) the equivalent of almost 2 cents out of the County Tax Rate.

14. How is my privacy protected?

All department members have been trained on patient privacy through the Health Insurance Portability and Accountability Act (HIPAA) and adhere strictly adhere to those standards. In addition, everyone in the department must attend mandatory HIPAA training every year.

15. What if I am unable to sign for the receipt of the HIPAA privacy practices during/after my transport?

If a patient is unable to electronically sign for receipt of the department’s privacy practices, the patient care provider documents the reason for not being able to obtain a signature.

16. Does billing impact the donations and fund drives for volunteer Fire-Rescue agencies?

We would hope not. Research conducted by most agencies and billing companies have not found evidence to validate this claim. While Goochland County covers most of the operational funding of services, individual volunteer stations rely on donations for the upkeep of facilities and improvements. Goochland County Fire-Rescue has not seen a decrease in volunteer donations since implementing fees for service.

17. Does Ambulance Transport Cost Recovery provide all the support needed to fund Fire-Rescue?

No. Money collected from cost recovery offsets taxpayer funds but does not cover all operating and capital expenses of the department.

18. How does this program benefit the taxpayer?

Insurance, Medicare, and Medicaid cover emergency medical transports. Many transported patients are not residents of and do not pay taxes in Goochland County. Billing for service generates revenue from only the users of the services in lieu of raising taxes for all Goochland constituents. Most localities in Virginia are now billing for transport services in order to better fund their emergency fire and rescue response needs. The fees collected reduce the burden that would need to be collected through additional taxes.