The Department of Health Services (DHS) regulates ambulance services within the State of Arizona and sets charge rates for ambulance transports.
Ambulance providers may request adjustments to their rates no sooner than every six months, or based on DHS initiating an automatic rate increase, which they do periodically based on the medical consumer price index (CPI) and other cost factors.
The following adjustments have been made to Sedona Fire District (SFD) ambulance transport rates over the last few years:
11/30/07
10/28/08
5/14/10
Transport Rate
$600.71
$1056.83
$1150.89
Mileage
$8.46
$16.01
$17.44
The ambulance transport revenue rates have continued to increase as overall tax collections for SFD have decreased, resulting in a higher percentage of the overall revenue coming from this non-tax source, and therefore offsetting the amount needed to be collected through taxes.
Ambulance transport revenue is projected at approximately $1.6 million for the 2011 Fiscal Year.
SFD bills in accordance with Federal rules set up by the Centers for Medicare and Medicaid Services (CMS), which regulate a variety of aspects of medical billing procedures and practices. Per these rules, we are required to bill all patients’ insurance companies.
Per a longstanding SFD Fire Board Policy, residents or property owners within the Sedona Fire District limits, pay no balance after insurance. Only non-residents will be billed for the portion of their ambulance transport services not covered by insurance.
SFD’s Billing Specialist must keep abreast of numerous federal regulations regarding medical billing, changes in insurance laws, and execution of insurance allowables through various contractual agreements with government supplemental payment and insurance plans.
The Billing Specialist also acts as SFD’s compliance officer for federal and state laws impacting patient privacy and medical records management and must have a thorough understanding of various medical procedures which dictate level of services for which SFD may bill.
SFD paramedics and EMTs use medical report-writing software in the field to electronically capture as much pertinent treatment and billing information in order that our Billing Specialist has the necessary information to maximize opportunity for reimbursement. This software also interfaces with the medical billing software, so that we may utilize technology where we can to maximize revenue.
SFD contracts with most government insurance plans, including Medicare, Arizona Medicaid, VA, etc.
Although the approved DHS rate for Sedona Fire District is $1150.89, payments can vary based on level of treatment. By contracting with CMS, we agree to accept their allowable rates.
Sedona Fire Chief Nazih M. Hazime
Submitted for Facts From the Chief column
by Nazih M. Hazime, Fire Chief
Sedona Fire District
Sedona Arizona
928-204-8924
voters are entitled to transparency and this is a start
I agree with you Don on the need for transparency. At the same time, it also needs to take place on the governing board level. For transparency to fully function and survive, there is no room for side deals and backroom politics.
as a caregiver in a larger city that frequently used 911 and private ambulance options, a problem we had with private carriers was not accepting insurance reimbursements from medicare, major med, or private insurers due to a monopoly on services
taxes pay for 911 and you always get serviced-not so with private services-it’s prepay or stay as we call it.
not sure how it might work here but be careful down the slippery slope