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Pittsylvania County Officials Give Input on EMS Billing

DRY FORK -- Some of Pittsylvania County's fire and rescue organizations are in favor of a countywide ambulance billing system, but they want a clearer sense of what its guidelines would be. Clarence Monday, Martinsville's city manager, told representatives from four of the county's fire and rescue agencies of the system's advantages during a meeting at the Tunstall Fire & Rescue station Tuesday night.

Martinsville Fire & EMS began a fee-for-service ambulance billing system in 2004 after the city's paramedic-level firefighters were waiting up to 45 minutes for ambulances to arrive at calls. Its volunteer rescue agency, which was separate from the fire department, suffered from a lack of volunteers and a high volume of calls, Monday said. So city and fire officials decided the fire department should get ambulances for the patients' benefit.

The city also has a backup EMS provider, Stone Ambulance. "We felt that the best thing to do would be to get our patients to the hospital sooner," Monday said during an interview before his presentation. "It's been a good system for Martinsville." Fees go to the city's general fund which pays for the now combined EMS and fire service, said Monday, who has a member of Bassett's rescue squad since 1979, when he was 14.

Martinsville's EMS and fire service receives about 2,200 EMS calls a year and transports 1,720 of those patients, Monday said. The billing system generates about $300,000 in revenues per year that go to the city's general fund to pay firefighters' salaries and buy new equipment. The city does soft billing for patients, but goes after Medicare, Medicaid and private insurance, Monday said. The city's service sees about a 65-cent return for every dollar billed, he said. The city's fire and rescue department is paid and supplemented by volunteers. The fee-for-service option has had little effect on donations for organizations who adopted the system, Monday said.

The Pittsylvania County Board of Supervisors could vote on countywide billing for ambulance service from its rescue squads as early as next week. Kermit King, chief of Callands Fire & Rescue, said he favors the proposed system for the county but he wants to make sure there are guidelines for its operation. Pittsylvania County needs a backup system for answering calls, he said. "I think it's something that has to be done," King said after the meeting. People have less time to volunteer, said King, who also works two jobs. Kenny Hudson, Tunstall Fire & Rescue chief and vice president of the Pittsylvania County Fire & Rescue Association, said he would like to know what percentage of the fees would go to which departments and to operate the backup system. Eric Clark, a firefighter with Brosville Fire & Rescue who serves on the Fire & Rescue Association's EMS Billing Committee, said it's about time insurers begin paying for patient transports. "Insurance companies are getting a free ride off of us," Clarks said. Clark expressed disappointment at the low turnout at the meeting and said the billing system idea has been dragging out for too long.

The county has 14 emergency medical providers, including the rescue squads in Altavista and Danville. The county also pays Regional One EMS -- which bills its patients -- $70,000 a year to provide backup service. The proposed county ordinance would establish a countywide billing system for ambulance service and a back-up service, Ingram said. Revenues from billing would go into an enterprise fund in the county treasury. The money would pay for the backup emergency service and equipment for rescue squads. Some of the squads may not participate; Chatham and Gretna already bill on their own.

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