In 2010 HRS implemented a fee-for-service system also known as “Revenue Recovery”. With municipal budgets being reduced drastically, and requirements for the squad at an all time high, the City of Harrisonburg and Rockingham County in conjunction with the area fire and rescue agencies, developed a plan to help offset the increasing costs of providing emergency services. The HRS leadership was deeply involved in the planning process to assure that our community will benefit from this program, that there will be as little impact as possible to our patients and that our volunteers will not be unnecessarily burdened with paperwork.
Here are a few frequently asked questions about our revenue recovery program:
Q: Will it cost me a lot of money if I am transported by the rescue squad? A: If you are a citizen of Harrisonburg or Rockingham county, or attend a school within that region, the system is being designed to prevent you from receiving a bill. We are investigating our ability to expand that to people who live in Augusta county as well through a reciprocal agreement.
Q: What if I do not live in those three municipal areas? A: If we provide service to someone from outside our area, we will bill any available insurance prior to sending a bill to the patient. Should the insurance company deny the claim, or if there is a copay or deductible, the patient will be sent a series of invoices for the balance of their bill. We will have a hardship plan in place for those people outside our area who are able to document their inability to pay for services.
Q: If I live in the area, will I receive anything regarding the bill? A: If we are unable to obtain your insurance information prior to billing, you may receive a phone call and/or letter in an attempt to collect your insurance information. Your insurance company will also likely send you an “EOB” or Explanation of Benefits which outlines the invoice they were sent.
Q: If I do not have insurance will I receive a bill? A: Not if you live within the partnering municpal areas.
Q: Would anyone ever be denied service based on inability to pay? A: Absolutely not. First, our purpose is and will continue to be to provide the best care we possibly can to every person who needs us. This is only a way to help fund that goal. Second, the crews who respond will not be concerned with the billing functions of the agency. They see a patient…a person in need of assistance…not an insurance claim.
Q: Will you still be asking for donations and doing fundraisers? A: Yes. Our agency will remain a volunteer, non-profit, 501c3 designated agency. Revenue Recovery will provide a steady income which is at least somewhat reliable regardless of economic conditions at the time. However, it should be viewed as a supplement to the support we currently receive from the community, not a replacement. We will still rely on donations for many of our major purchases such as ambulances and other response vehicles.
Q: What do you do with this income? A: Running a rescue squad is an expensive task, even without a payroll to cover. The equipment and supplies we purchase tend to be extremely expensive. An ambulance, depending on design, can cost upwards of $275,000. A single cardiac monitor nears $40,000. A service vehicle often takes $45,000 to purchase and outfit. Then maintaining these items is expensive as well. We have expenses like any business, for utilities, hvac, insurance, uniforms, computers, etc…and of course, the medical supplies and even if not used, have to be replaced by expiration dates. If our income does increase, the biggest change we are likely to make is to increase the training opportunities available to our members. We will be able to host training in this area that typically we have to send people away to receive. For instance, did you know there is no Paramedic training available in the Shenandoah Valley? We routinely have members traveling several days per week to northern Virginia to take this course. We hope to work in conjunction with other training institutions in our area to develop new training programs here in Harrisonburg and Rockingham County. There are also a number of excellent training programs that are not available in this region that we currently cannot afford to send our members or officers to attend. These courses would allow our agency to bring back what are termed “best practices” from agencies and teachers they would otherwise not have exposure to. Again, all in an effort to provide the best care possible to those we serve in our community.
Q: Why have a company in North Carolina do your billing? A: Medical coding, the process of turning care of the patient into a bill, requires special training and software. Ambulance billing specifically, is a sub specialty of this that not many people know how to do well. While there are billing agencies in Virginia who do ambulance billing, finding one that does it well and is a good fit to your agency without charging tremendous amounts of money is difficult. After a lengthy process, EMS Management and Consultants was chosen due to their references, their experience and their rate.
If you have any questions for our agency about billing, we have set up a special email address: billing@rescue40.org to address questions and concerns. If you have a question about a letter you received regarding your insurance or a bill, please contact EMSMC directly by going to www.emsbilling.com or calling them at 800-814-5339.