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Oregon City Council is taking a close look at the wisdom of billing insurance companies, Medicare, and Medicaid for emergency medical runs by the city's fire department.
The practice, known as “soft billing,” is the norm for cities in the area, according to city Administrator Michael Beazley who has suggested that this was a way to help maintain Oregon’s financial stability.
Historically, medical runs were a service communities did not bill for, he explained at a safety committee meeting last week, but no more. Equipment is much more expensive than it used to be. Moreover, he said, the current policy meant Oregon residents were effectively subsidizing other fire departments. He emphasized that if council authorized the new policy, the bills would go only to insurers.
“No bill will ever be received by any [Oregon] citizen?” Councilman Mike Sheehy asked.
“The administration feels very strongly that under no circumstances will we have anything other than insurance billing,” Mr. Beazley responded, adding that he had no position on billing nonresidents.
He estimated that eventually soft billing could generate annual revenue of about $250,000 for the city.
Tom Steuer, sales director of a Cincinnati firm that does emergency medical billing for communities, told council members that Ohio medical insurance is required to cover such medical transports, and that billing for it would reduce the burden on taxpayers and generate revenue for services.
“It will not force [tax] rates to rise,” he explained, adding that EMS runs today are more of a fee-for-service operation, with those who use the service paying for it.
“Oregon residents will not see any sort of out-of-pocket expense,” he continued. “Insurance payments will satisfy the obligation for Oregon residents.”
Mr. Steuer’s PowerPoint presentation showed that his company, Medicount Management Inc., provided EMS billing for Whitehouse as well as Monclova, Providence, Springfield, and Richfield townships in Lucas County. In Wood County, Perrysburg Township was a customer, and in Henry County, Ridgeville Township.
He said Medicount had more than 50 customers that had been with the firm in excess of 10 years. He described the company as a full-service operation that would act as an extension of the fire department. It would charge Oregon about 7 percent of the money it collected.
Mr. Beazley noted that in Oregon insurance companies already were paying for advanced life support runs, which are handled by Lucas County. The new billing policy, if adopted by council, would apply only to basic life support runs, which are for less serious cases.
Councilman Jerry Peach recalled that soft billing had been discussed in the past, and “council was reluctant because it was not clear that runs were covered by insurance,” but “that tipping point has passed.”
Mr. Steuer said the average charge for a basic life support transport was $600, but that Medicare and Medicaid paid much less.
Council President Tom Susor said no decision on the new policy had been made.
— Carl Ryan