First Responder Fee Treat and Release Fee AC

First Responder Fee Treat and Release Fee A/C Scott Clough March 28, 2013

FRF/ TRF What is it? O Legal, ethical, honest billing for services that is recognized by most private insurance companies O Is charged for all encounters that result in a patient assessment O Has NOTHING to do with ambulance transport O Is not regulated by your LEMSA

FRF/ TRF What is it not? O It’s not a “crash tax” O It’s not a money grab O It’s not a scam

FRF/ TRF How does it work? O Metro passed a resolution allowing the billing to O O take place We established a fee schedule based on costs There are two costs; First Responder Fee is bundled into the transport cost Treat and Release Fee is billed for non-transport

FRF/ TRF Projections O 80, 000 calls for service annually/ 73% are EMS = 58, 400 O 72% transport rate = 42, 048 O 20% collection rate on FRF and TNT = 11, 680 O $275. 00 per contact O Total collection/yr = $3. 2 million – 2% of budget

FRF/ TRF Methodology O Average time on task E/T = 20 minutes O Average hourly rate per unit = $150. 00/hr. O 58, 400 calls / 3 (20) = 19, 466/hrs on task O 19, 466 x $150. 00 = $2, 919, 900. 00

FRF/ TRF Actual reimbursements to date O Collection rate is about 17% O 17% collection = 9, 928 billable calls O 9, 928 x $275. 00 = $2, 730, 200. 00

FRF/ TRF What is the backlash and how do we handle it? O Since introduction in February 2012 - 67 complaints O Most will come from senior groups – most vocal O Explain that taxes do not cover the full cost of service O Explain the cost of response and treatment of “individuals” medical cost

FRF/ TRF What is the backlash and how do we handle it? O Most will come from senior groups (continued) O “Individual” treatment above and beyond suppression is costing all tax payers O Without supplemental payments the service would be cut back or eliminated O “Individual” service that can be covered offsets the cost and allows continuation of medical services O Because 20% of patients have FRF/TNT coverage it allows us to wave the fee for those who don’t

FRF/ TRF O Auto insurance coverage O Statewide mandate O Needs to be looked at the same as work comp O Medical coverage is paid on first come first serve O Pays the full cost of transport if there is money to cover it O Most if not all insurance providers have a 1 st responder covered amount O Not billing is disenfranchising the policy holder

FRF/ TRF O Auto insurance coverage O Metro does 6 MVA transports per day 3 are insured O Average transport = $1640 + $275 = $1915 O 3 x $1915 x 365 = $2, 096, 925

FRF/ TRF How do you get this started in your department? O Need to have Board approval and pass a resolution O You do not need to have LEMSA approval for FRF/TNT fees

FRF/ TRF How do you get this started in your department? O If you receive FRF pass through from ambulance co. can you still collect? O If the ambulance is not billing a separate line item for FRF O If the pass through is for compliance purposes (stopping the clock) O If the pass through is considered a dispatch fee

FRF/ TRF How do you get this started in your department? O You must obtain an NPI number O BLS counts and will be reimbursed at the BLS rate O Dead bodies pay $$$ O Medicare = $532. 00 O Medi-Cal = base ALS rate for ALS intervention