On Monday night, members of the common council discussed an estimate of potential revenue from a city-run ambulance service which was prepared by Multimed Billing Service of Baldwinsville, NY. Bill Shipman, senior vice president of the company, was at the meeting to discuss the estimate and answer questions.
Shipman explained that Multimed’s estimate for the city is based on 1620 “billable” emergency medical service calls per year which require transportation. Amsterdam Fire Chief Michael Whitty provided that number based on actual calls responded to by the fire department over the previous year.
According to Shipman, the amount of money that can be realized from each call varies due to the type of call, mileage traveled, and what type of insurance the patient carries.
Calls that require either intravenous medication or a cardiac monitoring are referred to as “advanced life support” calls and receive a higher pay out, while other calls are referred to as “basic life support.” Multimed’s estimate used a mix of 58% advanced life support and 42% basic life support based on actual call data from the fire department.
The estimate considered a mix of 12% commercial insurance patients, 31% medicaid patients, 52% medicare patients, and 5% self paying patients. For each type of patient, Multimed figured collection rates of 92%, 100%, 96%, and 6% respectively.
Shipman also explained that the amount billed for each call consists of a base rate with a mileage rate added on. He explained that ambulance providers are required to transport a patient to the nearest appropriate facility. Whitty said that for certain types of cases, such as cardiac arrest or trauma, that patients could be transported directly to Ellis Hospital in Schenectday or Albany Medical Center, rather than St. Mary’s Hospital in Amsterdam. If a patient is taken in through the emergency room at St. Mary’s but then requires transportation to another hospital, that responsibility would most likely fall to GAVAC, the city’s current ambulance service provider which also operates county-wide.
In order to come up with a final estimate of $634,787 in gross revenues per year, Shipman said he used statistical data from several other cities in NY State with similar insurance payer mixes and advanced versus basic life support percentages. Shipman said the company’s fees would amount to approximately 10% of the gross revenue. He said funds would be either transmitted to the city’s account electronically, or in the case of a check, deposited in a city account first. The company would bill the city on a monthly basis based on the actual amount of money collected.
Shipman said his company was founded in 1989, handles ambulance service billing exclusively, and currently has over 100 clients in multiple states.
Council members Jim Martuscello and Chad Majewski both said they favored Multimed to handle the city’s billing if the proposed city-run ambulance service moves forward.
Majewski said that out of several other billing companies who submitted proposals, that Multimed “came up with the most conservative proposal” that took into account the payer mix in the city.
A public hearing on a change to the city’s charter which would remove a current restriction on the fire department from running an ambulance service is scheduled for tonight at 5:40pm. The common council already voted 4-0 to approve the change, however the mayor must wait until after the hearing before he signs the change into law.
