Finance committee moves ambulance financials to quarterly reporting; EMS collections and staffing update

The Sawyer County Finance Committee on March 13 agreed to move its ambulance financial reporting from monthly to a quarterly schedule and reviewed a detailed EMSMC (ambulance billing manager) report that ties charges to collections by run.

County staff said ambulance operations finished 2024 with a profit of about $53,000 that was placed into an assigned fund balance. For 2025 staff reported early-year gross charges and a net collection pattern that lags by several months — staff warned March’s current-month collection percentages are lower because insurance payments commonly arrive three months after billing. As a result, staff said cash-flow graphs should be read on a rolling, multi-month basis rather than by single-month snapshots.

Staff and the third‑party EMSMC representative explained key billing terms to the committee: gross charges, contra‑allowance (insurer-negotiated reductions that typically remove roughly one-third of gross charges), net charges and the net collection rate. The packet showed Medicare and Medicaid constitute much of the payer mix; patient/self-pay and private insurance make up a smaller portion and have lower collection percentages.

On staffing, staff reported the ambulance service had filled all but one paramedic position in late winter and had promoted and certified three AMTs to paramedic status; the county was actively backfilling the resulting vacancies. Staff said increased staffing improves availability (the county is aiming to staff three rigs rather than two) and helps reduce reliance on external transfer contractors.

The committee accepted EMSMC-style reporting on a quarterly basis and asked staff to continue monitoring billing/collection timing and transfer activity.

Ending: Staff will provide quarterly EMS financials and continue targeted quarterly monitoring of transfers and collections.