Iredell County authorizes EMS billing contract revisions, adopts new ambulance fee schedule

The Iredell County Board of Commissioners gave consent to authorize the county manager to finalize a three-year contract with EMS billing vendor EMSMC, and approved a revised ambulance fee schedule effective Feb. 1, 2025.

County staff said the contract change updates the electronic patient care reporting software used by EMS from EMSCharts to ESO. Eric Morrison, who presented the item for emergency medical services, said the vendor agreed to absorb the increased implementation costs when the county moved from about $35,000 of incorporated costs to roughly $67,000 for the new software. "We were able to work with the vendor and make sure that this remained budget neutral," Morrison said.

Morrison told commissioners the vendor continues to be paid a percentage of collected bills and that the current collection rate with EMSMC remains unchanged. When asked about the collection rate, Morrison confirmed, "Yes. And that has been our existing, collection rate with them as well," and elsewhere staff noted the rate as 7.4 percent.

On fees, county staff explained the last change was in 2014 and recommended aligning ambulance charges to 150 percent of Medicare reimbursement — a level the presenter said is consistent with neighboring counties. Morrison said the county expects the higher schedule will increase what is billed to about $4,300,000 per year, with projected actual collections near $2,500,000.

Both items — authorization for the manager to execute the revised three-year contract (subject to final attorney review) and approval of the updated fee schedule effective Feb. 1, 2025 — were approved by consent.

The contract authorization included a caveat that the county manager and county attorney review the vendor redlines before signature; no formal motion maker or seconder was recorded in the administrative session for these consent approvals.