City approves $4.06 million ambulance billing write-off; leaders say new GEMT reimbursement could offset losses

The Idaho Falls City Council on Wednesday approved the write-off of $4,060,999.85 in unpaid ambulance service accounts covering calendar years 2021 through 2024, after an extended staff and public safety committee presentation that explained why much of the amount is uncollectible under current billing and insurance practices.

“Medicaid and Medicare discount that down to what they call allowable,” said Pam Alexander, the city’s director involved with utility and billing matters. She told the council the city is required to bill at published rates but insurers often pay a discounted allowable amount, producing a large gap between billed charges and actual reimbursements.

The council heard that about 72–75% of billed ambulance charges typically reduce to allowable reimbursement for Medicare and Medicaid claims. The…