Zion updates EMS billing structure; chief says residents won't be repeatedly sent to collections, hardship waivers handled case by case

The Zion City Council on May 20 approved updates to the city's emergency medical services billing structure designed to align local rates with recent federal and insurer practices and to address collection and hardship cases.

Chief Street presented the update and told the council the main driver is alignment with rates used by the federally funded Ground Emergency Medical Transport program (referred to in the presentation as G E N T). He said audits showed discrepancies between G E N T rates and amounts paid by some carriers, and that some insurers have requested refunds where rates did not match.

"Our annual provider affirmative to the local base to our EMS billing structure [is] based on multiple factors. The biggest being that our current rates cannot align with recent G E N T program rates," Chief Street said. "For those that don't know, G E N T is ground emergency medical transport program, federally funded, government program for Medicaid." (speaker: Chief Street)

On collections and hardship waivers, Chief Street explained that the city historically has worked with its billing vendor to set up payment plans or waive fees on a case-by-case basis in instances of demonstrated hardship. "I don't have the actual ordinance in front of you... every once in a while, a previous chief or something would get a call from somebody explaining that they lost their job or, you know, that's just an example and they can't pay their bills and they will work with our our vendor on either waiving it, or setting up a very small payment plan," Chief Street said. "But again, it goes back to that also the clause that our city residents will never be sent to collections over and over again." (speaker: Chief Street)

Council members asked where patients are transported and how destination decisions are made. Chief Street said most transports from Zion go to "Vista and Waukegan" and that transports to other hospitals, including ones farther north, are made when a patient's condition and doctor preference warrant it. "Most of our transports are Vista and Waukegan," Chief Street said. "If it meets certain trauma criteria, maybe injury, we can go to Convo." (speaker: Chief Street)

The council moved to approve the updated billing structure, with implementation timing dependent on the city's billing vendor making the required changes in the vendor system. The update will take effect "as soon as our billing vendor can make the updates in our system," according to the memorandum provided to the council.

Clarifying details discussed at the meeting: - The update is intended to align local EMS rates with federally recognized ground emergency medical transport (G E N T) rates and to address audit discrepancies. - The ordinance language includes a hardship/waiver provision that allows the fire chief or a designee to waive fees on an individual basis; meeting discussion indicated the city historically has used that provision sparingly and typically works with patients and the billing vendor on payment plans or waivers. - Implementation is contingent on the billing vendor's software updates; no specific vendor implementation date was provided.

The council adopted the billing-structure update by roll call. No changes to transport protocols or hospital destinations were adopted in this vote; Chief Street described current practices and limits on destination choices during discussion.