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County reports large rise in ambulance billing charges and proposes switch from ESO to Fireworks after interface problems
Summary
County finance and EMS staff reported significant ambulance‑billing growth and described repeated interface failures between ESO (EMS run reports) and TriTech (billing), and proposed switching to the Fireworks records/CAD vendor after a successful test transfer.
Davidson County finance and EMS staff reported to commissioners on Nov. 6 that long‑term ambulance billing and a recent change in claims processing have increased gross charge volumes and collections, and that ongoing software interface problems are causing dropped calls and manual reconciliation work.
County staff explained that ambulance charges and collections have increased in recent years. Finance staff presented a historical trend of charges billed back to 2008 and said the county has collected roughly $111 million of about $142 million charged across the last 18 years (collection percentage varies by year). Staff noted that contracting directly with payers — rather than routing payments through patients — produced a…
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