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EMSMC review: County EMS posts about $721,000 in collections for year; board to weigh flat $22 fee versus percentage model
Summary
EMSMC reported May net collections of $72,732 and a year-to-date net collections figure of $720,967, yielding about a 72% net collection rate; county EMS leaders asked EMSMC to model alternatives to the current $22-per-billed-trip fee, including a percentage-based management fee.
Chelsea Mach, customer success executive for EMSMC, presented an account review to county EMS leadership, saying the vendor closed May with 141 billed trips and reported $72,732 in net collections for that month. "So for the trips billed, we ended May with a 141," Mach said, and later summarized fiscal-year figures on the client dashboard.
Mach showed the agency’s dashboard figures and explained accounting details such as prior-period adjustments and contractual allowances. She reported fiscal year-to-date gross charges of $1,938,097 and contractual allowances of $937,648. On the dashboard Mach used to calculate performance she reported total payments collected of $720,967 and a net charge figure listed as $1,000,448; dividing those two numbers produced a net-collection percentage of about 72%. "So that's actually a really good number," Mach said, calling it above a common industry benchmark of about 65%.
Board members and staff asked for clarifications about what "net collections" represents; Mach confirmed it refers to money actually received (payments posted), not gross charges billed. She offered to provide a more detailed comparison of gross charges, contractual allowable adjustments and net collections on request and to generate client-facing reports for the board.
The group also discussed EMSMC’s fee structure. The current per-claim management fee of $22 was described as a flat, predictable line item. Mach outlined an alternative: charging a percentage of net collections; she used 7% as an illustrative example and said actual percentage proposals can vary widely by provider size and mix. "If we were to charge 7 percent on that same month of May at $72,732, that means your management fee would have actually been more at $5,000," she said. Participants asked EMSMC to have the company’s CFO prepare a comparative projection of the two models so the agency can evaluate budget and incentives.
Mach also recommended reviewing the agency’s fee schedule to better align list charges with Medicare allowable rates — typically recommending fees at about two to three times Medicare allowable rates to improve commercial reimbursement capture. She confirmed such changes could include mileage charges and said she would prepare written recommendations for the board.
Next steps: EMSMC will prepare a detailed projection comparing the $22-per-billed-trip structure with percentage-based management-fee options and will review the agency’s Medicare-contracted rates and proposed fee-schedule changes with local leadership.
