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Ambulance billing shows signs of recovery; committee reviews calls and collections data
Summary
Committee reviewed ambulance billing and operations: average ~160 calls per month, changing billing vendors affecting accrual reporting, improved percent-current receivables and high Medicare payer mix limiting collection rates; committee discussed levy timing and collection strategies.
The finance presenter provided an ambulance billing analysis showing operational stability and improving collections after a period of deterioration. The committee heard that the system has averaged about 160 calls per month in recent years and that average billing per call varies with mileage and service type.
Staff described a recent shift to a new billing company that is reporting on an accrual basis; that change can move amounts into prior months and requires adjustments to past monthly totals to maintain consistent trends. Presenter said the percent-current receivables have improved, with roughly half of accounts now current, reversing a downward trend.
The payer mix—high reliance on Medicare and Medicare Advantage—means collections as a share of billed charges will be lower than counties with different payer mixes; staff said counties typically collect roughly half of assessed inmate fees or billed amounts in some contexts. Presenters noted some large write-offs and reversals from prior vendors that affect year-to-date figures and that overall ambulance income statements could show short-term variance, which complicates setting the levy before year-end actuals are known.
Committee members asked for continued monitoring and emphasized the effect billing trends have on levy-setting; staff described steps to refine monthly reporting as more months of data accumulate with the current billing vendor.
