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Patrick to bill for fires

Thursday, December 13, 2012

By SAM JACKSON - Bulletin Staff Writer

Patrick County Emergency Services plans to begin billing for certain fire incidents Jan. 1, according to a release from the county EMS.

Services that will be billed include the fire department’s responses to house and vehicle fires and accidents, the release said. Fees typically will range from $100 to $1,000, and the cost will be determined by the nature of the call as well as the time and materials needed, the release said.

According to Patrick County Emergency Management Coordinator Steve Allen, the decision to bill for services is due in part to the rising costs of maintaining volunteer emergency services.

“You have to look at cost of fuel, how much it’s gone up in the last couple years,” he said. “It’s almost doubled the past couple of years. If you go out on a fire scene, you can run up $100-$200 in just fuel on a fire scene.”

Patrick County’s rescue squads have been billing for services for the past couple of years, Allen said, such as transporting patients via ambulance. Billing for rescue calls has helped fund training and supplies for the rescue squads, he said.

“It’s worked pretty well with the (EMS) volunteers,” Allen said. He said the fire department hopes to use the same billing plan to fund replacement fire equipment.

Allen said he was not sure how much money the fire departments could gain by billing for services, as each call would be billed differently. “A hazmat (hazardous materials) call would be a whole lot higher,” Allen said, as would a vehicle extraction. A call to fight a small fire would be cheaper, he said.

The fire departments’ decision to bill for fire services comes as a result of HB 1202, which was signed by Gov. Bob McDonnell in March to amend the state code to allow volunteer fire companies to charge for services and directly bill liability insurance companies. The bill makes it easier for volunteer fire companies to collect payment for their services, Allen said.

The release stated that “if the policy holder is a taxpaying resident of Patrick County and does not have insurance, or if insurance denies part or all of a claim, the balance will be written off and the policy holder will not owe anything.”

Insurance companies will not cover illegal burning, and the property owner or responsible party will be billed, the release added.

Asked how the money would be collected if a party responsible for an illegal burn did not or could not pay, Allen said, “we haven’t gotten that far, and we hope we don’t have to.”

Allen said several other volunteer fire departments in the area are considering similar billing plans, including Henry County. Public Safety Director Rodney Howell said no decisions have been made by the local companies, but the departments are “evaluating it now to see what kind of course of action they want to take.”

When the companies meet again in January, “I’m sure it will be discussed again,” he added.

According to Steve Simon, division chief of administration for the Roanoke County Fire Department, one issue that could make billing for fire services difficult is the difference in billing procedure between a health insurance provider (in the case of EMS services) and a property casualty insurer for fire calls.

“When billing for extrication or fire services, as a person who’s injured or needs those services, you have to submit a claim, (then) the insurance pays you, and then you pay the fire department,” said Simon, who has worked with the state Office of Emergency Medical Services to outline how emergency agencies can effectively set up billing programs for services. “That’s a very cumbersome process, and in a lot of cases the person hasn’t met their copay. That’s why most places in Virginia don’t bill for services.”

By comparison, he said, “when it’s EMS services or transport, there are statutes that allow the money that goes to insurance to come right back to the local government.”

In some cases, Simon warned, the cost of collecting for a fire call might exceed the return. “If that was a feasible way to generate revenue, every county and city in Virginia would be doing it,” he said. However, he added that with smaller counties such as Patrick, which might have fewer than 10 billable calls per year, it might be something of zero-sum equation, in which any return would be better than none.

“As an agency, you have to be careful,” Simon said. “Are you doing hard collections or soft collections? They’re going to get a little, but they’re not going to get a lot.”

Allen said Patrick County uses Fidelis Billing, a third-party vendor, to collect for EMS and will use it for the fire billing as well. On its website, Fidelis describes itself as “a leading nationwide pioneer of billing and revenue cycle management services for public, private and not-for-profit providers of emergency and nonemergency medical transportation and fire services.”

Allen said Fidelis would be paid about 6 percent of the revenue generated by fire and EMS calls.


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