An ordinance that would permit the township to bill third-party insurances for ambulance services that are provided from 7 a.m. to 7 p.m. was introduced — by a 3-2 margin. Township residents will not be charged directly for service.
Township officials estimate that the township can generate some $200,000 in revenues annually by adopting the ordinance. “Any way that we can increase our revenues, I want to do it,” Business Administrator Robert Hary said.
According to the ordinance, the township will contract with a professional medical billing service for the collection of payment for services by the township’s fire and emergency services personnel. The bill will be issued to the insurance company for the person served, if any, or directly to that person if insurance coverage is not available.
The ordinance also sets up the fees that will be charged for service. For ambulance transportation: $600. Other charges include $14 per loaded mile for basic life support; $75 for oxygen administration; $75 for automatic external defibrillator pads; $25 for cervical collars; $1,000 for motor vehicle extrication; $250 for first responder engine response; and $150 for fire responder response.
If a resident requires an ambulance or emergency response, the resident’s insurance carrier will be charged. The resident, however, will not be responsible for covering the co-pay, nor will a resident without insurance be forced to pay the entire bill.
The ordinance was introduced despite concerns raised by Councilman Charles Morgan. Morgan worried that the township could be accused of committing fraud by submitting claims for ambulance and emergency services for non-residents, but not charging township residents.
Morgan said he wanted to delay the introduction to do more research. He was concerned that the township could misrepresent the “usual and customary” charge in waiving the fees for residents.
For example, Morgan said, in the insurance industry, a doctor who charges a fee of $100 for a visit cannot waive co-pays for one patient and not another. If one patient has a co-pay of $20, he cannot waive the fee for that person, but continue to accept it from another. If he does, the “usual and customary” charge then becomes $80. Therefore, patients who have a 20 percent co-pay will only be responsible for paying $16, because he previously accepted a payment of only $80.
According to Township Attorney Michael Herbert, his office researched the issue and found that federal regulations allow municipalities to waive the charges under the argument that residents already pay taxes for the services.
“If a township resident does not have insurance, we’re covering the cost,” Hary explained. “If a township resident has insurance, we don’t charge the balance.”
Morgan suggested including language in the ordinance that states that the township would provide full disclosure of amounts waived for residents or those who are uninsured.
The council, however, voted to introduce the ordinance without the language. Morgan and Diane Ciccone, who did not state a reason, cast “no” votes. A public hearing is scheduled for Monday, April 6.
