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OFFICE OF EMI~RGENCY SERVICES '~45 Cabarrus Avenue. W. · ' CONCORD, NORTH CAROLINA 2R025 TO: Mr. Charles McCinnis '- FROM: 'B.H. ~brey,'Sr.-- - -' ....... ~:- · .' ' DATE: April 30, 1986 ' ' ~ ' ' ' SUBJECT: Ambulance Service Fees and Collections The cost of operating the ambulance service continues to increase each year and is directly related to the level of care provided. As a result of this relationship, it is time for the county to consider a tiered charge system dependent on the level of care given the patient that is transported. A patient that is transfered from a nursing facility to a doctor's office does not require the same level of care as a patient in cardiac arrest or a patient that is pinned in an automobile accident with severe head injuries, loss of large amounts of blood and spinal injuries. By the same token the charges for these calls should not be the same. At the present time the base charges for all calls are equal. I would recommend an increase in the BLS (Basic Life Support) base rate from $50.00 to $60.00 an~]~rease in ~.~ ALS (Advance Life Support) rate to~_~85.0Q. These increases will keep us in line with other services in~e area and help to cover some of the costs of the ALS equipment that is required to provide the best possible service to the citizens of Cabarrus County. The increase in the BLS charges will also deter some of the request for service from outside the county because we have the lowest transport rates available. The second request is to drop the $150.00 minimum before collection of ambulance bills can be initiated. The county commissioners gave permission to pursue collection of unpaid bills last year but only if the total was over $150.00. State law says we can only use attachment of bank accounts, garnishment of wages, etc. for the period beginning 90 days after the date of service up to 180 days after the date of service. This allows the use of the ambulance once a month free since an abuser would not go over the $150.00 collection limit imposed. This request is not intended to hurt little old grandmothers on a fixed income. Discretion would be used, as it has in the past, as to which accounts should be actively pursued for collection. My third request also deals with bill collection. The auditors have made the reco~endation that billing and collection be done by separa[e agencies to insure proper control. We have never had a problem in this respect but with the increase in the number of ambulance calls and increase in the general work- load, division of billing and collection needs to be done. My request is to move ambulance fee collection to the tax collector's office. With some modifications to our computer program to give both the ambulance billing office and the taz collector access to the ambulance files, this system would work