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Ambulance board mulls insurance [Glasgow Daily Times, Ky.](Glasgow Daily Times (KY) Via Acquire Media NewsEdge) Oct. 30--EDMONTON -- The board of directors for Barren-Metcalfe Emergency Medical Services is still weighing whether to negotiate contracts to be considered a provider by certain health insurance companies. The service once had contracts with major insurance companies, but let those go with the understanding that the companies would have to cover ambulance service as if it were a contracted, in-network provider, because Barren-Metcalfe EMS is the only service in the area. But board members have received numerous calls in recent months -- as well as a complaint from one person who came to a meeting -- about insurance companies trying to postpone or avoid paying claims. And in some cases, the insurance companies send payments directly to patients, some of whom don't use the money to pay the ambulance bill, which requires further collection efforts. Representatives of Paducah-based Medical Accounts Receivable Systems attended Wednesday's board meeting at the Edmonton City Building to address the situation. A major reason the contracts were dropped was to save money, but several board members questioned whether it truly saved costs in the long run. Board member Greg Wilson, Metcalfe County's judge-executive, said some patients are nervous about what coverage they will have if an ambulance is needed. Board member and Barren County Judge-Executive Davie Greer asked whether, even with a contract, issues could persist depending on which plan or company is involved. Melanie Watson, a board member who is also chief compliance officer for T.J. Samson Community Hospital, said they could. One aspect to consider when under a contract, physician and board member Kyle Kiser said, is that if the insurance company decides the ambulance run was not medically necessary or not an emergency, the service has to accept that decision and cannot try to collect payment from the patient. Watson said some hospital employees have had trouble getting their insurance company to provide the expected coverage. She asked for figures regarding the cost effectiveness of being under contract versus continuing the way they are, because different issues are arising, even within the same insurance company. Nancy Jolly, office manager for the ambulance service, said she struggles to understand the logic in why some claims are paid and others are not. Daniel Hale, chief operations officer for MARS, said he would provide the information before their next meeting. Board Chairman and Edmonton Mayor Howard Garrett asked the board whether they wanted to take action, and several members said they would like to wait until they have that additional information from MARS. Wilson looked at Watson and asked, "So can I give them your number when they call? What are we supposed to do in the next two months?" Watson said he should recommend that patients check with their employer about whether ambulance service is covered, or address it directly with their insurance providers. Not on Wednesday's agenda, however, was discussion regarding a special Barren County taxing district to cover Glasgow and Barren County governments' portion of the ambulance service funding. At the conclusion of the last regular meeting in August, some members of the board planned to compile information to be presented to Barren County Fiscal Court. The fees the service collects cover the majority of its expenses, but the amount they do not cover each year is split among those two government entities at 30 percent each, and Metcalfe County and the hospital at 20 percent each. Metcalfe County created a special taxing district years ago, so its portion of the money does not come from the fiscal court's general fund, as do Barren County's and Glasgow's portions. In other business Wednesday, the board adopted a two-page policy for handling charity care cases that had been drafted by two board members since August, and it agreed to provide a comparable degree of benefits and paid time off to two employees filling new part-time positions that had not previously been specified in the budget, along with their salaries. The board plans to revisit the question of how many hours of vacation, sick and personal time all employees get. The next meeting of the ambulance service board will be Dec. 17 at 4 p.m. at the Barren County Government Center. ___ (c)2014 the Glasgow Daily Times (Glasgow, Ky.) Visit the Glasgow Daily Times (Glasgow, Ky.) at www.glasgowdailytimes.com Distributed by MCT Information Services |