CLEAR LAKE — The Clear Lake City Council this week passed the first reading of an ordinance that would make adjustments in the ambulance service user fees.
City Administrator Scott Flory says the recommendation for the slight increases come from the city’s third-party billing administrator, PCC of West Bend, who has determined that the fees charged for the operation and maintenance of the ambulance service need to be raised to better offset the costs of the service. “They keep track of what the maximum allowable fees are for Wellmark, it’s kind of the industry standard for this. There’s a number of categories that we’re increasing, so this is one of those items that we try to stay on top of. As you know, the ambulance service does not necessarily cash flow, so anytime we get an opportunity to increase the fees consistent with what the insurance companies pay, we try to get all over that.”
Flory says the increase will help close the gap between the city’s costs and the amount paid by Medicare and Medicaid. “I think Iowa is still 51st in terms of ambulance reimbursement for Medicare, and that is the overwhelming amount of our calls are Medicare and Medicaid call, maybe 20% of our calls are private insurance calls. So this will definitely help in terms of bottom line numbers on the cash flows on the on the ambulance but on the private insurance side of things I think it’s only about 20% of our call volume.”
The costs of non-emergency transport would stay steady, with the basic life support fee being $400 and the advanced life support fee being $600. Emergency transport with basic life support would go up from the current rate of $595 to $625, while emergency transport with advanced life support would go from the current $706 to $750. Ambulance service at the “Advanced Life Support 2” level, which typically includes the administration of medically necessary services, would go up from $1023 to $1100. The “loaded mileage charge” would also increase a half-dollar to $13.50.
If passed on all three readings, the new fee structure would go into effect on July 1st.