Item 2: Functional Consolidation of Fire Departments

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ATTACHMENT C ? FireMed ? Organizational Structure ? Office Locations ? Compliance (HIPAA, SOP, policy/procedure) ? IT (all tech & software support) ? Records Management/Storage Description of Present Service Delivery Model: Ambulance Billing: Both Eugene and Springfield operate ambulance service as a fee-for-service function. Billing is a necessary function in the success of ambulance operations. Billing for patient services rendered is primarily influenced by the reimbursement practices of various health insurers including Medicare, Medicaid, private insurance, worker’s comp, and private pay accounts. The majority of the patient claims for both departments are from government reimbursement programs. Medicare provides federally funded governmental health insurance for people 65 years of age and older. Medicaid is a combined federal-state program with the federal government contributing a portion of the total funds required. The Medicaid program is administered by the state of Oregon to provide medical care for those patients whose low incomes would otherwise prevent them from being cared for. Both Eugene and Springfield have designed billing systems and developed personnel to operate the system to produce good collections results. Each ambulance billing section runs essentially the same in that once a patient is transported; the run is entered into the billing system generating a bill for service(s) rendered. These bills are then sent to the patients’ primary insurers: Medicare, Medicaid (Oregon Health Plan), commercial insurance or other third party payor. Patients without insurance coverage are put into a self-pay category and invoiced directly. Often the self-pay patients have minimal resources and staff attempts to find ways for payment through payment plan options. Accounts in arrears are forwarded to an outside collection agency for payment recovery. Springfield’s Ambulance Account Services section provides ambulance billing services for 19 government entities besides Springfield. Billing Accounts and Collection: Springfield Billing Contracts Total Eugene Springfield (IGAs) Accts. FY09 # Pt. Accounts 11,008 6,779 15,090 32,877 FireMed: FireMed is an ambulance membership program of the Eugene, Springfield and Lane Rural Fire Departments. Membership constitutes a prepayment of the member’s out-of-pocket expenses for ambulance transport such as insurance deductibles and co-pay amounts. FireMed covers emergency (Eugene) or emergency and non-emergency medically necessary (Springfield and Lane Rural) ground ambulance service. A $52 annual membership covers all members of a household. Program administration for all three partners is consolidated. 27 ATTACHMENT 3