Fire Rescue
Billing Department History
Prior to 1975 and emergence of a County run EMS System, the Office Manager for Alachua Ambulance Service, Inc. handled whatever billing was done for the services provided. Ambulance Crews were encouraged to collect payment at the time the services were rendered. When collection for services was impractical, or payment was not received, the patient, or patient's family would be immediately invoiced for the service.
In 1975 the Alachua County Clerk of the Circuit Court, Office of Finance and Accounting assumed the billing responsibilities for ambulance services. Patients could then submit claims to Medicare and private insurance carriers for reimbursement. Invoices were generated on a typewriter and mailed to patients. No follow up statement was generated, unless a payment was made toward the balance. If a payment was received, the amount was typed on the original invoice, and the invoice mailed again to the patient. Only Medicaid was billed directly by the Ambulance Billing Department of the Office of Finance and Accounting. The Clerk of the Circuit Court charged the Department an annual fee for processing ambulance billing. The collection rate was estimated to be 38%, which was considered acceptable at that time.
In 1985, the Ambulance Billing Department was enhanced to a computerized system. Ambulance fees were entered on a mainframe type computer and payments could be posted to the patient's account. The computer could now generate invoices and statements. The collection rate had improved to just under 50%.
In 1989, the Ambulance Billing Department, still under the Clerk, began billing Medicare and third party insurers directly. This created a slight improvement in collection rates to just over 50%.
In 1991, the Ambulance Billing Department was transferred to the Support Services Division of Alachua County Fire Rescue. This transfer proved to be a success. Now, with a Department-dedicated billing office collection efforts improved, and there was a noticeable improvement in the collection rates. In the first year, the collection rates improved by 10%, and the Department collected more than 55% of the amounts invoiced.
The Ambulance Billing Department has continued to improve billing efforts through the use of electronic filing for Medicare and Medicaid, a billing software specifically designed for EMS billing and more assertive collections for Medicare, Medicaid and Insurance payers. Rapidly changing and constricting Medicare laws have lead to an industry-wide average collection rate of 50 to 55%. Despite the changes in Medicare and the insurance industry, and despite the large population of college students who are uninsured, the Department's collection rate in 1998 was 62%, excluding forced Medicare/Medicaid adjustments. The ambulance fees collected during 1998 generated approximately $3,500,000.00 in revenue - considered outstanding by industry standards.
