SMCAS helping to lobby for insurance pay bill

By By BEN RAYMOND LODE / Niles Daily Star
NILES -- Southwestern Michigan Community Ambulance Service, which is headquarted at 2100 Chicago Road in Niles, is welcoming state legislators to its facility on Monday morning
The legislators will talk about a piece of legislation that could help solve a major problem for the state's ambulance industry.
Present at Monday's meeting, which starts at 11 a.m., will be State Sen. Ron Jelinek, R-Three Oaks, and State Rep. Neil Nitz, R-St. Joseph.
The legislation, which is currently before the Senate and the House Health Policy Committees, would require that insurance companies send payment directly to the ambulance service.
That's unlike now when sending payment directly to the patient often results in tremendous losses to the ambulance industry, either through revenue not being received or the added administrative costs of trying to collect the money.
Marlene Beach, executive director of SMCAS in Niles, said the Michigan Association of Ambulance Services has tried to negotiate with Blue Cross Blue Shield of Michigan.
That is the insurance company that reimburses most of SMCAS patients, as well as many other patients who require ambulance services throughout the state.
To illustrate SMCAS's problem, Beach said SMCAS currently has $42,000 outstanding with Blue Cross Blue Shield of Michigan, who only bill directly to ambulance services who are participating providers.
SMCAS is not a participating partner, but would consider becoming one if the reimbursement rates offered were better.
The insurance reimbursement issue is more poignant for ambulance services than for physicians. Physicians can often pick and choose their patients, while ambulance services cannot deny service to those in need.
Beach hopes the bill will hit the floor of the state Senate in late September or early October and that it will be approved early next year.
So far, the bill has 15 co-sponsors in the Senate, she said.
Jelinek, who is one of the founders of Three Oaks' Ambulance Service is one of the senators co-sponsoring the Bill.
Many state politicians became aware of the issue after ambulance services across the state organized Ambulance Day in Lansing, Beach said.
She said before that event, many of the legislators were unaware of the problem.
Beach, who is anxious to see what will happen to the bills, said there are meetings like the one to be held here on Monday held all over the state.

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