By By BEN RAYMOND LODE / Niles Daily Star
NILES -- Southwestern Michigan Community Ambulance Service hosted a meeting with state legislators on Monday.
The meeting, which took place at the SMCAS headquarter in Niles, focused on the need for ambulance services to changing the way reimbursements are being collected.
Currently, SMCAS, who on average responds to 10 to 12 calls a day, is having a hard time collecting money owed to them by patients who have needed their services.
The problem, which is common for ambulance providers statewide, stems from Blue Cross Blue Shield of Michigan, and other insurance companies, not using a direct reimbursement system for payment for non-participating ambulance service providers.
Rather, they send payment for ambulance services to the patient, who in turn is supposed to reimburse the ambulance service.
Michigan Association of Ambulance Service (of which SMCAS is members) statistics, in fact, say nearly half the time the patient either doesn't understand their obligations or simply uses the money for other purposes and fails to reimburse the ambulance provider.
SMCAS, who is not a participating partner with Blue Cross Blue Shield, has billed Blue Cross Blue Shield over $42,000 this year, but has so far collected only $2,700.
The average cost for each ambulance call is $600 to $700, of which Blue Cross Blue Shield of Michigan covers 60 percent by mailing a check directly to the patient.
The patient is then supposed to cover the remaining 40 percent out-of-own pocket.
The money SMCAS hasn't collected, and in many instances eventually has to write off as a loss, said Beach, comes in addition to ambulance services already being pretty far stretched financially in terms of the challenges that have been imposed on them in recent years.
State Sen. Ron Jelinek, R-Three Oaks, who was a founding father of Three Oaks' Ambulance Service, said the increased challenges come from Homeland Security and a lot more responsibility than before.
Which appears to leave ambulance services short of funds they desperately need to keep down the costs for people who are in need of their services.
Harry Klingeman, an attorney who represents the Michigan Association of Ambulance Services, said the Association has been in negotiations to solve the problem with reimbursement from Blue Cross Blue Shield for several years, but nothing has ever come out of the negotiations.
Currently, however, there is legislation before the House and Senate Health Policy Committees to address the problem.
The legislation, which would apply for emergency medical transport only, would install a two party check system to the patient and the ambulance provider from Blue Cross Blue Shield and other insurance companies involved.
Having sat in on the meeting and asked several questions to better get an understanding of the issue, Charles LaSata, State Reps., 79th District, said there seems to be a need for the legislation
After the meeting, the state representatives were given a tour of the SMCAS facility.