The Shadow
The city of Covington is now soft-billing residents for emergency transport to LewisGale Hospital-Alleg-hany by the Covington Rescue Squad.
Soft-billing went into effect in July and city officials are now working to make sure Covington residents understand how the process works.
“The first thing (the squad) will do is their very best to aid the injured or the sick,” said Covington City Manager J.B. Broughman at a public forum on soft-billing held Monday night. “After that, they’ll get some basic information that will probably come from what they give to the hospital.”
The next step in the process is to turn that information over to MCA, the vendor handling the billing process for the city.
“The vendor will send a bill to everyone, because that’s what the law requires,” Broughman ex-plained. “The insurance company, pending whatever coverage is in place, will pay what they will.”
Any co-pay required by the insurance company, as well as anything else that isn’t covered by insurance, will then be billed to the patient.
By the terms of the ordinance passed earlier this year by Covington City Council, the city considers the co-pay and any other charges to have been taken care of through taxes.
“Our ordinance says that all city of Covington residents, and those in our primary coverage area, deems those residents to have paid their co-pay and other charges by having paid their taxes,” Broughman said.
Those who live outside the city and the squad’s primary coverage area, which extends into Alleghany County in areas immediately adjacent to the city, will not qualify for the automatic waiver of the co-pay.
Patients who receive any other charges from their trip to the hospital may apply for a waiver.
“Anybody that feels like the charges that might be theirs outside of what insurance covers, those folks can find themselves under some sort of coverage,” Brough-man said. “If they come in and fill out a form that claims its a financial hardship, we’re gong to give those folks waivers.”
Broughman said “very few” people should actually have to pay for EMS services.
“There are very few people who should fall outside of the avenues of coverage that we have in place and have to pay,” he said.
Other localities in Virginia have adopted “hard billing” for EMS services.
“They don’t care. If they respond and transport you, then will expect you to pay. We’re not that place,” said Broughman. “The purpose here is not to burden folks by paying for transport.”
“All we really want to do is cover the cost of what it takes to run our rescue squad,” he added.
Since 1933, the Covington Rescue Squad has been fully supported by the city of Covington.
The squad answers an average of 1,300 calls per year, and officials have said it would be reasonable to expect that half of those calls would involve transport.
The Clifton Forge Rescue Squad currently soft-bills patients for transport to the hospital. According to data released at a Covington City Council meeting in March of 2012, the Clifton Forge Rescue Squad collects an average of $250,000 per year from 1,300 to 1,400 calls for service.
Soft-billing has the potential to be a tremendous shot in the arm to a city budget that has grown increasingly tighter in recent years.
“Our squad, like all city departments, comes before council for funding. They get a lot of what they need and they get told ‘no’ a lot,” Broughman said. “This should make it a little bit easier for them to have the funds to take of the things they need.”
Among the squad’s list of needed equipment is a new ambulance, which would be the first step in replacing the squad’s current aging fleet of emergency vehicles.
A single ambulance carries a price tag of approximately $160,000.
City officials are unsure of how much revenue soft-billing will generate, but Broughman said they remain hopeful.
“We’ve made projections of what we may bring in, but until we get a couple of years under our belt we just don’t know,” he said. “We do think it’s going to bring in enough to cover the basic operations of the rescue squad.”
