Scarborough rescue fees on the rise

SCARBOROUGH — The cost of an ambulance ride in Scarborough will jump 25 percent under a price hike approved unanimously Jan. 18 by the Town Council, following a recommendation from Comstar Ambulance Billing of Rowley, Mass.

Late last year, Town Manager Tom Hall took advantage of a vacancy in his collections/excise office, juggling other positions and outsourcing the town’s EMS billing to avoid filling the post. As low bidder, Comstar agreed to take 4 percent of whatever payment it collects, starting with a patient’s insurance provider, including Medicare, MaineCare, then trying private health, automobile, workers’ compensation, or homeowner’s policies, where applicable. 

“It will cost us no more than it did to do the billing in house these past 25 years,” said said Fire Chief Bruce Thurlow, “and probably less, frankly. But they are professionals at what they do, they’ve very much up on all of the federal regulations, and their providing education to make sure we are doing the best job documenting the services we provide. All in all, I think it’s a win.”

Part of the Comstar’s three-year contract with Scarborough called on it to review the rates charged by the town. Although rates have tracked maximum allowable Medicaid rates, the basic structure has not changed in 10 years, Thurlow said.

Comstar’s recommendation was to charge 25 percent above the 2012 Medicaid rates, which Thurlow said did not cover the actual cost to deliver rescue services in town.

“We’re just trying to put things in line with what other cities and towns around us charge, so it makes more sense,” said council Chairman Ron Ahlquist.

Over the past five years, when doing its own billing, Scarborough succeeded in collecting between 78 and 86 percent of all dollars invoiced at the maximum Medicaid rate. The rest was written off when people proved unable to pay.

Under the new rates, emergency transport with basic life support jumps nearly $87 –from $349 to $436, while the price changed per mile of transport climbs from $6.86 to $8.61. That rate still leaves them below other local municipalities. Cape Elizabeth and South Portland, for example, both charge $10 per mile. The base rate for the highest level of medical service, advance life support level 2, will go up from $599 to $750.

“If someone is uninsured or has a balance due for co-pay or insufficient insurance coverage, Comstar will bill them individually according to the town’s billing policy,” said Thurlow.

That policy provides exceptions to the billing process for certain situations and allows residents to set up payment plans, when necessary. Billing may be waived or reduced for any balance not paid by insurance for senior citizens on Medicare but without supplemental coverage, and for cases of “hardship.”

“This will not cost the individual taxpayer more than their [insurance] plans will pay,” said Councilor Judith Roy.

According to Thurlow, it costs Scarborough an average of $656.70 per billable call to provide EMS services.