Scarborough outsources EMS billing

SCARBOROUGH — From now on, when you get a bill for an ambulance ride in Scarborough, the return address won’t be the town office, but a company in Rowley, Mass.

Town Manager Tom Hall advised councilors at their most recent meeting that he had contracted with Comstar Ambulance Billing, a service founded in 1984 to collect payment for municipal EMS services.

“For some time we have appreciated that the complexity and ever-changing world of Medicare/Medicaid and third-party payers have made our efforts to collect for EMS services rendered challenging to say the least,” Hall said on Friday.

When an employee in the town’s Collections/Excise Office moved away early this summer, that gave the town, Hall says, “an opportunity to evaluate all of the functions we were performing.” Some positions were juggled, and EMS billing outsourced, which allowed the town to carry on without filling the vacant position.

As low bidder, Comstar will take 4 percent of whatever payment it collects, starting with a patient’s insurance provider, including Medicare, Mainecare, private health, automobile, workers’ compensation or homeowner’s, where applicable. 

“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 Scarborough Fire Chief Mike 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.”

Thurlow says current EMS rates in Scarborough are “set at the Medicare maximum allowable charges for our geographical area.” However, “those rates are significantly lower than the cost of providing the service and they are also lower than many of the other private health care insurance companies are willing to pay,” he said.

According to Hall, part of the service Comstar has promised to provide is a full review of Scarborough’s EMS rates, with the aim of maximizing revenue from insurance companies and minimizing the cost to taxpayers.

Those new rates could be in place as soon as January, said Hall.