Guest Column: Fire Department working to fix ambulance-transport record problems By JOHN ROBERT RAY and BILL RYAN, For The Capital
Published 03/08/10 The Capital editorial, "Costly blunder raises questions about Fire Department," (Feb. 23) stated you wanted to hear more from the Fire Department on this "blunder," and what actions are being taken to avoid future mistakes.
Advertisement The editorial questions the current county Fire Department administration wherein it states the software was purchased in July 2005. The decision to purchase this software began in August 2003, prior to our appointments and prior to John R. Leopold's tenure as county executive. As public officials we have a responsibility to be accountable to the taxpayer. We do, however, have an issue with being held accountable for decisions made by a prior administration.
HealthWare Solutions provided two features lacking in the no-cost state emais system. The one you identified was the ability to track trends in patient symptoms to identify potential use of weapons of mass destruction. The Fire Department had a heightened concern about WMD's in the aftermath of 9-11 and remains vigilant to this concern.
Ensuring that our providers deliver quality medical care, and identifying areas where we can improve, remain a priority for the Fire Department and the state emais system is not robust in this area.
While I cannot tell you what led to the interest by the Fire Department in HealthWare Solutions in 2003, I can define what the department continues to do to rectify this problem.
Immediately after being made aware of this issue in April 2009, Leopold directed the Fire Department to investigate the matter. This included identifying the cause of the problem, identifying solutions to stem the loss of reports and initiating efforts to locate and retrieve missing reports. A priority was placed on reports for calls that occurred after April 1, 2009, to ensure maximum revenue recovery from the Ambulance Transport Fee legislation. To date, we have recovered 99 percent of the missing billable reports.
As of Feb. 19, the department has identified 89 reports for medical transports during the billing period that have not yet been located. The information that the county gets 80 percent of the fees was incorrect, and we apologize for the error. The county collects on roughly 40 percent of our ambulance transports. That figure is consistent with the average throughout the region. On average, we receive $382 per transport for which we receive payment. The county contracted billing company receives 6.68 percent of every dollar collected. We continue efforts to recover the 89 missing reports and are confident we will find them. A more accurate revenue loss projection for these reports is about $13,000, not $42,000. We recognize any lost revenue is unacceptable in these austere times.
The current reporting system was provided to the county at no cost by the successful ambulance billing vendor.
On what the Fire Department is doing to avoid another such mistake, we offer the following:
Under Leopold's administration the Fire Department is now billing for ambulance transports. This recovers costs at no additional expense to the taxpayer. Many of our citizens have long been paying for insurance coverage for ambulance service and we are now collecting from those insurance companies.
Nonresidents of the county are billed. If they have insurance coverage they are billed for any co-pays not covered by their insurance company. Co-pays for county citizens are waived.
The Fire Department and OIT are working to recover all missing ambulance reports. Using the new system, the Fire Department and OIT work daily with our billing vendor to identify and reconcile all reports using 911 center Computer-Aided-Dispatch data versus ambulance report data.
As a long-term solution, OIT and the Fire Department continue the transition to a new CAD system that provides additional features. Once implemented, the new system will auto-populate critical data into the ambulance reporting system eliminating human error in data entry responsible for some of the yet unlocated ambulance reports.
County staff has been working with MIEMSS staff successfully since January 2007 regarding the transmission of required data. Since that time, the county has responded to changes in the format and substance of the data required. To date, the county continues to work with MIEMSS and is not in violation of any regulations - nor is any funding in jeopardy.
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Ray is a fire chief and Ryan is the director of the office of information technology.
