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Sep 23, 2011 5:03 PMPublication: The Southampton Press

Southampton Ambulance Districts Eager To Look At Third-Party Billing

Sep 28, 2011 12:35 PM

Tough economic times have driven some ambulance districts in Southampton Town to pitch a new way to help fund the growing cost of emergency services: charging patients or their insurance companies for an ambulance ride.

In a presentation to the Southampton Town Board at a work session on Friday, representatives from the Hampton Bays Volunteer Ambulance Corps and the Flanders-Northampton Volunteer Ambulance company told Town Board members that through third-party billing, or asking health insurance companies to pay for ambulance services, districts could offset operating costs and, by extension, lower the amount that district residents pay in property taxes to fund the companies.

Town Board members agreed to have an advisory committee look into the feasibility of implementing a third-party billing system. Town Supervisor Anna Throne-Holst said this week that the town’s Emergency Medical Services Advisory Committee most likely would vet the proposal.

Generally, the idea is to collect from insurance companies, though it’s unclear whether the bills would first go to patients, and whether uninsured patients also would be expected to pay out of pocket for ambulance trips. The committee likely will address those aspects of the proposal.

“No one will be denied care,” said Bill Sommer, who sits on the Hampton Bays Volunteer Ambulance Board of Directors,

The idea is a good one, Ms. Throne-Holst added, and comes at a time when municipalities are being encouraged to share services. She said she could envision a third-party billing system that all ambulance and fire districts could utilize. “I think it’s the direction all of these entities have to go, including the town, where we consolidate and share services,” she said.

The ambulance company representatives were called to Town Hall on Friday in an effort to have them revisit their 2012 budget requests, in light of the Town Board’s efforts to reduce spending in the town’s overall 2012 budget. A recently imposed New York State 2-percent cap on increases to the tax levy has town officials scrambling to plug a $5.1 million budget hole. Town officials have asked the ambulance company officials to scale back their 2012 proposed budgets, aiming for no increase in spending, and certainly no more than a 2-percent increase.

According to budget figures from Town Comptroller Tamara Wright’s office, three out of the four districts the town contracts with—districts where the Town Board serves as the ambulance company’s board of commissioners—are asking for an increase. Hampton Bays Volunteer Ambulance is asking for the largest out of the four, an 9.6-percent increase, from $874,000 to $958,000. Southampton Volunteer Ambulance is looking to increase its budget by 7.6 percent, from $473,500 to $509,500. Westhampton War Memorial Ambulance is seeking a 1.9-percent increase, from $803,400 to $818,400. The Flanders-Northampton Volunteer Ambulance company proposed a flat budget, meaning it would not increase from this year’s $457,720 spending plan.

The Hampton Bays Volunteer Ambulance company asked for the spending increase in part to pay their current staff of paramedic/first responders for additional coverage to answer critical calls between 10 p.m. and 6 a.m.

Those requests are reduced from some of the companies’ original requests. Southampton Volunteer Ambulance had initially asked to increase its budget to $598,500, representing about a 26.4-percent increase—in part to fund an overnight paid first-responder position, Ms. Throne-Holst said last week. Also, the Flanders-Northampton Volunteer Ambulance had asked for a $476,220 budget, an increase of about $19,000. Both companies further trimmed their requests before submitting budgets to the supervisor’s office.

Town officials are looking for answers as to whether the state will count the ambulance districts’ budgets as part of the town’s budget, and thus make them subject to the 2-percent tax levy cap. The town sets the levy for the ambulance companies, Ms. Throne-Holst noted. She also said she’s trying to find out whether the ambulance budgets could be excluded from the cap.

If the ambulance budgets are considered part of the town’s overall budget, the town will be forced to find cuts in its overall spending to meet increases within the ambulance budgets, Ms. Throne-Holst said. Town officials have reached out to lawmakers in Albany for guidance on how to proceed.

Ronnie Hintze, who sits on the Flanders-Northampton Volunteer Ambulance Board of Directors, said third-party billing makes sense because many health insurance policies have ambulance transportation reimbursements included. Since they are already paying for the health insurance, he said, also paying property taxes to fund ambulance services is essentially paying for the same service twice. “You wouldn’t go to King Kullen and pay twice for a gallon of milk,” he said.

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If my policy covers me will my taxes be eliminated...NO. My policy wont eliminate that section of my plan, so I continue to pay twice anyway. What about those without insurance, a freebe, if its in "All" of our taxes so be it. The Ambulance districts should be interested in reducing their budgets. I think the Town should review and audit their budgets which by the way they don't. Shame on our Town officials for giving the Districts a free pass without oversight. Their all hiring personnel to take ...more
By The Crow's Nest (64), Red Creek on Sep 23, 11 6:02 PM
This comment has been removed because it is a duplicate, off-topic or contains inappropriate content.
By The Crow's Nest (64), Red Creek on Sep 23, 11 6:02 PM
This sounds like a good idea, but there is simply no need for ''an advisory group'' representing additional red tape. The volunteer ambulance teams out here are incredibly dedicated and always there when we need them. The health insurance, in most cases, would pay the ambulance charges. In those cases where there is no health insurance, there can certainly be ways to handle that as there are now. But to insinuate that there is some sort of shenanigans going on with the budget and that the ambulance ...more
By kaluss45 (44), southampton on Sep 24, 11 7:26 AM
1 member liked this comment
To clarity: they did say to create a new "advisory group." The Town already has the Town Board appointed "Southampton Town Emergency Medical Services Advisory Committee" in place. It's that group they were speaking about at Friday's Work Session
By Robert I Ross (247), Hampton Bays on Sep 24, 11 11:12 AM
Sorry, they did NOT say to create a new........
By Robert I Ross (247), Hampton Bays on Sep 24, 11 1:50 PM
1 member liked this comment
Sounds like a good idea but it is also another layer of paperwork the responders have to deal with, insurance claims forms. As the calls or cases grow, who is going to sit on the phone chasing the insurance compainies for payment? My Doctor just folded her practice and merged with another, as the paperwork chasing the insurance companies was to great to stressful. Every call they go on would be another insurance claim, so now you may have to actually hire someone to do collections in each district ...more
By North Sea Citizen (535), North Sea on Sep 24, 11 8:45 AM
actually, the ambl. will not have the burden of more paper work. there is a company that does all this paperwork for the districts and it can be paid for by the moneys recieved from the insurance companies.
By moe (4), Riverhead on Sep 24, 11 4:19 PM
My tax bill includes the Hampton Bays Water District, but I receive a bill each quarter for “consumption” of water. My tax bill includes the Southampton Town Highway Department, but I pay for the “green” bags and pay when I bring “stuff” to the North Sea Transfer Station. I pay a user fee. This would be the same thing - - and it’s a good idea - - and the additional revenue would go to REDUCE their budgets and thus the tax bill!
Most, if not all, health ...more
By Robert I Ross (247), Hampton Bays on Sep 24, 11 11:08 AM
I have to mention that 3rd party billing isn't a new idea. It's being resurected and was tried and failed years ago. The Supervisor and Town Board members decieded to end that practice. Did we all forget that? Go back and you will see all the trouble and residential complaints that followed, Mr. Ross should remember that era.
By The Crow's Nest (64), Red Creek on Sep 24, 11 8:42 PM
Never had that in the 30 years I am living in Southampton Town. What Town are you talking about?
Sep 25, 11 7:38 AM appended by Robert I Ross
Can you please supply some details? What year did the Ambulances charge for transport via 3rd-party billing, or any other method?
By Robert I Ross (247), Hampton Bays on Sep 25, 11 7:38 AM
Port Jefferson VOLUNTEER Ambulance bills. They can tell you all about it! It works! Its reducing the budget!
By WHB19 (7), westhampton beach on Sep 26, 11 3:12 PM
1 member liked this comment
If memory serves me correctly, it was a lady named Therez McGinnis who went to the Town Board exposed the scheme and the Town stopped the practice. Ask around and yea shall seek it out. I don't remember the timeline, but believe me, it was in place years ago. The only way it could remotely work is if the Town had total control of the money. BIG PROBLEM...this will set a precedent and now the "Volunteer System" will collapse. More paid people No more vollies. All corps will want to be included, including ...more
By The Crow's Nest (64), Red Creek on Sep 25, 11 9:59 PM
rich, why do you always have to be so negative. instead help find a way. and no the vollie system will not collapse. and also no not fooling with mandates, they are forced to beband by the fcc. they have no choice. why dont you write that column, tell the town how to reduce spending instead of complaiming about it.
By moe (4), Riverhead on Sep 26, 11 5:24 PM
1 member liked this comment
I, too have no recollection of of third party biiling ever having been attempted in Southampton, and I have been a member of a local volunteer fire department and ambulance company for most of my adult. I think Crow's Nest is getting a past memory confused with something else. And I believe that the doom and gloom scenarios he outlines above are way overblown. Most of the bigger town vol ambulance corps have had paid responders integrated with the volunteer staff for years and it has worked great. ...more
By GlassHouses (63), anywhere on Sep 26, 11 12:19 PM
2 members liked this comment
I agree with you glasshouse, very well spoken. i think the public just needs to be educated about how it works and what the plan entails.
By moe (4), Riverhead on Sep 26, 11 5:27 PM
glasshouses, I guess you havent lived here long enough to know that Flanders Ambulance did third party billing years ago... You dont have to take my word for it, call Flanders Ambulance and ask for a long time member and they'll tell you. Im really surprise that at the work session that Flanders ambulance didnt advise the Town Board they did this once before and the Town made them eliminate it back then. Why did the Town make them eliminate it?? Because it caused to many problems with the elderly ...more
By SHTownHB (75), Hampton Bays on Sep 26, 11 7:32 PM
Then is your position that since Flanders tried it 20 years ago and it didn't work then that it should never be attempted again? Now that computers can do the heavy lifting, sounds like a good time to try it again. It will not increase the cost of your health insurance - that's what the new healthcare reform legislation is for.
By kaluss45 (44), southampton on Sep 27, 11 6:49 AM
I am an EX chief. Flanders Ambulance has tried this 3rd party bill in the past and it didn't work out. If you are going to bill people for your ambulance service then why would you call yourself volunteer ambulance company. It will be a paid ambulance company. Flanders gets $78,000 a year for LOSAP. So that means the people will be paying twice for everyone. That is not fair. Is Flanders doing this so that they can take more trips? The town should be looking into how ambulance companies are spending ...more
By chief emt (2), riverhead on Sep 27, 11 1:01 PM
Look into it EX Chief! 3rd party billing is to off set the budget and the tax payers burden. Our budget will not go up and hasnt in 3 years! It is being looked into for all Southampton Agencies not just Flanders! It's funny how people start attacking an agency after they are no longer part of it.Get your facts strait befor you go talking about something you don"t understand.
By Twty1221 (4), Flanders on Sep 27, 11 2:47 PM
2 members liked this comment
This comment has been removed because it is a duplicate, off-topic or contains inappropriate content.
By SHTownHB (75), Hampton Bays on Sep 29, 11 7:02 PM
Did you,leave or were you asked to leave, if you preach that you are truthful try speaking the truth. Sorry you are so bitter, but you should know we get audited every 3 years and just did. We also have outside people who do our taxes and reconcile our books are you saying they are being fraudulent to?
By Twty1221 (4), Flanders on Sep 29, 11 8:49 PM
One more thing get the facts befor you go running your mouth, look into it!
By Twty1221 (4), Flanders on Sep 29, 11 8:52 PM
I'm sorry but am I the only one confused by this raint. umm, if your talking about one community, should'nt you live in that community? or is that a lie, maybe you might not want to yell your opinion, it makes you sound like a disgrunteled person. but i agree with the artical cause we, a vol. ambl. company in nassau do bill insurance companys and for years now, it has worked.
By moe (4), babylon on Sep 29, 11 9:59 PM
1 member liked this comment
@Kaluss45 so that is where your banking all of your health and safety - on the Healthcare reform - what a joke - the healthcare reform will kill you before it pays any bills for you. Perhaps there is a better way to do this, since people want to use the ambulance as a taxi, those people should pay as they are exiting the ambulance, you know the ones,,,,,baby has an earache, baby has a belly ache, I have a toothache, should I go on, oh yeah, this happens while there are cars sitting in the driveway ...more
By checkin1234 (2), Riverhead on Sep 27, 11 5:22 PM
2 members liked this comment
yo checkin, that WAS a joke. read it again. you got the wrong guy if you think i'm defending any sort of unconstitutional law. carry on.
By kaluss45 (44), southampton on Sep 27, 11 5:29 PM
in that case I apologize.

On a more serious note, perhaps to save money all the volunteer organizations could revamp their accounting systems - it works in private sector business, here are just a few ideas:
1 - Accounting should NOT be done in house by members. An outside bookkeeping company should be hired who weekly would collect all invoices and expense reports. All invoices and expense reports require vouchering: ie: supporting documentation.
2 - Two signatures should be ...more
By checkin1234 (2), Riverhead on Sep 27, 11 6:00 PM
Sounds like a good idea on the surface, but look a little more closely at the premise.

Problem to me is that the ambulance companies have to be up and running whether or not they have any calls to respond to, and cash flow will be unpredictable if dependent on third party reimbursements, particularly as not every call will involve insured individuals for whom there is a third party to bill.

By M. O'Connor (147), Southampton on Sep 28, 11 10:10 AM
Third Party Billing is done throughout New York State, and the United States for that matter. This practice is done BOTH by volunteer ambulance services and commercial ambulance services. The fact that you bill for services does not make you any less volunteer, it just changes your sources of funding.

For example, in upstate New York; independent volunteer ambulance corps (VACs), most often formed as 501(c)(3) corporations are almost entirely funded by third party billing. Volunteer ...more
By HB1 (1), Manhasset on Sep 28, 11 12:26 PM
3 members liked this comment
Thank you for explaining that so perfectly!
By Twty1221 (4), Flanders on Sep 28, 11 3:10 PM
Well said HB1!

I’ve been an advocate for this for a number of years. I made a presentation on this topic to a group of EMS leaders which was not well received. There was a member at this meeting who wanted to contact his Legislators to keep this from happening. He had to be told we are the exception to the rule, that over 85% of EMS systems were already invoicing for their calls. This was back in 2008!

My concern was that we need to look not only where we are today ...more
By Medic154 (2), Lindenhurst on Sep 29, 11 2:21 PM
I don't quite even understand why people would be against this at all except for fear of change and general ignorance.

Hampton Bays is a great place for this to be implemented. Low tax base, high call volume, and many of the patients being from out of town (especially in the summer).

You can actually even implement a system where if you get billed for your copay/out of pocket cost and you are resident and can prove payment of your property taxes, your copay/out of pocket can ...more
By C Law (340), Water Mill on Oct 5, 11 12:46 PM
Just to clarify, the proposal looked at "third party billing" which involves billing a person's insurance company for the service of ambulance treatment and transport. This idea has yet to determine how person's without insurance, person's with deductibles or copays, or residents of the Town would be handled if there were balances remaining after the insurance company paid the claim. This is not a new concept. Long Island just happens to be a region that has traditionally never charged for the ...more
By HBGuy (14), Hampton Bays on Oct 2, 11 3:11 PM
This could work if implemented properly and thought out and not put a burden on community memebers without insurance or with deductibles.

I am under the impression though that those of us living in districts where the ambulance is included in the fire department, that billing is not allowed. Anyone have clarification on this?
By eqresident (4), East Quogue on Oct 3, 11 12:17 PM
your are correct.

This 3rd party billing is only permitted by non profit corps contracting with the ambulance districts to provide emergency care.

In, lets say east quogue for example, since the services are provided by the district itself, 3rd party insurance billing isn't allowed
By C Law (340), Water Mill on Oct 5, 11 12:38 PM
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