Leon County, Florida EMS Short Of Expected Funds

Leon County's ambulance service didn't collect as much money as predicted in the first nine months after it assumed control of the operation from Tallahassee Memorial Hospital, according to a recent report.

County officials attributed the shortfall to collection delays they say are normal for a new system and add that revenues now are on track. The county took over the service from TMH in late 2003.

The county estimated Emergency Medical Services would collect 39 percent of its bills during its first nine months of operation, but the program collected just under 29 percent, according to an annual performance and financial report, issued last month. The program relies on bill collection and a property tax for funding.

EMS issued $8.15 million in bills and collected $2.36 million, said Alan Rosenzweig, the county's budget director. The county had hoped to collect just over $3 million, he said.

"When you're starting up a system, things aren't as smooth as you want all the time," he said. "But the dollars are coming in fine right now. I think the county is comfortable at this point in the process that EMS revenues are on target and coming in greater than the previous provider."

Rosenzweig and EMS Chief Dan Moynihan said the collection rate cited in the report will increase as the county continues to collect on outstanding bills. It took two or three months for revenues to begin coming in after county took over EMS. The program took in about $1 million in the first 10 weeks of the new fiscal year, which started Oct. 1.

Moynihan said it took the county about six months to obtain its Medicare provider number, which allows the county to bill the government program that provides health insurance for elderly persons for ambulance runs.

It took another month for the county to be able to bill Medicaid, the joint federal-state program that insures low-income persons. About half of the county's ambulance runs are billed to Medicare and Medicaid, Moynihan said.

Also, the county learned that local HMOs Capital Health Plan and Vista were paying less than 100 percent of what the county was billing, based on previous agreements with TMH. The county and the HMOs since have worked out agreements where 100 percent of the bills are being paid, Moynihan said.

When the county was taking over EMS, county officials pledged to do a better job of collecting bills than TMH. The hospital collected about 38 percent of its bills in the last year of its ambulance operation, Moynihan said. The performance report said EMS is on track to meet its collection goal this year.

Moynihan said Advanced Data Processing Inc., based in Miami, is doing a good job of collecting bills for EMS. The company, which receives 7 percent of EMS collections, pointed out to county officials that the ambulance program wasn't collecting as much as it could from local HMOs.