Report Reveals Lots of Complaints For N.H. Provider

Report Reveals Lots of Complaints For N.H. Provider

News Nov 20, 2012

Nov. 20--MANCHESTER -- A long-awaited report on the city's emergency ambulance provider, American Medical Response, finds little evidence of overbilling but confirms many of the complaints lodged against the company over the past year.

The report, presented to the Committee on Accounts, Enrollment and Revenue Administration Monday by Auditor Kevin Buckley, describes several practices that have upset patients and aldermen, but that are not violations of its contract with the city Fire Department.

These practices include sending patients bills for thousands of dollars for a single ambulance trip, while the amount actually owed by the patient is still being worked out, and then having those bills sent to a collections department.

"No actual overcharge errors were noted; however, the billing seems to be confusing for most patients," Buckley states in the report. "This confusion makes it appear to the patients that they are being overcharged."

The problem is compounded by the fact that AMR is expensive compared to other ambulance companies in the state, with average per-trip rates at close to $2,000. While the contract with the fire department states that the company can charge no more than 35 percent above the Medicare reimbursement rate -- around $600 -- for emergency trips, the company seeks a higher rate from insured patients.

In addition, patients, once they are taken to the hospital, often end up being transported by AMR for non-emergency trips to other facilities -- and are billed at its standard rates. The problem, according to Buckley, is that the hospitals often don't indicate to patients that there are other cheaper ambulance services available. Anthem and AMR

One reason city residents have been so closely involved in billing issues with AMR is that the city's largest insurer, Anthem Blue Cross Blue Shield, does not have a provider agreement with the company. Anthem administers the city of Manchester's health plan, which includes hundreds of employees.

Anthem had been reimbursing patients directly for bills from AMR. At the beginning of 2012, however, a new state law, HB 31, went into effect requiring insurers to pay out-of-network ambulance companies directly. Since then, Anthem has been paying its own standard rate for ambulance reimbursements, leaving patients in some cases to cover the balance.

Anthem representative Amy Winning told the aldermen that HB 31 created less incentive for out-of-network ambulance companies to enter agreements. She said Anthem has attempted to reach an agreement with AMR, but that the company had not responded to it most recent request.

An AMR representative is quoted in Buckley's report saying, "AMR has reached out to Anthem on several occasions and tried to reach an amicable agreement. Like all emergency ambulance providers in New Hampshire, AMR is not opposed to entering into an agreement... provided (it ) satisfactorily compensates for the high cost of readiness associated with providing emergency ambulance coverage and response."

Continue Reading

AMR had acknowledged earlier this year overbilling 323 patients; it has since paid refunds or corrected the bills.

Contract up for renewal

Buckley found that of 60 ambulance trips he tested as a sample, one was overbilled and not discovered by AMR. The company makes about 18,000 transports in the city per year.

The anecdotal evidence, however, appeared to weigh more heavily for the aldermen.

Alderman Patrick Arnold called the practice of quickly referring bills to collections the most "troubling" aspect of the company's behavior.

The report comes as the aldermen are weighing whether to renew AMR's contract, which expires at the end of December. Fire Chief James Burkush has proposed a one-year renewal while the department explores operating its own emergency ambulance service, as it had more than two decades ago.

Alderman Pat Long said it was unlikely that he would support renewing the contract if the "unacceptable" continued. "If so, I'll lean toward getting another provider or having the city pick it up itself," he said.

The full Board of Mayor and Aldermen is expected act on two committee recommendations at its meeting Tuesday. One urges Anthem and AMR to come to a service agreement and calls on the city's legislative delegation to come up with a bill that would require such agreements.

tsiefer@unionleader.com

Copyright 2012 - The New Hampshire Union Leader, Manchester

Source
The New Hampshire Union Leader, Manchester
Ted Siefer
The drones are used to improve scene management by assessing areas that are difficult or dangerous for personnel to reach.
Dozens of firefighters and police officers join the annual week-long Brotherhood Ride to honor 20 first responders who have died in the line of duty in Florida.
The event will be held on August 20, with all proceeds going to Narberth Ambulance, an agency that provides emergency services to 145,000 residents.
Speakers presented on topics such as disaster relief, emerging pathogens, the opioid crisis and cyber security.
The state's Department of Health has established an agreement for UNC and NCBP to collaborate on providing public health data to NEMSIS to better prepare EMS for national emergencies.
State troopers rendered aid before turning them over to responding EMS units and New Castle County Paramedics.
Three people were fatally shot and at least 21 others were wounded in separate attacks from Saturday morning to early Sunday.
Crestline Coach attended the Eighth Annual Saskatchewan Health & Safety Leadership conference on June 8 to publicly sign the “Mission: Zero” charter on behalf of the organization, its employees and their families.
ImageTrend, Inc. announced the winners of the 2017 Hooley Awards, which recognize those who are serving in a new or innovative way to meet the needs of their organization, including developing programs or solutions to benefit providers, administrators, or the community.
Firefighters trained with the local hospital in a drill involving a chemical spill, practicing a decontamination process and setting up a mass casualty tent for patient treatment.
Many oppose officials nationwide who propose limiting Narcan treatment on patients who overdose multiple times to save city dollars, saying it's their job to save lives, not to play God.
While it's unclear what exact substance they were exposed to while treating a patient for cardiac arrest, two paramedics, an EMT and a fire chief were observed at a hospital after experiencing high blood pressure, rapid heartbeat, and mood changes.
After a forest fire broke out, students, residents and nursing home residents were evacuated and treated for light smoke inhalation before police started allowing people to return to their buildings.
AAA’s Stars of Life program celebrates the contributions of ambulance professionals who have gone above and beyond the call of duty in service to their communities or the EMS profession.