“If a resident or person who worked in the city didn’t have insurance, then we would not pursue the balance any further,” said Fire Chief Steve Dawson.
For those who live outside of the city, an insurance payment would be accepted and a bill would be sent for the remainder of the balance, but never took the step of going to collections.
An ordinance recommended by city administrators and approved Wednesday by Hamilton City Council changes how the city bills and collects.
“We will accept the insurance payments, then bill for residents and non-residents alike for the difference,” he said. “For those residents who don’t have insurance, we will bill them directly and those individuals will be responsible for the full balance.
“We will use collections procedures, if it comes to that.”
Those with Medicare and Medicaid will not receive a bill from the city, Dawson said.
Because hard billing is a “new arena” for the city, it’s unclear how much revenue it can garner, he said.
The city of Troy, which has enacted such a measure for a year, has seen collection revenues increase by 2 percent, Dawson said.
“The feedback we’re getting from our billing agencies is that we can probably expect between from 1 and 3 percent,” he said.
That means Hamilton, which collected $1.7 million in 2012, could see a revenue boost of anywhere from $17,000 to $51,000 as a result of the billing switch, Dawson said.
City Council members voted Wednesday to approve the new billing.
Mayor Pat Moeller, who voted against the measure, said it probably would not stop those who use the life squad as a taxi service.
He also voiced discomfort with it over the possibility of even one uninsured person hesitating to call for help because of the potential cost.
“What I’m concerned about is, is a fixed-income senior citizen who happens to fall … and they’re hurt, but they don’t want to call 911 because maybe they’re concerned about how it’s going to be collected,” Moeller said.
City Manager Joshua Smith said the communities in which he previously worked always did hard billing “because it’s the way to recoup the cost.”
“The common argument you’re going to hear is, ‘Well, we pay taxes for a fire department that provides medical,” but it’s no different than (when) you pay an insurance policy premium and if you actually use it, you typically pay the deductible that goes along with it,” Smith said. “Obviously, you hope you never have to use it, but I would hope that people would use discretion, and if they’re hurt and need an ambulance … I would hope they would call the ambulance versus not calling for it.”
He said going to hard billing was part of a Berkshire Advisors report prepared for the city in 2012, and his suggestion to council members was to adopt the measure as presented.
“Our general fund has lost seven-and-a-half million dollars in the past six years and the costs keep going up,” Smith said. “Frankly though, we do have large contingent of people who do use it more as a taxi service than for medical purposes, and I’m a big believer that we need to make sure our medic units are available for the true emergencies and they’re not being abused for other purposes.”
Councilman Archie Johnson said those who need to call should continue to call, regardless of the billing change.
“This is not a deterrent, but we are in tough times,” Johnson said. “It is what it is, but this is not something where if they need to make a call, that they don’t.”
About the Author