first responder fee treat and release fee
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First Responder Fee Treat and Release Fee. A/C Scott Clough March 28, 2013. FRF/ TRF. What is it? Legal, ethical, honest billing for services that is recognized by most private insurance companies Is charged for all encounters that result in a patient assessment - PowerPoint PPT PresentationTRANSCRIPT
First Responder Fee Treat and Release Fee
A/C Scott CloughMarch 28, 2013
FRF/ TRFWhat is it?O Legal, ethical, honest billing for services that is
recognized by most private insurance companies
O Is charged for all encounters that result in a patient assessment
O Has NOTHING to do with ambulance transport
O Is not regulated by your LEMSA
FRF/ TRFWhat is it not?
O It’s not a “crash tax”
O It’s not a money grab
O It’s not a scam
FRF/ TRFHow does it work?O Metro passed a resolution allowing the billing to
take placeO We established a fee schedule based on costsO There are two costs; O First Responder Fee is bundled into the transport
costO Treat and Release Fee is billed for non-transport
FRF/ TRFProjectionsO 80,000 calls for service annually/ 73% are EMS = 58,400
O 72% transport rate = 42,048
O 20% collection rate on FRF and TNT = 11,680
O $275.00 per contact
O Total collection/yr = $3.2 million – 2% of budget
FRF/ TRFMethodologyO Average time on task E/T = 20 minutes
O Average hourly rate per unit = $150.00/hr.
O 58,400 calls / 3 (20) = 19,466/hrs on task
O 19,466 x $150.00 = $2,919,900.00
FRF/ TRFActual reimbursements to date
O Collection rate is about 17%
O 17% collection = 9,928 billable calls
O 9,928 x $275.00 = $2,730,200.00
FRF/ TRFWhat is the backlash and how do we handle it?
O Since introduction in February 2012 - 67 complaints
O Most will come from senior groups – most vocalO Explain that taxes do not cover the full cost of serviceO Explain the cost of response and treatment of
“individuals” medical cost
FRF/ TRFWhat is the backlash and how do we handle it?
O Most will come from senior groups (continued)
O “Individual” treatment above and beyond suppression is costing all tax payers
O Without supplemental payments the service would be cut back or eliminated
O “Individual” service that can be covered offsets the cost and allows continuation of medical services
O Because 20% of patients have FRF/TNT coverage it allows us to wave the fee for those who don’t
FRF/ TRFO Auto insurance coverage
O Statewide mandate
O Needs to be looked at the same as work comp
O Medical coverage is paid on first come first serve
O Pays the full cost of transport if there is money to cover it
O Most if not all insurance providers have a 1st responder covered amount
O Not billing is disenfranchising the policy holder
FRF/ TRFO Auto insurance coverage
O Metro does 6 MVA transports per day 3 are insured
O Average transport = $1640 + $275 = $1915
O 3 x $1915 x 365 = $2,096,925
FRF/ TRFHow do you get this started in your department?
O Need to have Board approval and pass a resolution
O You do not need to have LEMSA approval for FRF/TNT fees
FRF/ TRFHow do you get this started in your department?
O If you receive FRF pass through from ambulance co. can you still collect?O If the ambulance is not billing a separate line item for
FRFO If the pass through is for compliance purposes
(stopping the clock)O If the pass through is considered a dispatch fee
FRF/ TRFHow do you get this started in your department?
O You must obtain an NPI number
O BLS counts and will be reimbursed at the BLS rateO Dead bodies pay $$$O Medicare = $532.00O Medi-Cal = base ALS rate for ALS intervention