CITY OF PHILADELPHIA,
Since 1988, the City of Philadelphia and Lockheed Martin IMS have collaborated to enhance emergency medical services (EMS) billing and collections processes. The improvements made have enabled the City to offset partially the rising costs of providing additional EMS services by dramatically increasing the amount of reimbursements collected from third-party insurers. This cooperative effort has allowed Philadelphia's Fire Department to concentrate its efforts on responding to medical emergencies while IMS utilizes its expertise in billing and collections to increase the level of reimbursements.
Recognizing that 85 percent of reimbursements for EMS services are collected from Medicaid, Medicare, or private insurance companies, IMS has focused on forging relationships with these third-party insurers and local hospitals, to ensure that necessary recordkeeping and documentation requirements are satisfied, and that billing and collection information is exchanged in a timely and efficient manner.
Over the course of this 10-year public/private partnership, the level of reimbursements for EMS services has increased over 570 percent, from $1.85 million in Fiscal Year 1989 to $12.43 million in Fiscal Year 1998.
Improving the level of reimbursement from year to year has allowed the City to keep pace with rising costs resulting from an explosion in demand for service: Between FY94 and FY98, the City had to cope with an almost 30 percent increase in the number of EMS runs. Requests for EMS have come to represent more than 70 percent of the Fire Department's total service calls. This sharp increase in demand has necessitated the addition of 12 units to the City's fleet of ambulances over the past four fiscal years . a 48 percent increase over the 25 units the City had in place in FY94.
To reduce paperwork for EMS crews and to further enhance the level of reimbursements, IMS is equipping the City's municipal ambulances with on-board computers. These computers, installed in January 1999 at no cost to the City, will allow EMS crews to record and transmit handwritten information electronically to a central databank as they provide on-site medical care. This portable, pen-based technology enhances both the accuracy and the amount of information EMS workers are able to gather during an emergency. To further expedite the billing process, the new system also electronically documents the signature of patients. In most cases, it will eliminate the need for EMS workers to fill out reports or prepare additional paperwork . freeing them up to respond to the next emergency.
The use of this cutting-edge technology gives the City and IMS an opportunity to increase the level of reimbursement for EMS services without necessitating an increase in fees. It automates cumbersome clerical tasks, thereby improving the morale of EMS personnel and allowing them to concentrate on responding to emergencies; and it provides a model system for EMS billing and collection services that can be replicated in other municipalities.
The United States Conference of Mayors
J. Thomas Cochran, Executive Director
Copyright © 1999, US Conference of Mayors, All rights reserved.