Woodland Hills EMS Attempts to Collect Missing Reimbursement Funds

Woodland Hills Emergency Medical Services' annual subscription drive is underway, and emergency officials are saying the support of the community is needed more than ever.

That's because in 2012, Woodland Hills EMS missed out on about $150,000 worth of insurance reimbursement due to current Highmark practices, according to interim manager Keith Morse.

Highmark, one of the region's major health insurance companies, mails all reimbursement checks to the ambulance patient, who in turn, must forward the check to the ambulance company. That is, unless the ambulance company is a member of Highmark's network.

Woodland Hills EMS, which covers Forest Hills, Wilkins Township, Churchill, Chalfant and Braddok Hills, is not a member of Highmark's network. Morse said if it was, it only would be reimbursed about 30 percent of the total cost of service.

What's happening now, Morse said, is that many patients are receiving checks from Highmark that are intended for the ambulance company. However, those people don't forward the checks, and some even cash them for themselves.

"There is some confusion with some people, but we're able to explain to them how the process works beforehand," Morse said. "In those situations, we clear up confusion during the early stages.

"There are people who have caught on and call the ambulance on a regular basis. We have one person who has actually cashed $15,000 worth of Highmark checks. We have a few people around the $5,000 mark."

Many other ambulances in the region also have experienced the same problem, according to the Valley News Dispatch.

Morse said each ambulance trip costs about $700 to $1,200 depending on the type of care needed by the patient. The insurance reimbursements account for about 10 percent of the Woodland Hills EMS' annual budget.

That's why EMS personnel are working with a collections agency to get back the money owed to the ambulnce service.

"We really labored over this," Morse said. "It's not something we were comfortable with, but after thinking long and hard about it, we felt we were missing out on a considerable amount of money that could pay for better equipment or more staff."

And that's why this year's subscription drive is as important as ever, Morse said.

Subscription holders are entitled to unlimited, one-way emergency service to hospitals within the coverage.

Subscriptions have accounted for about $160,000 of the ambulance company's budget in recent years. Last year, only 36 percent of addresses in the five municipalities covered by Woodland Hills EMS were subscribers.

This year, the cost of subscriptions have increased by $5—$35 for an individual, $60 for a family, $30 for a senior citizen, $35 for a senior household and $105 for businesses. It's the ambulance company's first rate increase in 14 years.

"The subscription helps the organization, and it also protects the patient in a lot of different ways," Morse said. "Our intention is to take care of the patients who need our help."

For more information, contact Woodland Hills EMS at 412-351-9111.

________________________

"Like" Patch on Facebook. | Follow us on Twitter. | Sign up for our daily email newsletter.