Pa. Ambulance Billing Dispute Builds
Aug. 12--A billing dispute among ambulance companies that serve West Hazleton will make its way before borough council later this month.
But an official for West Hazleton Community Ambulance Association said the issue will not jeopardize the volunteer organization's ability to respond to calls.
In an Aug. 8 letter to council President William Sharkey, American Patient Transport Systems General Manager David Fatula charged that West Hazleton Community Ambulance failed to complete more than 113 patient care reports over the past year and a half and has not reimbursed APTS for paramedic services it provided for patient transports.
While Fatula puts the outstanding balance at around $46,000, community ambulance board Chairman T.R. Laputka contends that APTS officials are seeking fees above and beyond a joint billing agreement that has been in place since 2001.
Fatula plans to bring the issue to borough council's attention on Aug. 16 and APTS officials have set an Aug. 31 deadline for the community ambulance to review three years of back records and resolve the billing dispute.
Laputka said the community ambulance received at least one letter from APTS attorneys only two weeks ago -- and fully intends to review its records and respond appropriately.
"We are going through records, making sure that everything was covered," Laputka said. "As far as I can tell, everything was paid. If we do find something, we will be happy to pay them but they do have to give us some time."
The concerns from APTS stem from a joint billing agreement it has with the community ambulance. APTS serves as the borough's advanced life support (ALS) provider and provides paramedic services while the community ambulance is West Hazleton's basic life support (BLS) provider.
According to Fatula, the joint billing agreement applies only to scenarios when both the community ambulance and APTS respond to a call. In those cases, APTS provides a paramedic who is taken with a patient to the hospital by the community ambulance.
The transporting agent, or community ambulance, handles billing responsibilities for both responders. The community ambulance works through a billing company.
"They get a percentage and we get a percentage," Fatula said. "The agreement has been in place for years."
Officials with APTS recently reviewed about two years worth of records and discovered that the community ambulance changed billing companies in early 2010. By last April, officials discovered that patients were continuing to make payments on outstanding bills -- and that the company eventually wrote off people with outstanding balances, Fatula said.
APTS officials reached out to the billing company and were told that while it received a "trip sheet" from APTS -- or a document required by the Department of Health that outlines treatment provided to the patient -- it did not receive a similar document from the community ambulance, Fatula said. Forms are submitted for billing purposes.
Fatula contends there are at least 113 cases where the community ambulance did not complete the form -- which means 113 patients weren't billed.
Another issue Fatula said he is concerned about is that when forms were properly submitted, the billing company wrote a check for the entire bill to the community ambulance.
In some cases, APTS didn't receive its share, Fatula said.
"They would never forward that portion to us," he said.
An even bigger concern of Fatula's was that trip sheets weren't completed in a timely manner -- and that state Department of Health officials weren't responsive to his concerns when he reported the problem.
"The Department of Health wanted us, the ambulance, to give West Hazleton our trip sheets so someone could copy them and write their own trip sheets," Fatula said. "Are you kidding me? They just blew it off. It's 113 minimum trip sheets that we know about and they did nothing about it."
Laputka feels APTS is blowing the issue out of proportion.
Under the billing agreement, the BLS provider handles the billing. The agreement between the community ambulance and APTS is fairly standard, Laputka said.
"If we get paid, they get paid," he said. "We split the percentage. It varies from call to call, but on average it's like 50 percent. If we get paid $100, half goes to them and half to us. If it's nothing, then no one gets paid."
Trip sheets are completed and turned over to the billing company, which turns over the money it collects from a patient, Laputka said.
He said a quick look at the records indicates the community ambulance has consistently paid APTS its share, and claims APTS is seeking a roughly $160 charge for each call for a service that's not part of the joining billing agreement.
Laputka said he believes that some of the documentation the community ambulance was responsible for "slipped through the cracks" but also found that some of the records sought by APTS have been submitted to the billing company.
Volunteers with the community association will review the last three years worth of records and work to match documents that have been turned over to the billing company -- and whether any others need to be submitted, Laputka said.
The association won't know what it owes APTS until that review is finished, Laputka said.
"Even if we have to borrow money to pay them, we will," he said.
Laputka said APTS officials have to understand that the community ambulance is not about to chase down patients who legitimately cannot afford to pay their bill.
"We will bill the insurance company, bill the Medicare, Blue Cross, whatever the insurance company is," he explained. "We ask if there's anything over and beyond that, we ask if you can afford it, please pay it. We have senior citizens. If these people are only getting a couple of dollars per month we're not going to put them in the poor house to try and cover our bill (to APTS)."
The issue won't derail the community ambulance's ability to respond to calls, Laputka stressed.
"Collecting money is not our first priority," he said. 'Everyone has to have money to survive -- to put fuel in the tank and pay the light bills. First and foremost is treating the patients."
Sharkey and Mayor Frank Schmidt said they didn't know enough about the dispute to comment.
Sharkey said that from what he's heard, the issue sounds like it's between the ambulance providers.
"They have to work this out somehow," he said.
sgalski@standardspeaker.com
