Oklahoma Officials Defend EMSA Billing Practices
March 14--City Manager Jim Couch and most members of the Oklahoma City Council defended Tuesday the billing practices of the city's ambulance service, but one councilman said he wants to know more.
The Emergency Medical Services Authority, which manages the ambulance service for Oklahoma City, Tulsa and several of the cities' suburbs, has been subjected to increased scrutiny in recent months after investigations by The Oklahoman and the Tulsa World about spending and billing practices.
The most recent series of articles focused on billing practices involving members of the TotalCare utility fee program, which is designed to pay for out-of-pocket expenses for its members' ambulance rides. The Tulsa World spoke with about a dozen people to whom EMSA sent bills for ambulance service despite their enrollment in TotalCare.
Though previous investigations into spending and financial practices drew criticism from Oklahoma City staff and council members, most city leaders appear satisfied with EMSA's response to charges of unfair billing practices.
"The experience we have had in Oklahoma City has been significantly different than those portrayed in the articles," Couch said in a memo to the council.
Few patients sued
EMSA President and CEO Steve Williamson explained that more than 130,000 patients are taken to hospitals by EMSA ambulances each year, and only about 230 of them are ever taken to small claims court. An EMSA spokeswoman said "few, if any" of those 230 are members of the TotalCare program who shouldn't have been billed, though she said she didn't have an exact number.
EMSA attempts to verify who lives at addresses covered by TotalCare enrollment through the patient, city utility databases and third-party address databases. People who are billed for costs have the opportunity to prove it, Williamson said, and Couch highlighted an example of a similar situation in Oklahoma City.
An Oklahoma City woman who thought she had enrolled in TotalCare was charged after being taken to a hospital by an EMSA ambulance but was later billed, Couch wrote in a memo to the council. The city discovered she wasn't enrolled because of an error she made when applying, so they allowed her to retroactively pay for the TotalCare program and the bill was forgiven.
"We all have a responsibility as consumers of this emergency medical service to ensure that our bills are taken care of in an accurate way," Councilman Larry McAtee said.
Complicated billing
Councilman Gary Marrs, an EMSA trustee and former city fire chief, said he thinks EMSA does the best it can in a complicated billing environment.
"If you think federal regulations on minor issues are complicated and change all the time, you ought to delve into Medicare and Medicaid, especially when it comes to billing on emergency runs," he said.
Councilman Pat Ryan concurred, saying he understands why a small portion of people may be charged erroneously.
"When you have a system designed by humans (and) maintained by humans, occasionally, dealing with 100,000 plus accounts, you're going to have mistakes made. It's unavoidable," he said.
But Councilman Ed Shadid, a physician and EMSA trustee, said he thinks some people who were incorrectly billed may have simply paid it instead of proving they didn't owe anything. And until EMSA can say how often that has occurred, which it hasn't yet, he said he can't tell whether there's a problem.
"I don't know that we know the scope of how many people paid their utility fee but erroneously were charged and just went ahead and paid," Shadid said.
A suit filed in Tulsa against EMSA regarding billing practices is seeking class-action status.
Williamson said he couldn't comment on pending litigation.
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Copyright 2012 - The Oklahoman, Oklahoma City
