City accepts fee increase for emergency medical services

Some ambulance fees are going up but most users won't feel the impact.

Le Mars City Council members Tuesday, on recommendation from Bill Rosacker, Le Mars ambulance director, authorized city acceptance of a Wellmark-introduced change in payment for emergency medical services (EMS).

The council's action paves the way for an increase in current EMS rates for amounts acceptable under Wellmark's health care program.

"Wellmark will pay X amount for each call," Rosacker said, explaining that the current rate was below Wellmark's rate for two categories.

The fee increase includes that for Basic Life Support (BLS) 1 emergency service from the current $450 to $500 and an increase of from $650 to $775 for Advanced Life Support (ALS) 2 service.

"If we didn't do this, we'd be leaving money on the table with Wellmark," Rosacker said.

Depending on people's insurance, they shouldn't notice the change, he said. Anyone with Wellmark insurance or Medicare with a Wellmark supplement won't see the increase.

"The majority of our people are on Medicare with the Wellmark supplement," he said.

During his talk with the council, Rosacker said the fee increase should allow for any overruns in costs of service supplies that result from Wellmark no longer paying for supplies for a given ambulance call.

Wellmark's new billing program as approved, calls for Wellmark to pay emergency service providers directly for the maximum allowable fee for specific services. Local service providers are then expected to "write off" charges in excess of the allowable fees.

Should the city have not have accepted the insurance provider's change, fee reimbursement would have gone directly to the respective patient with the city responsible for collecting its fees.

"What this new Wellmark billing does," Rosacker said, "is that it prevents us as a provider, or the city, from becoming a collection agency collecting only what payment we can."

The change, he added, does not affect mileage payments for services.

Rosacker told the council that several Iowa cities -- Cedar Rapids, Des Moines, and Sioux City -- have rejected Wellmark's changed plan. He added that each of the three entities currently do their own billing and have expressed their belief that Wellmark will rescind the change.

"As for us," Rosacker said, "I think accepting the change is the right thing. While we are in some degree, currently in the collection business, we don't want to become a collection agency for services."

Members of the city council agreed.