Northport Considers Billing Process For Ambulance Transports

NORTHPORT, AL — The City of Northport on Monday moved one small step closer to creating a framework that would allow Northport Fire Rescue to recoup costs of ambulance transports through billing insurance firms and Medicare.

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Northport Fire Chief Bart Marshall explained to City Council members that things are looking better for response times following a new deal being inked with the city's ambulance franchisee — Northstar EMS. As it stands, though, there are no measures on the books for the city to be able to bill insurance companies or Medicare in the event that the city's lone ambulance franchisee decides to stop offering its services in Northport.

"With this, we're not staffed to transport, so if we transport more, there's going to be more manpower hours and we don't have a means to get anything back," the fire chief said on the financial complications related to ambulance transports. "It's a lengthy process to get approved through Medicare. If we do the application — and if and when we have that problem or it gets worse — then we have a means to move forward. But I recommend we start the framework."

Marshall also pointed out that the City of Tuscaloosa and Tuscaloosa County were both taking similar avenues for its ambulance services in the future.

Northport City Administrator Glenda Webb was quick to mention that, at present, there is no charge for taxpayers if they are transported in an ambulance operated by Northport Fire Rescue, with a few exceptions for outlying areas that often results in the bill being passed on to the county.

"If we don't have an ambulance franchise holder here, [Northport Fire] can start recouping the cost, because we know the demand will be there," she said. "We are concerned and the penalties that are assessed against our ambulance provider are much greater than they were in the past and we've been told that those penalties may have an adverse effect in the future on our franchise holder."

With this in mind, Marshall said the city's longtime franchise holder — Northstar EMS —previously had to be on scene 90% of the time in 10 minutes or less, which is where the penalties come in if that expectation is not met. For example, if Northport Fire's ambulance arrives on scene first and it is a matter of life and death, then Northport will charge Northstar with a penalty for having to transport the patient to an area hospital.

Marshall said the city has not seen a 90% rate achieved under this dynamic since before the pandemic. In fact, he said that percentage has been more in the neighborhood of the 55% range.

"So, that tells you about half the time we're going to have an ambulance that meets the performance requirements," he said.

As city leaders considered moving forward with the plan, Marshall also mentioned that the transition to a billing system would be fairly seamless since the necessary digital infrastructure to do so is already built in to the department's reporting software. All it would require, he said, would be some light training for those using the software, in addition to likely having to hire an additional employee solely to handle billing.

Talks then focused on addressing "wall time" or the time paramedics and first responders must spend with a patient before handing them off to medical professionals and going back out into the field for the next call.

"Our wait times and wall times aren't as bad as they were six months ago in the height of everything," Marshall said, reflecting on the widespread staffing shortages and other challenges posed by the COVID-19 pandemic. "Birmingham medics, I talked to them and they're at the patient's house and they're not even in a transport vehicle and they are waiting six hours ... waiting on an ambulance to come and they don't have a way to get to the hospital or a way to take them to the hospital and they're just sitting there."

There's also hope in the department's efforts to recruit and retain paramedics in the face of an ongoing nationwide shortage of trained personnel.

"We had two new paramedics that started today that came from Birmingham Fire," Marshall said. "We also have one that's graduating and two guys now in school that start in August. A year from now, we should have two more. And we've not lost any and we're slowly moving forward."

Marshall then attributed the staff improvements to the Council's recent decision to include paramedics under its overtime pay guidelines, in addition to recently approved pay raises.

The Northport City Council's Public Safety Committee unanimously approved the measure presented by Marshall, which will now go before the full council for a vote.

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