photo by: Eric Ayres

Wheeling Fire Chief Jim Blazier discusses ambulance rates with city council members this week during a meeting of council’s Finance Committee.

WHEELING — Officials in Wheeling are looking to update the city’s ambulance rates in order to bring billing in line with today’s insurance reimbursement structures.

City leaders stressed that if the emergency medical service rates for ambulance transport are approved, patient co-pay amounts should remain the same. Additional costs for increased rates should not be passed on to patients. Instead, higher reimbursements available from insurance companies will be received.

“Our ambulance rates have not been reviewed or increased since 2014,” Wheeling City Manager Robert Herron said. “There have been several changes in reimbursements from insurance companies, Medicare and Medicaid, that involve different types of transport that may occur as a result of our ambulances and the fact that we have paramedics on our ambulances in addition to that mileage charges, etc.”

Wheeling Fire Chief Jim Blazier this week presented to members of the Finance Committee of Wheeling City Council a proposal for an updated ambulance fee schedule. Blazier noted that it’s been more than 10 years since the city last implemented any kind of increase to its ambulance rates. The last adjustment was put in place in April of 2014, he said.

“In the last 10 years, expenses or costs of everything have escalated, as everyone knows,” Blazier said. “We currently charge $10 per mile for Basic Life Support, and the ambulance trip is $550. For Advanced Life Support — which would require more advanced skills from the paramedics — $650.”

The fire chief gave recommendations to city officials in order to bring those rates more in line with today’s standards.

“Projected increases would be to go to $15 per mile,” he said. “We would keep the Basic Life Support fee the same and increase our Advanced Life Support 1 to $850. Since the last time we revisited our ambulance rates, they have added an Advanced Life Support 2 column that you could bill for – and that we are not taking advantage of that. We would want to charge $950 for that.”

Blazier explained the different billable service categories offered by EMS crews in an ambulance. Basic Life Support would not involve the use of a heart monitor or intravenous injection – it would be for treatment of patients with lacerations or broken bones. Advanced Life Support 1 would involve the use of a cardiac monitor, IV access and administering medications. Advanced Life Support 2 would involve the most serious situations in which paramedics are performing advanced life saving measures while en route to the emergency room.

“Someone in cardiac arrest, where they’re using everything in the truck on them,” Blazier said of an Advanced Life Support level of care. “Someone with severe trauma, patients that we’re throwing the kitchen sink at, that we’re trying to do everything we can for. Those are allowed to be charged a little bit more, and the insurance companies recognize that as a billing category.”

The fire chief said the newly proposed rates are based on other area agency’s current rates.

“We did a comparison of two local ambulance services – Ohio County EMS and Bethlehem EMS,” Blazier said. “They’re probably the two busiest in our county other than us, and we kind of mimicked what they are charging for our fee increases.”

Blazier noted that if any financial hardships arise with patients, the Wheeling EMS works with them to develop a plan that works for them.

The city has been losing out on potentially larger reimbursements because of its antiquated fee structure, officials noted.

“Our billing agency is actually the one that brought this to our attention,” Blazier said. “One about the category that we’re not billing for at all, and two is the fact that we’re leaving some money on the table that is going to be reimbursed by the insurance companies, Medicare and so forth.”

Officials said the proposed increase should not affect citizens.

“One thing we don’t want to happen is people being afraid to call the ambulance because they’re afraid they’re going to get a bill,” Blazier said. “We will work with anyone who has a hardship to make sure that our services are available to them.”

Members of the Finance Committee agreed to forward the proposal to the full Wheeling City Council for consideration.