Wilson County EMS adopts billing policy to track Medicare adjustments, broadens hardship write-offs to retirees

Wilson County’s EMS committee voted to adopt updates to its billing and hardship policies aimed at keeping rates aligned with Medicare and reducing billing burden for county employees and retirees.

At the meeting, staff presented proposed Policy 501.34 to align EMS billing rates to a set percentage of Medicare reimbursement so the billing company can auto-adjust when Medicare rates change. Brian summarized the proposal and provided concrete examples: he said 61% of call volume was classified as ALS emergency and that aligning at a 65% factor would raise ALS calls by roughly $45.68 per call and BLS emergency calls by about $37 per call; mileage would increase by about 38¢ per mile. "It's 38¢ per mile as well," Brian said while explaining the rounding and accounting approach.

Why it matters: The change will streamline annual adjustments and reduce the need for repeated committee action whenever Medicare updates its rates, but it will change per-call billing amounts and collections.

Hardship policy change: Staff also presented a revision to the hardship policy to include county retirees and family-plan members in the write-off provision. Under the revised language, the county will bill insurance first and then write off the remaining eligible balance (after deductibles and insurance payments) for covered county employees, retirees and eligible family members. Brian characterized the change as an internal policy to ease billing burden for county-affiliated individuals; the committee moved and approved the revision.

Committee action: Members voted to adopt the billing procedure and to revise the hardship policy; staff noted they may accompany the billing policy adoption with a resolution for documentation. The policies will be implemented administratively by the billing company and county finance/EMS staff.

Next steps: Staff will finalize policy language and administrative procedures, and return if a formal resolution is needed. Members asked for clear documentation of how the write-off process will be tracked internally.