Fire and EMS seek long‑term EMS billing solution, say ambulance fees could yield millions
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Antonio Stevens, director of the Virgin Islands Fire & Emergency Medical Services, presented VIFEMS’ FY2027 general fund request of $34,318,681 and described agency priorities including staffing, fleet modernization and fully operational ambulance billing.
Stevens said VIFEMS obtained a dedicated employer identification number and national provider identifier to support Medicare and insurer billing, and has contracted with a billing firm to operate the system. Assistant Director Lyall Elyn told the committee the system could go live in about two to three months and projected potential revenue between $3 million and $8 million depending on call volume.
Lawmakers pressed Stevens on three years of ambulance runs for which revenue was recorded through the Department of Health, asking whether formal invoicing and a clear transfer of collections to VIFEMS is in place. Stevens and other VIFEMS officials said the billing vendor and banking (lockbox) arrangements are in process; he said detailed reconciliation and agreements remain outstanding and that he expects fuller operational control once the billing vendor and lockbox are activated.
On equipment and operations, VIFEMS reported recent acquisitions (seven new ambulances) and ongoing maintenance needs: older units remain in service as backups, and the Star of Life medical boat requires significant maintenance and a planned dry‑dock. Senators also pressed VIFEMS on overtime (FY2025 overtime roughly $5.98M; year‑to‑date FY2026 ~ $4.61M) and vacancies; the director said overtime will fall with new hires but recruitment remains challenging for paramedics and RF technicians.
Stevens said VIFEMS continues to pursue federal grants (SAFER, AFG) for hiring and equipment and asked the committee to consider revenue agreements that would allow ambulance billing collections to support operations.
The committee requested follow‑up documentation on ambulance counts, revenue estimates, and the timeline for the billing system to go live. The hearing transcript shows staff and senators pressing for firm reconciliations of prior collections and for formal agreements with DOH to ensure ambulance revenues are routed to VIFEMS.
Stevens said VIFEMS obtained a dedicated employer identification number and national provider identifier to support Medicare and insurer billing, and has contracted with a billing firm to operate the system. Assistant Director Lyall Elyn told the committee the system could go live in about two to three months and projected potential revenue between $3 million and $8 million depending on call volume.
Lawmakers pressed Stevens on three years of ambulance runs for which revenue was recorded through the Department of Health, asking whether formal invoicing and a clear transfer of collections to VIFEMS is in place. Stevens and other VIFEMS officials said the billing vendor and banking (lockbox) arrangements are in process; he said detailed reconciliation and agreements remain outstanding and that he expects fuller operational control once the billing vendor and lockbox are activated.
On equipment and operations, VIFEMS reported recent acquisitions (seven new ambulances) and ongoing maintenance needs: older units remain in service as backups, and the Star of Life medical boat requires significant maintenance and a planned dry‑dock. Senators also pressed VIFEMS on overtime (FY2025 overtime roughly $5.98M; year‑to‑date FY2026 ~ $4.61M) and vacancies; the director said overtime will fall with new hires but recruitment remains challenging for paramedics and RF technicians.
Stevens said VIFEMS continues to pursue federal grants (SAFER, AFG) for hiring and equipment and asked the committee to consider revenue agreements that would allow ambulance billing collections to support operations.
The committee requested follow‑up documentation on ambulance counts, revenue estimates, and the timeline for the billing system to go live. The hearing transcript shows staff and senators pressing for firm reconciliations of prior collections and for formal agreements with DOH to ensure ambulance revenues are routed to VIFEMS.
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