By Karissa Minn
kminn@salisburypost.com
SALISBURY – Emergency medical service can save lives, ease pain and calm worry, but some Rowan County residents might feel ill when they see a bill they don’t expect.
A reader recently contacted the Salisbury Post expressing concerns about being charged $140 for an ambulance after only a brief examination – not a ride. Health insurance would only pay for ambulance fees that include transportation, leaving the reader stuck with the bill.
In an interview last week, county officials explained Rowan’s various Emergency Medical Services fees and the reasons behind them.
For basic life support -meaning transportation to a hospital and first aid if needed – the fee is $350. Patients also are charged the same amount for the first level of advanced life support, which involves low-level interventions like oxygen or medication.
The second level of advanced life support, when electrical therapy or airway control is needed, costs $400. When multiple advanced therapies are needed, that raises the life support fee to its third and highest level of $570.
And if a patient is treated but not transported to the hospital, that person will be charged about $140.
“The county does incur costs when we have to dispatch that ambulance out to that call,” said County Finance Director Leslie Heidrick.
EMS Chief Lennie Cooper said that if a passerby sees a car accident and dials 911, but no medical treatment is needed, no one will be charged for the ambulance.
But fees will come into play if emergency responders give first aid, medication or other therapies, even if the person chooses not to take a ride to the hospital.
“You have incurred a cost because I provided treatment without transportation,” Cooper said.
Fees also will be charged if a patient calls for an ambulance, gets evaluated by responders and decides help isn’t needed. Blood pressure tests and similar checks count as treatment, Cooper said.
It’s department policy for responders steer clear of billing talk while giving treatment, Cooper said. The county must treat people who need emergency care regardless of their ability to pay.
Frank Thomason, the county’s emergency services director, said people have said in the past that they felt coerced either to go to the hospital or not to go.
“When we get to the scene, our medics’ primary concern is for the welfare of the patient,” he said.
Thomason said he understands how there could be some confusion, especially when a few local governments in other areas of the country use taxes to cover all EMS costs.
In Rowan County, the combined costs of emergency services and ambulance billing and collections totaled about $4.9 million in the past year. But Heidrick said those divisions only brought the county about $3.4 million revenues from those divisions.
“The difference is $1.5 million, and… that is the county’s subsidy to provide emergency services,” she said. “There is a tradeoff there. Do they want higher property taxes and lower ambulance fees?”
She said Rowan typically charges less than surrounding counties for ambulance service.
“In June 2011, we called eight counties either surrounding or similar to Rowan County,” Heidrick said. “They all had the same type of fees, and they all do have treatment-no-transport fees.”
For treatment with no transportation, other counties’ fees ranged from $110 in Davidson to $266 in Forsyth.
Basic life support charges ranged from $200 to $532. Depending on the level of treatment, Heidrick said, advanced life support carried a cost of $233 to $832.
If someone doesn’t pay the bill, the county can deduct money from the person’s income tax return or take other measures to collect it, she said.
But the county can set up a payment plan for people who have trouble paying their bills. Heidrick encouraged people in this situation to contact the county tax office.
Cooper said he knows the fees can seem high to patients, but EMS now provides a lot more than just transportation.
“We are so beyond being ambulance drivers,” he said. “A mobile emergency room, basically, is what we have.”
Contact reporter Karissa Minn at 704-797-4222.
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