A Kingston Fire Department ambulance in the bay Tuesday afternoon, Jan. 30, 2024, at the main headquarters on West O’Reilly Street in Midtown Kingston, N.Y. (Tania Barricklo/Daily Freeman)
KINGSTON, N.Y. — Mayor Steve Noble says the city hopes to have a billing company in place for the city-run ambulance service operated by the Kingston Fire Department by April.
Noble told the Common Council’s Finance Committee Wednesday that the city has put out a Request for Proposal for billing companies with the RFPs due back by the first week in March.
Once a billing company is in place, the city will be able to bill patient’s insurance companies to defray the expenses the city incurs from operating ambulance services.
“That’s going to help us solicit all the different insurance billing firms that are out there,” Noble said. “There are at least a handful of firms out there that handle this and a few have expressed interest in working with the city,” he said.
He said the city is working with EMS consulting firm Cambridge Consulting Group on the RFP. He said the consultants are helping the city make sure it’s asking the right questions to find a billing company that follows all the proper procedures.
“They’re going to help us review that and make a recommendation as to which company is the best,” he said.
Noble said he hopes bringing in a billing firm by April would allow the city to do back-billing of people’s insurance to help defray the expense of the ambulance service back to Jan. 1, when the fire department took over ambulance service from Empress EMS.
As of Wednesday, the Kingston Fire Department responded to 552 calls and ended up taking approximately 350 people to the hospital, Noble said. This works out to about 12.5 ambulance calls in the city per day, he added.
He said sometimes patients decline to go to the hospital even if it’s recommended that they go.
Noble said right now one advanced life support and one basic life support ambulance are running 24/7, with the city now running two ALS units during select shifts when staffing allows.
Noble said fire engines continue to respond along with ambulances to calls when asked by Alderwoman Sara Pasti, D-Ward 1.
Noble said being able to do back billing requires the fire department to keep good records of services rendered. He said the fire department uses a digital patient sheet known as a “PCR” to take down data such as patient’s name, address and what medical issue they are dealing with and what services are provided.
“These PCRs are what are used by the billing company to see if there was anything billable during a call,” he said.
Alderman Michael Tierney, D-Ward 2, questioned if the city could still bill a person’s insurance if they declined to go to the hospital.
Noble said he suspects certain things on these types of calls may be billable, but the billing company the city selects will be able to better make that determination.
Tierney also inquired if the city would resort to sending a person who doesn’t have insurance or refuses to pay to collection or put it on their tax bill.
Noble said the city is still working on creating a policy telling the billing company if people will be charged co-pays, and if people who can’t pay will be sent to collections or not.
“Generally our thought is no, we are not going to send people to collection,” he said. “We will be exploring all that in the months to come.”
Noble said the city will continue to work with Cambridge Consulting on a second phase where the firm will delve into Chief Chris Rea’s EMS plan and help create maps, examine response times and release a detailed report about the city’s future EMS needs.
The report will also look at future staffing needs and the right number of ambulances based on call volume, Noble said. He expects that report to be released to the Common Council by the end of March.
“This will help us with potential next steps for future hiring,” Noble said. “We’ll have a plan that’s been reviewed. We’ll have revenue numbers that have been brought in and a couple of months of actual data.”
Noble said once the city has this data in hand, and a solid grasp on what can be billed for, the city can move to fully staff the service. Noble said that number could ultimately be as high as 16 additional employees. That number includes the eight firefighters, including three paramedics and five EMTs, the city recently hired, he noted.
Noble also updated the Finance Committee on the status of the new hires Wednesday night.
He said right now they are undergoing medical and physical testing and training and are expected to be out on the streets soon. He said the new hires include three women and at least two bilingual people.
He said the new firefighters were hired from a pool of 15 candidates in the city’s civil service list after scoring the highest on the test.
“We’re very excited to have new staff to be able to help our current staff who have been working a lot of overtime,” he said.
