NORWICH – The City of Norwich has been flagged by the New York State Comptroller's Office which released two audit reports Wednesday, one condemning the city's handling of emergency medical services (EMS) billing; and the other chastising city officials for not having a plan to meet an estimated $1.8 million in future capital needs.
According to the audit report on the city's EMS billing, the city has missed out on an estimated $200,000 in revenues. The EMS department did not bill for 614 incidents between Jan. 1, 2017, and Oct. 31, 2018, resulting in $417,600 of unbilled medical services. Moreover, the comptroller found nine incidents totaling $8,300 that were inaccurately billed.
The report also found 903 unserviceable incidents resulting in roughly $400,000 in unrecoverable costs, and that no one reconciles the billings to the medical services provided.
The comptroller gave recommendations that all EMS services provided are billed appropriately in accordance to an up-to-date rate schedule, and that department heads routinely reconcile billings to medical service providers. The city should also consider billing for unserviceable incidents, the report says.
However, city officials argue that the comptroller's audit amounts are “overstated” (although the city council did approve updated ambulance recovery rates earlier this week).
Norwich Mayor Christine Carnrike credits much of the EMS shortfalls to the amount of calls billed to Medicaid. About 80 percent of the population served by Norwich EMS is Medicare or Medicaid patients. Since fees covered by Medicare and Medicaid don't typically cover the whole cost of an EMS call, the city often takes a loss.
What's more, the city usually doesn't charge patients who don't need medical treatment. This includes elderly patients who need help up after a fall; patients who accidentally triggered a medical alarm; those who refuse treatment after someone called an ambulance on their behalf; and calls that are canceled en route.
Nor does the city charge for DOAs (dead on arrival). City officials point to 20 DOA incidents during the audit period. At $900 each, that totals $18,000 not billed.
“It is the position of this administration that those calls where there are no medical services provided due to Death on Arrival are not billed to the decedent's family/estate,” Carnrike wrote in response to the comptroller's report. “Also, the City of Norwich does not plan to bill for 'accidental' emergency alert calls (i.e. Lifeline, etc.).”
Carnrike also said that the city's taken steps to reconcile billing by using software upgrades purchased in April.
“The City of Norwich believes the OSC audit amounts are overstated,” said Carnrike. “However, practices have been implemented to remedy data entry errors by EMS personnel to accurately reflect services provided or services not provided.”