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How many calls does the Wading River Fire District respond to annually?
In 2024 the WRFD responded to 1,155 Rescue Calls and 1,471 Fire Calls for a total of 1,522 calls
Is the Rescue Company ALL volunteer?
No. We are a mixed organization. We have 24/7 paid Paramedics, paid per diem EMT Drivers and rescue volunteers
Why is the district enacting “Cost Recovery?”
To make sure the community has 24/7 emergency medical care and supplies they need without costing the taxpayer more yearly
On April 9, 2022, Governor Kathy Hochul signed into law the 2022-2023 NYS Budget. Part of this legislation amended Section 209-b of the General Municipal Law to allow fire Districts previously not permitted to bill for ambulance services to begin doing so for a four-year period, beginning July 8, 2022.
Why was this legislation important?
New York was the only state that prohibited fire District billing for ambulance services. This enabled direct payment of $750,000 each year by Medicare to ALS intercept services for rural ALS intercepts. The 465 fire Districts in NYS prohibited from billing lost over $100 million annually in health insurance reimbursements. Until now, taxpayers had to fund those losses. Tax caps and hard financial times have forced many fire District ambulances to cease operations, primarily in rural and suburban communities.
Are there any restrictions on the use of monies received from ambulance billing?
Yes. Monies received from cost recovery must be used to offset the costs of providing ambulance services to the Authority Having Jurisdiction over the Fire District.
Is a separate account required for EMS Cost Recovery funds, or can the funds be placed in the general operating accounts maintained by the Fire District?
The new law does not require that a separate account be formed. However, the Wading River Fire District WILL be segregating ALL funds recovered by municipality served.
Will uninsured persons be expected to pay out of pocket for emergency medical services provided by the Wading River Fire District?
NO. By law an uninsured sick or injured person that is transported to a hospital can NOT be “billed” for service.
What if an insured patient cannot pay the cost? Will there be a sliding scale based on income? A payment plan? Some other arrangement?
The Wading River Fire District will NOT be participating in a sliding scale based on income or payments plans. ANY person stating a hardship in their ability to pay will have their associated costs waived.
How will an Emergency Medical Service Cost Recovery Program not cause a financial burden on the people of Wading River?
The Wading River Fire District has gone to great lengths to establish a policy of compassionate billing while still being 100% compliant with the State and Federal guidelines.
Will members of the Wading River Fire District or Fire Medic Company be determining my ability to satisfy the invoice I received for the Cost Recovery Program?
NO. The leadership of the Wading River Fire District will NOT be involved in determining a person’s ability to satisfy the invoice they received for the Cost Recovery Program. ALL decisions will be made by the 3rd party billing company based on policies and procedures that have been pre-determined. The Wading River Fire District will ONLY be informed of a case number and the amount of funds collected. The 3rd party biller will not be informing the District of reasons why a case was closed or why only a percentage of funds were recovered.
How does gathering a patient’s insurance information work?
At the time of transport a significant amount of information is recorded at the scene from every patient on the Patient Care Report (PCR). The gathering of insurance information will be attempted. If it is not recovered it is the responsibility of the 3rd party biller to locate the proper information. NO ADDITIONAL TIME WILL BE TAKEN AND NO DELAYS IN PATIENT TRANSPORT WILL OCCUR FOR THE GATHERING OF INSURANCE INFORMATION.
Where will the patient’s insurance information be recorded?
The patient’s insurance information will either be written down on the PCR or insurance cards may be photographed/scanned with the WRFD PCR tablet and uploaded into the system. Member’s phones are strictly prohibited from being used. ALL information is then uploaded and double encrypted when transmitted to the 3rd party biller.
What happens once a PCR has been completed and transmitted to the 3rd party biller for processing? How will the costs be recovered?
1st Step – EMS Personnel record proper medical insurance at time of transport and claim is processed by 3rd party biller.
2nd Step – If EMS personnel are unable to record proper medical insurance at time of transport the 3rd party biller will utilize a computer program in an attempt to locate the patients information. If the information is located the claim is processed. If not-
3rd Step – If the 3rd party biller was unable to located the patient in the initial computer survey the 3rd party biller will then utilize another more enhanced computer program. If the information is located the claim is processed. If not-
4th Step – The 3rd party biller will attempt to make contact with the patient via telephone at any of the phone number(s) that may have been provided at the time of transport. ALL Calls are made by Certified Ambulance Coders (NAAC) or Certified Ambulance Privacy Officers (CAPO). If the information is recovered the claim is processed. If not-
5th Step – The 3rd party biller will attempt to make contact with the patient via written document that will be sent to the home address provided to the EMS crew at the time of transport. The form is NOT A BILL it is simply a request to provide Insurance Information. If the patient or their representative responds in writing or with a telephone call to the 3rd party biller and provides the requested information the claim is either processed or CLOSED based on WRFD policies and procedures.
*** The 3rd party biller will do all they can to avoid sending the Request for Insurance Information form.
What if a patient simply refuses to cooperate with the cost recovery process?
After 60 days ALL cases with balances due under $200 are marked closed
ALL debt is forgiven after 90 days even if amount due to the District is greater than $200
If after 90 days the party does not respond the case is closed
What if the patient’s bill is greater than their insurance company agrees to pay?
Aside from co-payments and deductibles the Wading River Fire District will ONLY accept what the insurance provider agrees to remit.
What if the patient’s deductible is greater than the cost of the services provided?
Deductibles are selected or chosen by individuals. The Wading River Fire District has no say or input in the patients decision making process when choosing their deductible. Individuals know what their deductibles are long before they need to use them. And yes for a multitude of reasons a person may have chosen a high deductible and may have difficulty satisfying said amount due. With that said please refer to the 60 and 90 day procedures outlined above.
What out of pocket expenses can sick or injured persons that are transported expect?
Sick or injured persons are responsible for their CO-PAYS and any deductibles associated with their insurance plan.
Other than the “Co-Pay” or “Deductible” the Wading River Fire District is prohibited by law from collecting any additional funds other than what is paid by the patient’s insurance provider.
Will patients that do not “pay their bill” be placed into collection?
The ONLY persons that will be placed into collections are those who receive compensation directly from their insurance provider and cash said insurance check and DO NOT forward the funds received to the Wading River Fire District. The claim will then ONLY be forwarded to the credit bureau if the patient is unresponsive to numerous attempts to contact them.
What will Cost Recovery Achieve?
Hold the line for the near future on the portion of taxes that fund Emergency Medical Services in the Wading River community
Provide EMTs and Advanced Life Support (ALS) technicians (either AEMT-CC or Paramedic) during times when WRFD volunteers of equivalent training may not be available to respond. To ensure this:
Provide an Advanced Life Support EMS technician to be available 24 hours a day, 7 days a week
Provide additional staff as required to operate an ambulance 24 hours a day, 7 days a week
Will Cost Recovery increase EMS operational efficiency?
In conjunction with Wading River Fire District volunteers, cost recovery will provide sufficient Emergency Medical Technicians to allow Advanced Life Support Technicians (ALS) only transport patient in need of advanced procedures, thus freeing up the ALS technicians for additional multiple alarms - which typically are almost 40% of ambulance calls in Wading River.
Will Cost Recovery change anything about Wading River Fire Districts Emergency Medical Service other than recovering cost?
Instituting Cost Recovery will NOT change the basic ambulance operations procedures: Both the members of our public and the WRFD volunteers and employees will continue to participate in ambulance calls will not see any difference in the way EMS is carried out in our community. The ONLY exception will be that Advanced Life Support providers will be much more readily available on all calls.
Instituting Cost Recovery will NOT change the way people call for an emergency ambulance: Whether members of our community call the Suffolk County Fire Communications Bureau “Fire-Com” at 929-4344 or they dial 911, the call will still go to the WRFD the fastest way possible.
Though we are instituting Cost Recovery the Wading River Fire District will NOT provide extensive transport services currently provided by commercial and hospital-based providers (so it will not be competing with them for billable patients). The Wading River Fire District has recognized the importance of these other ambulance services operating in our community to provide scheduled and non-emergency transport between private residences and nursing homes and hospitals and clinics. They have always relieved the District of the burden of responding to these somewhat more routine transport needs and will continue to do so. In this way the Wading River Fire District will be that much more available for true emergencies.
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