Phoenix Fire Reworks Budget Request After KJZZ Raises Questions

Published: Tuesday, May 17, 2016 - 7:20am
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(Photo by Christina Estes - KJZZ)
According to Phoenix Fire, crews responded to over 180,000 calls last year.

The Phoenix City Council is scheduled to decide on a budget that tops $1 billion in general fund spending and calls for a property tax hike. With so much money at stake, each department has to make its case to the city manager and council. And, one department had to do some backpedaling after KJZZ started looking at the numbers.

Among the city manager's proposed budget, one paragraph caught our attention.  The fire department was asking for approximately $2.8 million dollars for an electronic billing and records system.

The public document stated that next year, major insurance carriers will begin withholding payment and charging providers for not having an electronic billing system. And here’s the part that really stood out: It said, “This will result in lost revenue to the general fund." But it turns out the lost revenue part was not accurate.

“We could have been more precise in our documentation, the way we explained that," Executive Assistant Chief Mark Angle said.

After KJZZ and Councilman Jim Waring started asking for details about the so-called lost revenue the fire department, city manager and communications office got together and came up with what they call a "clarifying statement."

Here's how the original budget request relating to the department's Emergency Transportation billing system (ETS) read:

"Next year major insurance carriers, including Medicare and Medicaid, will begin withholding payment and charging providers for not having an electronic billing system. This will result in lost revenue to the General Fund as ETS currently brings in approximately $36 million annually."

Here's how the clarified portion reads: (the clarifying statement is in italics)

"Next year major insurance carriers, including Medicare and Medicaid, will begin withholding payment and charging providers for not having an electronic billing system. While currently ambulance providers do not face penalties for non-compliance, should this trend shift as speculated within the fire service industry, any possible imposed fines could result in lost revenue to the General Fund. Currently, ETS brings in approximately $36 million annually to the General Fund."

While the department no longer says Phoenix will lose money next year if they don’t get a new billing and records system, they say it’s still critical. I visited a station at 19th Street and Indian School Road to find out why.

Behind the doors of Station 61 is a triage unit on wheels. One of 37 ambulances across Phoenix, it’s stocked with intravenous bags, bottles of medications and a bright yellow gurney.

During his 11 years with Phoenix Fire, captain and paramedic Joe Meier has seen upgrades to gurneys, computers and the dispatch system, but one thing has stayed the same-- piles of paper work.

Riding along on a medical call, I see it firsthand. While other crew members assess the man’s condition and prepare to take him to the hospital, Meier begins asking questions and filling out the paperwork.  

Every medical call involves at least one form with multiple copies. This case requires a second form since the ambulance is taking the man to the hospital. And, sometimes there’s a third form for extra notes.  

As another paramedic monitors the patient’s vital signs, Meier continues filling out forms and once they enter the hospital, Meier rips off the yellow copy with the insurance information.

“Most hospitals you have to be in the system before they can treat so they’re all about getting (the form), You’ll hear them say 'Hey, can I get the yellow copy from you?'” he said.

According to captain and paramedic Ardell Deliz, Phoenix crews responded to nearly 190,000 calls last year and nearly 90 percent were medical.

"During a long shift if you miss something on a patient care form it could mean litigation," she said. "It could be something that you did, but you didn’t write it down and it’s like it didn’t happen.”

Toss in typos and messy handwriting and the potential for mistakes can grow, says Angle.

“Right now our folks they get a ticket and they have to input everything into a system to get it where it needs to go," he said.

He says a fully electronic system will get patient information to the hospital quicker, free up crews in the field sooner and get bills to the insurance companies faster.

Last year the city collected approximately $36 million from insurance carriers for its ambulance transports. Angle says Phoenix’s reimbursement rate is 84 percent, more than 10 percent higher than the industry average. And, while he’s convinced the electronic system they want will lead to a higher reimbursement rate, he’s not willing to put a number out there.

If the council approves the proposed budget, firefighters could begin testing the new system next year.