By Pat Hammert/Staff Writer

Parkview Hospital Authority will consider hiring an outside consultant to take a “top to bottom” look at its financially ailing ambulance operations, an area-wide service that has requested a subsidy from the city to continue.

For several weeks trustees have pushed to refine the hospital’s ambulance billing procedures through Accufile, a professional billing and collection company that would revamp the emergency medical services coding and reimbursements system.

When the authority met last week, the discussion included the research done on Accufile, the progress in limiting ambulance charge-offs and the ongoing meetings with city officials to provide a cash summary statement. City Manager Tony Rivera has requested the financial data before the City Council makes a decision on an ambulance subsidy.

Across the industry, ambulance bad debts far exceed hospital bad debts, said Administrator Lex Smith. Trustees looked at a preliminary cash-in-cash-out statement that showed the bad debt percentage for a seven-month period at 8.23 percent. In comparison, the hospital’s overall bad debt percentage for the same period was 5.43 percent.

In his recent discussion with the emergency medical services director of Northwest Texas Health Care System, based in Amarillo, those charge-offs were eye-opening.

“In every case, there were 50 percent higher ambulance bad debts than hospital bad debts,” he said. That EMS system, which is hospital-based like Parkview’s, loses more than $1 million annually in direct costs alone.

Last year, Parkview’s EMS went in the red more than $500,000, mainly because of fee changes in Medicare reimbursement.

Northwest Texas hired Polaris Group, a North Carolina-based EMS consultant, several years ago and one of the recommendations was to hire a company like Accufile to conduct outside billing and collection. As a result, Northwest Texas has entered an agreement with Accufile to do some comparison collections during a trial period.

Smith said he would follow up on the results of that study.

In earlier discussion, Smith told trustees the hospital auditor advised that there would be no advantage to the hospital in hiring the company. He said he was also skeptical as to any financial advantage the hospital would have from an outside billing company.

For the past 20 years, bad debts have been turned over to an Oklahoma City-based collections company. Trustee Willard Holsted requested the board receive a current report on its success rate.

Last month, trustees wrote off $90,650 in ambulance bad debts. This month, the write-off was $40,780.

Trustee David DeLana suggested they investigate hiring an EMS consultant such as Polaris Group to fine-tune the ambulance service to improve its performance in the face of rising costs. Smith said such companies review operations “from top to bottom.” Major EMS consulting firms include Platte City, Mo.-based Fitch and Associates and the Pennsylvania-based law firm of Page, Wolfberg and Wirth.

In other discussion, three trustees — Holsted, Mark Gilmore and Rosemary Klepper — relayed personal knowledge of instances of late billing for hospital services and urged the administration to look at ways to improve patient notification when a bill is owed.

In other business, Smith said a five-year agreement has been reached to treat inmate patients from the Federal Correctional Institution in El Reno and the Federal Transfer Center in Oklahoma City. Parkview is to provide primary care for the patient with St. Anthony Hospital providing specialized care.

Also, the authority appointed trustee DeLana as chairman and trustee Margaret Mehle as vice chairwoman, beginning May 1. DeLana and trustee Mike Compton have been reappointed to the board by the City Council for a three-year term.

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