EMS Compassionate Billing

Compassionate Billing means a patient’s ability to pay, or their insurance coverage will never be a consideration when it comes to the care they receive. 

A compassionate billing program is designed to minimize out-of-pocket expenses for insured residents due to the taxes they pay by waiving any copays or deductibles after a patient’s health insurance, Medicare, or Medicaid have been billed for transport services. Uninsured residents can be shown compassion and provided the option of submitting a waiver form ensuring financial hardship is avoided. 

Several localities in Virginia already use this approach. There is no charge if a patient is not transported by ambulance.

EMS billing will NOT be a consideration when providing patient care. The exceptional patient care for which this unique system is known will continue to be provided to Virginia Beach. 

No patient will ever be denied service, and every patient will be offered the same degree of care from EMS providers.

Taxes will not be increased. Compassionate Billing is the feasible solution to increase funding to avoid service delivery impacts. Rescue squads and the Department of EMS are challenged to fund ambulances, equipment and supplies. 

Billing for ambulance transport is expected to contribute $14 million or more for Virginia Beach EMS and the volunteer rescue squads in the first full year. 

Introducing compassionate billing would fund purchase of new ambulances, provide medical supplies, fund volunteer recruitment and retention initiatives and ensure the rescue squads vitality.

The identification and establishment of a sustainable alternative revenue source is a priority initiative in the most recently developed EMS strategic plan. This plan was developed with input from EMS staff, volunteer rescue squad members, the Rescue Council and the International Association of Fire Fighters – Local 2924 (IAFF L2924).

Volunteer Rescue Squads’ funding has been historically sourced from fundraising and city contributions. Department of EMS (VBEMS) operating expenses have been provided through the City of Virginia Beach General Fund. 

Due to rising costs, rescue squads have seen expenses increase by more than 40% and Department of EMS expenses have nearly doubled in the last few years. Traditional revenue sources for rescue squads and the department are not enough to sustain operational costs.

From the VB Rescue Council perspective – which represents the Virginia Beach Volunteer Rescue Squads and its volunteers – its main goal is to maintain a strong volunteer presence in the EMS system while maintaining exceptional care to the community. 

The reality is that the cost of operating expenses continues to increase while donations and fundraising have not kept up. Introducing compassionate billing will provide funding to ensure rescue squads continue to thrive and have sufficient funding to continue delivering exceptional prehospital care.

The consideration of EMS Compassionate Billing as a revenue source was a VB Rescue Council initiative. The Rescue Council represents the Virginia Beach Volunteer Rescue Squads, which have seen an increase in operating expenses including new ambulances, supplies, equipment and rescue squad infrastructure. 

Implementing a compassionate billing program can provide relief so rescue squad personnel and volunteers can concentrate on efforts, programs and initiatives to ensure it continues to thrive and serve the community. 

You can read the Rescue Council’s unanimous support of a compassionate billing policy at vbrescuecouncil.org/position-statements.

• Virginia Beach Volunteer Rescue Council commissioned a feasibility study on EMS Compassionate Billing as a potential funding source to help pay for increased operational expenses.
• Rescue Council is a democratic representative group of the 10 volunteer rescue squads and Marine Rescue Team. Under City Code, the Rescue Council serves as an advisory board to the EMS Chief on department policy matters and provides recommendations to the City Manager.
• Rescue Council worked with AP Triton Consulting, a firm that specializes in public safety solutions, to conduct the study.
• Virginia Beach EMS is a combined system of career members of the Department of EMS and volunteer rescue squad members. The system responds to 56,000 calls for service annually; approximately 40,000 calls require ambulance transport.
• Volunteer Rescue Squads’ funding has been historically sourced from fundraising and city contributions. Department of EMS operating expenses have been provided through the City of Virginia Beach General Fund. Due to rising costs, rescue squads have seen expenses increase by more than 40% and Department of EMS expenses have nearly doubled in the last few years. Traditional revenue sources for rescue squads and the department are not enough to sustain operational costs.
• Virginia Beach is the only locality in Hampton Roads that does not conduct EMS billing. Municipalities billing for emergency medical services is the norm – not the exception.
• Rescue squads are challenged to fund ambulances, equipment and supplies.
• Increased funding is necessary to avoid service delivery impacts.
• Billing for ambulance transport is expected to contribute $14 million or more for Virginia Beach EMS and the volunteer rescue squads in the first full year. This estimation was calculated on third-party payers (insurance)- uninsured and self-pay were not considered.
• If and when approved, it will take six to nine months to initiate EMS billing.
• EMS billing will NOT be a consideration when providing patient care. The exceptional patient care for which this unique system is known will continue to be provided to Virginia Beach. No patient will ever be denied service, and every patient will be offered the same degree of care from EMS providers.
• “Compassionate billing” aims to minimize out-of-pocket expenses to patients. Health insurance plans provide a benefit for ambulance transportation. Charges are based on the level of care provided- Basic Life Support (BLS) or Advanced Life Support (ALS) level 1 or 2.
• Billing laws require a ‘reasonable and customary’ effort to collect fees. City Council can elect not to charge residents copays, deductible or uncovered fees. Council can also elect policy to ‘write-off’ outstanding debt and not pursue collections.