CITY COUNCIL AGENDA ITEM
ACTION REQUESTED:
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Authorize the City Manager to increase the 2026 personnel headcount and hire two full-time Medical Billing Representatives in the Fire Department
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DEPARTMENT: Fire Department
SUBMITTED BY: Mark Puknaitis, Chief
BOARD/COMMISSION REVIEW:
N/A
BACKGROUND:
The Fire Department ("FD") is responsible for the billing of emergency medical service (EMS) calls. Traditionally, this function has been administered through a third-party vendor compensated through a commission-based fee structure tied to collected revenues. At this time, the FD employs one Medical Revenue Specialist to perform a variety of administrative duties related to ambulance billing including the organization, preparation, submission and posting of Medicaid, Medicare, private pay and private insurance billings and serves as the point of contact for both the third-party vendor and customers utilizing ambulance transport services.
Despite growing call volume and number of calls for service eligible for billing, the table below shows that the FD has experienced a year-over-year decline in dollars collected per trip, and as a result, lower annual revenue.
Year
# Total Calls
# of Billable EMS Calls
Avg. Collected Per Trip
Total Annual Revenue
2023
17,330
10,913
$549
$7,583,795
2024
18,198
11,639
$531
$8,060,713
2025
18,531
9,392
$503
$6,365,279
Staff has worked diligently to address these issues with the vendor; however, those efforts have resulted in only limited success. For example, in 2025 due to vendor and new hospital software issues, over 60 days of billable calls could not be billed or collected until 2026 and only after staff identified the errors.
After monitoring vendor performance, service delivery, and reviewing the experiences and operational practices of other municipalities, the FD recommends transitioning this function in-house. Bringing the billing operation under Fire Department administration will improve operational oversight,...
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