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IEMS explains: What's driving the cost of your ambulance bill?

Posted at 8:00 PM, Oct 01, 2018
and last updated 2018-10-01 23:34:41-04

INDIANAPOLIS — When Brittnea Andrew and a friend were injured in a hit-and-run crash, an ambulance crew was among the first to provide treatment before arriving at the hospital.

"They saved our lives," Andrew said.

Though Medicaid covered the bill for her ambulance services, Andrew wants to know what's behind the cost, saying, "You need to know where your money is going."

After a Call 6 Investigates request, the Indianapolis Emergency Medical Services is now working behind the scenes to provide consumers with a better explanation of what services you're paying for on your bill.

IEMS makes about 110,000 runs a year, responding to everything from accidents, to overdoses, to shootings and even a stubbed toe.     

The agency, which has 31 ambulances and 300 full- and part-time paramedics and EMTs, does not receive tax dollars and depends on its billing to operate. But the bills received by IEMS patients fail to explain the value of the services provided.

Dr. Charles Miramonti, Chief of IEMS, says the agency should provide an explanation. "You're right. We should," Miramonti said. "I don't have a good reason why haven't."

According to Miramonti, there are two types of responses: A "Basic Life Support" — or BLS — response includes a crew with an EMT who can provide trauma and wound care. An "Advanced Life Support" — or ALS — response includes a paramedic who has 1.5 years of extra clinical training. The type of response is determined by the 9-1-1 call.

The base charge for a BLS response is $2,006.46, while the base charge for an ALS response is $2,286.59. Most people do not pay the full base charge because their insurance covers a portion of the cost. Those who are uninsured are offered a 50 percent discount.

"If we did ALS for you and did absolutely nothing, and ALS for the next guy and did a full cardiac arrest — spending hundreds and thousands in labor, equipment and monitoring and all that infrastructure that goes into that — we get the same compensation," said Miramonti.

Beyond salaries, vehicle maintenance, support staff, supplies and technology, the bill covers a string of services, including:

  • The medical expertise of the paramedics or EMTs on the scene and assessments performed
  • Continuing education to keep staff certified
  • The training and supplies like Narcan for Indianapolis Fire and Metro Police
  • Supporting  Swat tactical medics
  • Outreach programs like CPR training
  • Sending teams into neighborhoods to help people stay healthy and out of the emergency room
  • Assisting efforts focused on mental health and the homelessness

"All of that is in the bill," Miramonte said. "This is not a private company trying to make a margin. We are truly a part of the city's fabric and infrastructure."

Your bill also covers a portion of what others don't pay. On average, IEMS provides $150 million in services a year, and only sees about $36 million in payments.

"It's not like those dollars go to profit-making venture capitalist groups in New York or Wall Street or anything else," Miramonti explained. "All those revenues we get go back into the service. They go into better pay rates, better ambulances."

IEMS does not plan to itemize the bills, but is working on providing more of a detailed description of what services benefit from the billing.

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