AUGUSTA — City councilors meet Thursday to discuss whether to more aggressively try to collect the debt left by unpaid ambulance bills.

In a typical year, according to City Manager William Bridgeo, the city takes in about $3 million in ambulance and other emergency medical services-related fees. But about $250,000 a year in ambulance bills goes uncollected.

At the request of city councilors, who asked during budget deliberations earlier this year whether the city should be more aggressive in collecting unpaid bills, city administrators researched the issue and are prepared to report their findings to councilors at their Thursday meeting.

The city does not currently have a collection agency go after those who don’t pay their ambulance bills.

Bridgeo said policies on collecting unpaid debt vary from municipality to municipality, but he said it doesn’t seem like many, regardless of their collection policies, recover a lot of additional money.

Fire Chief Roger Audette said most collection agencies charge between 25% and 33% of what they collect.


He said Brunswick, which he described as similar in size and demographics to Augusta, uses a collection agency and, in 2018, received $4,961 in bad debt collections. He said Augusta’s collections would be about the same as that amount. He noted the city cannot seek to collect additional funds from MaineCare or Medicare patients, beyond the set reimbursement fees.

Bridgeo said ambulance bills may go unpaid, or be only partially paid, when a victim in an emergency doesn’t have insurance, has insufficient insurance or a high deductible.

Audette said the city currently contracts with Windham-based Medical Reimbursement Services for its ambulance billing. He said 57 other agencies also use that firm, and about 40 of them also use independent collection agencies to go after clients with unpaid fees.

Audette said most Maine municipalities have policies that they don’t send collection agencies to collect unpaid emergency services debt from their residents, just from nonresidents. Some municipalities that do have collection agencies go after bad debt have exceptions for veterans, police officers, firefighters and others, and most have a “hardship” application by which someone can seek to have their unpaid bills waived or reduced, or set up payment plans.

Bridgeo said the city provides ambulance service by contract to Hallowell and Chelsea. He said both municipalities are billed, and pay Augusta, for the unpaid ambulance bills for ambulance calls in their municipalities.

Councilors meet at 6:30 p.m. Thursday in council chambers at Augusta City Center.

Councilors are also scheduled to:

• Hear an update on efforts to improve pedestrian safety in the city, from Public Works Director Lesley Jones and City Engineer Nicholas Hartley and;

• Discuss a recommendation from Police Chief Jared Mills to increase the maximum fees tow truck operators can charge customers when the police department calls for a tow truck on a motorist’s behalf. Mills said the police department was approached by the operators of two different towing companies to ask that Augusta raise the maximum fees they can charge, which Mills said were last changed in 2005.

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