WEST LAWN, Pa.- Local EMS providers are losing lots of money because of issues with insurance payments.
Western Berks EMS says they’ve lost nearly $1 million dollars in the last five years because insurance reimbursements aren’t making it back to them.
“It’s a breeding zone for fraud because if I take you to the hospital, I know I can take you to the hospital [and] it becomes a paycheck for you,” says Western Berks EMS CEO, Anthony Tucci.
It’s a big problem for EMS providers.
Tucci says since 2022, the agency hasn’t been able to recover close to $940,000 in insurance reimbursement checks that were sent directly to patients.
“We bill the insurance for them,” says Tucci. “Then they turn around and they give the patient the check and then we’ll send the patient a bill. We’ll try to follow up and say ‘hey you got a check. Here you go, you need to turn that over to us; and we send very complete instructions on what you have to do. Some don’t follow it.”
Tucci says EMS is the only healthcare provider that doesn’t receive direct payments and he says Western Berks is not the only EMS provider affected by this issue, adding the problem is far reaching.
Tucci says the District Attorney in Allegheny County filed charges on a case related to a similar issue.
Some bills are also making their way through committee in Harrisburg right now which could help resolve the issue.
“With HB1152 we would actually be paid a correct wage for EMS, that actually pays us the correct amount of money to do it and the check would come directly to us,” says Tucci.
He tells WFMZ, EMS is already in crisis and most ambulance services are underfunded; if these bills pass, he said it would help make a difference.