In a lengthy, detailed audit report that filled nearly two hours of Tuesday’s meeting, the Washington County Supervisors learned from Fitch & Associates of Platte City Missouri that, despite an initial antiquated billing system, the need for updated software and numerous other operational needs, the county’s Ambulance/EMS Department has a highly competent and dedicated staff.  Even more, steps were and are underway to modernize all aspects, especially for sending filings, doing follow-up, and to create a part-time (20 hours) office position to aid with tasks ranging from phone calls to billing help.

In the process, the board learned that dealing with insurance firms, Aetna is “terrible,” with Anthony Minge of Fitch detailing the company’s long policy of “denying claims,” and delaying payments.   However, he outlined problems with others, ranging from the government (Medicare, Medicaid), private insurances and private payees that had created by May 28 of this year a backlog of 318 claims that were more than 60 days overdue.  As of July 7, efforts by the staff had it down to 157 unpaid claims that had gone for 35 days.

A key recommendation was to have a part-time office position to provide support for the two-member full-time staff.  Equally important was to fully update the billing program via the well-known ESO system that also would provide for receiving electronic payments, starting with installation August 1.  However, the complete transition from the current situation to a fully modernized system was estimated by Minge as taking at least one year.

During the report, Minge in his detailed report of dealing with the various agencies, credited the county department with doing a good job under trying circumstances.  Even more, it was clear that unless there is follow up to billings, usually through phone calls, payment backlogs can go for more than a year or two.   He noted that with quick follow-ups, Medicare payment can be paid within 14 days.

As for using collection agencies, the Washington Credit Bureau has collected 13 percent of overdue accounts (compared to about 3 percent nationally); however, the bureau retains between 30 to 50 percent of what is collected.

The report also showed that the billing staff often has to respond to non-billing duties amounting (between the two member staff) to nine hours daily.  Hence, the recommendation for an additional part-time person.

At the conclusion the report (a full copy is in the auditor’s office), Minge stressed that the department is having progress, citing the positive and dedicated attitude of the entire staff as a major factor.  

The news received agreement from board members and from Katrina Altenhofen, the acting department administrator.  Following a few brief questions regarding meeting federal government compliance and updating operations via software that can be customized, the board unanimously approved acknowledgment/acceptance of the audit.

In other business, the board:

Acknowledged the treasurer’s semi-annual statement of funds, his quarterly report and the annual investment review and the quarterly report from the recorder.

Approved a Class C liquor license for outdoor service for the Washington County Golf and Country Club.

Approved a fireworks permit for Camp Reece at Lake Darling State Park for August 3 from 8 to 11 p.m.

Approved appointment of Edgar McGuire to the country Eminent Domain Commission, and approved considering a potential county wind ordinance.