Ambulance district to replace disabled ambulanace

Board discusses pros, cons of outsourcing billing

The Callaway County Ambulance Board unanimously voted to replace, rather than repair, a broken ambulance.

Director Charles Anderson told the board the ambulance, a 2010 Ford E-Series with 103,000 miles, has a failed engine.

He said the district had several options:

•Replace the engine for $15,000. The ambulance would be back in service in several weeks and the new engine would have a 200,000 mile warranty. Anderson noted that the last time the district replaced an engine on an ambulance, “we had nothing but problems.”

•Remount the box of the ambulance on another new chassis for $74,000-$80,000. Anderson said it would be about a year before the remounted ambulance would get back into service because of the manufacturer’s current schedule.

•Replace the ambulance with a new Mercedes Sprinter ambulance at an estimated cost of $125,000. It would be early 2015 before the district took delivery on a new ambulance.

Board member Chuck Baker asked Anderson about the district’s experience with the three Sprinter ambulances it recently brought into service.

Anderson said early issues have been resolved and those trucks are getting an average of 12-13 mpg — twice as many as the rest of the fleet.

After some discussion about problems with reliability of repaired trucks with higher mileage in the past, the board ultimately voted to order a new Sprinter from Osage Ambulances. Osage will provide the district with a loaner vehicle while it is building the new truck.

In other business, the board heard the pros and cons of outsourcing the district’s patient accounts.

Anderson said a decision on the issue — previously discussed during the board’s May meeting — recently became more pressing because the employee who currently handles patient accounts told him she was looking for jobs in St. Louis and would be leaving.

According to Anderson, the benefits of outsourcing include:

•Billing companies have policies and procedures in place to ensure the district gets paid and the manpower to follow up on claims.

•A billing company would be able to supply comprehensive performance reports automatically or upon request.

•The district wouldn’t have to interview, hire and train new personnel.

He said cons of outsourcing include:

•Cost — the average cost for a billing company is 6-8 percent of the money collected. Anderson said based on 2013 numbers, a billing company would have been $105,512 based on a 7 percent rate.

•The potential for hidden fees.

•Lack of control — Anderson said the district would still be ultimately responsible for what the billing company does, and he does not like “having responsibility for something that I have limited control over.”

After a short discussion, the board decided to keep patient billing in house and start looking for a replacement for that position.

Katherine Cummins can be contacted at (573) 826-2418 or


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