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ORANGE COUNTY <br /> BOARD OF COMMISSIONERS <br /> ACTION AGENDA ITEM ABSTRACT <br /> Meeting Date: September 17, 2002 <br /> Action Agenda <br /> Item No. -� <br /> SUBJECT: Blue Cross Bice Shield of North Carolina Ambulance Service Contract <br /> DEPARTMENT: Revenue PUBLIC HEARING: (YIN) No <br /> ATTACHMENT(S): INFORMATION CONTACT: <br /> BCBSNC Contract wlexhibil Jo Roberson, ext. 2727 <br /> TELEPHONE NUMBERS: <br /> Hillsborough 732-8181 <br /> Chapel Hill 9684591 <br /> Durham 688-7331 <br /> Mebane 330.227.2931 <br /> PURPOSE: To approve a contract o allow the direct payment of insurance reimbursements to <br /> Orange County from Blue Cross Blue Shield of North Carolina (BCBSNC)for Emergency <br /> Management ambulance services. <br /> BACKGROUND: Since Orange County began charging for the Emergency Management <br /> ambulance service in November 1996, Insurance claims have been filed on behalf of all clients. <br /> Shortly after Orange County began charging for the Emergency Management ambulance <br /> service,discussions were held with BCBSNC concerning the County's possible participation as <br /> a provider under the company's insurance program. BCBSNC requires a contract agreement <br /> as part of this participation,with providers accepting their designated fee as full payment. <br /> However, at that time,the reimbursement levels proposed by BCBSNC word not have allowed <br /> the County to recoup a reasonable portion of the cost of providing emergency merlical services. <br /> Since that time, BCBSNC has significantly increased the reimbursement rates they are willing to <br /> pay, to the point that the County would receive virtually all of the charges established in the <br /> Countys EMS fee schedule as approved by the BOCC. <br /> BCBSNC is one of the largest insurance providers in this area, with approximately 500 to 600 <br /> Orange County ambulance service claims fled annually with BCBSNC as the primary insurer. <br /> Approximately 30%m 35%of those clients receive the insurance raimbursement directly from <br /> BCBSNC, but for various reasons do not forward those funds to the County for the transport <br /> services provided. That results in substantial add itbnal staff effort expended In contacting <br /> these clients and a9em ri ng to recover money that should have been paid to the County. <br /> Under the proposed agreement with BCBSNC, all such payments (including those where <br /> BCBSNC is the secondary insurer, following Medicare as the primary insurer)would come <br /> directly to the County. <br /> This contract will enable Revenue staff to provide better service to citizens by handling the <br /> entire financial transaction associated with their ambulance transport. Direct payment from <br />