There appears to be alot of misunderstandings, and misinformation regarding billing and copays.
COPAYS- copays are not paid to the insurance company. When a provider submits a claim, the ins and the patient share a “coresponsibility” for payment to the provider. The insurer provides the bulk , while the patient owes the copay. All copays, including Medicare must be billed and can, under certain circumstances , be written off, including Medicare. This is typically done if a financial review indicates the patient cannot afford to pay and qualifies for a reduced payment. Providers have maintain a charity care policy and inform the patient of its existence.
Billing insurance companies for routine care is not that difficult , but billing for ambulances is whole different world and presents numerous challenges. The patient is often in no condition to provide demographic and ins info. In addition, Federal law (EMTALA) prohibits the gathering of information until the patient has been triaged and stabilized , by which time the ambulance is possibly gone . NYC hospitals receive monthly lists from the FDNY requesting ins and demographics for patients transported there. How would Hatzolla do it?
Billing would require the purchase of electronic systems for registration, billing , and tracking income, receivables and cash. It would also have to hire fulltime staff to gather information, verify it, post it and follow up on the billing . Even if the billing and collection were farmed out to a service, they would have to be paid. Staff would also be needed to review applications for charity care.
What I’m saying is that billing requires capital investment and hiring of salaried staff members
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