At the third meeting of the Idyllwild Fire Protection District Finance Committee, the members learned about the complicated processes of collecting fees for emergency medical service and for fighting fires outside the district.

Chief Patrick Reitz explained that final ambulance payment depends on whether the individual has insurance and who the insurer is.

Medicare and California’s Medi-Cal patients represented about 45 percent of the ambulance runs in 2013, according to Reitz. While the average claim for both groups is about the same, IFPD collects about 25 percent from Medicare, while Medi-Cal pays only 9 percent after withholding 1 percent for administrative costs.

Recovering the cost of transporting a patient to the hospital is growing more difficult, he said. Riverside County has established its own low-income health plan, but it limits transport reimbursements to $60 per trip. “We’re not even getting gas money,” Reitz lamented. “That doesn’t pay for the time [of staff] or equipment.”

With the implementation of the Affordable Care Act, Reitz said he expects Medicare rates to increase for several years, but then begin declining.

In 2013, IFPD collected about $350,000 from emergency medical services, but its actual billings were about twice that amount. Insurers reduce payments and some individuals have no insurance and are unable to pay from their own resources. Besides ambulance collections, IFPD has delays receiving payments for its work on fires outside the district. While these amounts are smaller, IFPD must still pay the staff’s time and expenses while waiting months, and sometimes longer, before reimbursements are received from the federal or state governments, Capt. Mark LaMont explained.

For example, in August 2012, IFPD was dispatched to the Volcano Fire in Riverside County and the Jawbone Fire in Kern County. Now more than 18 months later, the department still is awaiting reimbursement. Costs for another six fires, all within the past year, are still outstanding, he added.

The committee plans to review the budget before it goes to the commission for approval. Reitz expressed his goal that final commission approval of the budget might occur in June. He said an initial budget must be approved by July 1 and a final budget must be approved before Oct. 1.