By: Lydia Crawley
The Parsons Advocate
Mark Joseph, CPA for the Tucker County Ambulance Authority gave a detailed report to the Ambulance Authority Board at the Board’s August meeting August 19th. The report detailed the financial status of the Authority during it’s current fiscal crisis.
“People don’t understand that this is a very capital intensive operation, but the second that we can’t sign the checks, we have to close the doors,” Dennis Filler, Tucker County Ambulance Authority Board President said.
Over the course of the Fiscal Year ending in June 2025, the Ambulance Authority saw an average of 63 runs a month, according to Joseph. The highest number of runs billed were in June of 2024, which saw a total number of runs numbering 102 for the month. The lowest month billed was February 2025 at 32 runs for the month. Joseph said, however that the number of runs in his number were not reflective of the actual number of runs that the crews were out for the month, but the runs that were billed for payment.
“Keep in mind though that these runs are booked here by the posted date,” Joseph said. “So they may differ from the activity date or the date the service was performed. This would actually relate to the billing process and that is what our focus is on.”
The billing cycle versus the operations can have up to a two month lag, according to Tucker County Ambulance Authority Board President Dennis Filler. The time, however that the Authority takes to input the run into the system for billing to be initiated is only 72 hours, according to Tucker County Ambulance Authority Director Amanda Simmons. According to Filler and Simmons, the February numbers of 32 runs reflect runs that were completed possibly in November or December of the previous year.
As with the runs, the gross charges for the same fiscal period reflected the same trend as the runs due to the same insurance and billing delays. As before, Joseph’s data showed June 2024 had the highest gross charges at $94,445.50 and February was the lowest at $32,207.00. Overall, the average for the Fiscal Year was $64,000 a month.
“When I mention 63,000, that doesn’t necessarily mean its going to translate into cash collections on those charges,” Joseph said.
Joseph said that there were adjustments each month to the gross charges that reduced the amount of cash collected by the Authority. Some of the adjustments were due to insurance company caps on coverage payouts or what Joseph called “contractual adjustments.” Others are from noncollectable accounts that are written off during the year, according to Joseph.
“On the average, we’re seeing in this past year, that for every dollar that we’re billing out as a gross charge, 39 cents or 39% of that we’re never going to see that,” Joseph said.
The actual cash collections, according to Joseph’s data, is much lower. In the same Fiscal Year, the range varies from $66,369.23 in June 2024 to $29,133.85 in June 2025 with an overall average of $48,000 a month. Filler said that equates to roughly $550,000 in operating capital a year from billing. The Authority currently operates on a $1.25 million budget.
As far as a total collection rate on the overall collections of the Authority’s bills, the Authority has a collection rate of 74%. Filler said the National collection rate is at the 60% mark.
“So we are squeezing every penny we can possibly squeeze out of our revenue,” Filler said.
However,the cost of the runs, far exceeds what the Authority makes off each one. The employment cost of each run alone is $1,007 for the 12 month period ending June 2025. The Authority bills out $1,021 on each run. Yet, the cash collected on each run only amounts to $736 for the same period according to Joseph’s data. Those numbers do not account for medicines, equipment costs or administrative costs.
The Ambulance Authority recently petitioned the Tucker County Commission to withdraw $100,000 from the newly established 2% Special Ambulance Fee account. The Commission approved the request. The funds went towards operations of the Authority, according to Filler.
“The extra 100,000 we just asked for, well, that went towards I don’t know how many Chris and I signed, 50, 60,000 dollars, today of bills that went out,” Filler said.
Last year, the Ambulance Authority saw a loss of $493,666.01. Filler said the 2% Special Ambulance Fee is needed to keep the Ambulance Authority afloat under its current Reduced Capability Budget, which supplies the County with a “Crew and a Half.” The Tucker County Commission said its target with the fee is to be able to supply the Authority with $400,000 to $500,000 a year to breach the gap and keep Ambulance service in Tucker County.
The Ambulance Authority has also had issues staying competitive with neighboring Ambulance providers and medical facilities. The Authority has deferred pay increases for the past two years, according to Filler and cannot afford to pay as much as other employers. This has lead to hiring issues.
Currently, the Ambulance Authority is operating on a “Crew and a Half” operation. Essentially, the Authority operates with one 24 hour crew and one 12 hour crew on peak days which are weekends, Mondays and Fridays, days that see the largest influx of visitors to the county, according to Tucker County Commissioner Mike Rosenau.
