EMS|MC made the decision to move to a per claim fee for NC Medicaid claims after the implementation of Managed Care Medicaid on July 1, 2021. Prior to July 1, average reimbursement for Rowan County EMS for a NC Medicaid transport was $106 per claim. With the implementation of managed care, the Medicaid Cost Report dollars are now reimbursed at the claim level rather than the lump sum, which in effect increased reimbursement to $656 per claim. The County had 1,399 Medicaid Transports last fiscal year.
Since EMS|MC didn't historically take our fee on Medicaid Cost Report dollars, we decided not to implement our percentage fee to the higher reimbursement amount but to change to a flat claim rate to benefit the County. The County will pay EMS/MC $11.50 per claim.
Attached is the July 1, 2021 amendment, the master agreement and the new amendment.
The Finance and Purchasing Director request that the Board of Commissioners authorize the County Manager to approve a contract amendment with EMS Management & Consultants, Inc. for billing services for $11.50 per claim.
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