Fewer people received medical attention from San Diego’s ambulance provider last year but more of them skipped on the bill. More uncompensated care is bad news for the city, which has a revenue sharing partnership with the ambulance provider and could use the extra cash.

San Diego Medical Services Enterprise, LLC, provided $18.3 million in uncompensated care in the 2009 fiscal year, according to an annual report obtained by voiceofsandiego.org through the California Public Records Act. The company provided $16.7 million in uncompensated care the previous year.

The ambulance service is required by law to provide medical care, even to those who can’t pay for it. The company aggressively pursues its debtors but some people are unreachable or uncooperative, said company spokesman Michael Simonsen. The company will not pursue a debt for longer than 270 days.

San Diego’s contract with Medical Services Enterprise calls for the city to receive a portion of the revenue for ambulance service rendered within the city limits. It has similar agreements with other municipalities in the county. The number of patients receiving care dropped by 1,300 in fiscal 2009 to about 108,000.

Across the region, the ambulance provider collected $56.9 million in medical transport fees in 2008 and $60.6 million in 2009. It increased revenue with higher fees, but San Diego ended up getting a smaller piece of its pie. The city got $4.4 million in fiscal 2009, or about $277,000 less than fiscal year 2008.

It’s unclear why the city’s reimbursement decreased, but it’s possible the ambulance provider had fewer calls in the city and more calls elsewhere. It’s also possible that more people in the city avoided their bills. I put another call into Simonsen to nail down an answer, and will post again when I hear back from him.


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