XENIA — The City of Xenia is changing its EMS billing policy, introducing a “hard billing” system beginning Feb. 1.

When Xenia introduced EMS charges in the early 2000s, it was a “soft billing” policy meaning if a person who called 911 for emergency services did not pay the bill for the services, the account was not sent to collections. Eventually the city would write off the unpaid balance — which was more than $1.8 million in 2019.

But in an effort to offset rising costs and help curtail EMS abuse, Xenia contracted with a new EMS billing vendor which will maintain lists of accounts that are delinquent by 90 days or more and will send those accounts to collection.

“These billing changes make financial sense for the city and its residents while deterring abuse of our emergency medical service,” City Manager Brent Merriman said.

EMS calls have increased 5-8 percent the last several years, Merriman said. And a 30-year trend shows a 200 percent increase while the population has increased around 7 percent.

“Something is clearly amiss,” Merriman said. “It’s just totally off skew.”

In 2019, the Xenia Fire Division responded to more than 6,100 calls for fire and EMS service. Of those calls, 5,008 were for emergency medical services (EMS). That makes the division’s front line medic crews the busiest in Greene County and the trend appears to be getting worse into 2020 according to city projections.

“We had 10 residents who were responsible for 245 EMS calls in a year, which raises some red flags,” said Xenia Fire Chief Ken Riggsby. “Xenia residents shouldn’t subsidize service abusers.”

Merriman added that nursing homes and assisted-living facilities will call 911 for basic transport when they can’t secure private ambulance transportation. Merriman also cited a recent ride-along where one of the 911 calls was for a woman having trouble breathing. When medics arrived, she said she was feeling better and refused transport.

“All of our taxpayers … are subsidizing that abuse,” Merriman said.

Charges will be based on what Medicaid/Medicare deems allowable, which Merriman said most insurance companies follow as well. Patients who have private insurance, Medicare, or Medicaid will only be responsible for a copay or small portion of the total bill, according to a release from the city.

Cities are required under Ohio law to provide fire services, which are funded through taxpayer dollars. The state does not require cities to provide EMS, meaning those services are not necessarily funded by taxpayer dollars and can be billed separately.

Charges are:

— Basic Life Support (BLS) — $519.17

— Advanced Life Support 1 (ALS 1) — $830.67

— Advanced Life Support 2 (ALS 2) — $1,038.34

— Transport to a hospital — $12.98 per mile

Residents who are not able to pay the fee for emergency services have the option to fill out a “patient financial hardship form” within 45 days of the date of service. After the form is received, the account will be placed in “pending” status and a review will be done.