TAMPA — The city missed out on an estimated $270,000 in revenue in ambulance fees two years ago because of a previously undiscovered billing problem, according to an internal audit, so now officials have made some changes.
In 2012, Tampa Fire Rescue ambulances took nearly 17,350 patients to the hospital, but only about 16,400 of them received bills.
That's because the vendor that handles billing and collections for the city, Advanced Data Process Intermedix, has no record of 943 of those runs. Tampa officials use a secure data link to send patient transport records to ADPI for billing.
"We feel confident that (the records) left this building and that they were sent down south" to ADPI, based in Fort Lauderdale, Tampa Fire Rescue Assistant Chief Nick LoCicero said. "We're trying to make sure that certainly doesn't happen again."
But ADPI maintains that it "has not received the transport records in question," company spokeswoman Lisa Jardim said in an email to the Tampa Bay Times.
Tampa's average EMS bill is $651, which comes from a base charge of $600 per call, plus $10 per mile.
After paying ADPI about $248,000, the city cleared about $3.6 million in ambulance fees. But based on historical collection rates — Tampa's was 44 percent in 2012 — the city might have collected $270,000 more from the calls that ADPI has no record of, auditors said.
The missing money is a fraction of Tampa Fire Rescue's overall budget, which is $72 million this year.
Still, as a result of the discovery, city officials have put in a new method of verifying that Tampa's data arrives at ADPI, which has handled ambulance billing for the city since at least 2006.
"Quite a bit of discussion has gone on" in the wake of the audit, city chief financial officer Sonya Little said.
The audit also found that:
• Fire rescue staffers don't take every precaution they could to protect patient information; nor does Tampa Fire Rescue policy specifically address how to discard patient records.
• When auditors went to eight fire stations to check on 23 medical supplies — ranging from oxygen masks for infants to saline solution to drugs for treating high blood pressure — all eight were short one to four items, and seven of eight had one to three expired items.
• Recordkeeping for controlled medications, including morphine, Valium, Lorazepam and ketamine, was sometimes incomplete or varied from established procedure. Auditors did not find that any of the drugs were missing. "We didn't identify any shortages," internal audit director Christine Glover said. Rather, fire rescue staff sometimes didn't sign the log book when one shift went off-duty and the next came on or discarded medicines without proper documentation.
• Tampa Fire Rescue's system for monitoring response times is so "inefficient and time consuming" that the department should consider working with city computer programmers to automate the process.
The city's goal is to have its first units on the scene within eight minutes of the call 90 percent of the time. In 2013, fire rescue crews met that standard 88.5 percent of the time, LoCicero said. Among the factors that affect that response are an increasing volume of calls, road construction and traffic congestion.
"Sometimes the time of day does have an impact," he said.
In addition to creating a verification process with ADPI that allows the city to make an independent check, fire officials have responded to the audit by going over its findings with the entire department during in-service training. More follow-up is planned, for example, on handling protected health information.
"There's always room for improvement, and we don't shy away from looking critically at what we do," LoCicero said. "We're trying to make sure the education is out there, (that) they understand the consequences and how we should handle ourselves."
Contact Richard Danielson at firstname.lastname@example.org or (813) 226-3403. Follow @Danielson_Times.