Farmington weighs ambulance service provider options

FARMINGTON — Last November, Mary Power suffered a stroke at her home in Farmington.

Her husband was home at the time and called for an ambulance.

Power had a hospital stay that lasted 12 days. As unwelcome as that experience was, the news she received after that didn’t help.

“The ambulance came, and I’m on the east side of Farmington — the only part of Farmington that’s east of Orchard Lake Road,” Power said. “They took me to Botsford, Beaumont; whatever it’s called now — Corewell. … It’s less than 3 miles from my house. And then when I got out of the hospital, I got a bill for $3,077 for the ambulance ride, so that didn’t please me much.”

Power is insured through Blue Cross Blue Shield of Michigan and was informed by a representative that Blue Cross would pay $438 toward the cost of the bill.

She learned that BCBSM and Superior Ambulance Service, which is the company that provided her ambulance ride, are no longer affiliated, hence the reason for the large bill.

“The dispute, I guess, is they wanted to raise their rates because they said they had been spending so much on gas … and Blue Cross wouldn’t agree, so they just dropped them as an insurer they’ll work with. That’s what the ambulance company told me,” Power said.

Superior Ambulance Services did not respond to requests for comment by press time. However, BCBSM issued a statement via email.

“Superior Ambulance recently left our network for providing ground transportation between medical facilities,” the statement reads. “Because they are out of network, they can balance bill our members. Other ambulance companies are in our network and accept our payment minus normal copays and deductibles. We’re reaching out to hospitals and their discharge planners to inform them of the situation so they can best advise patients to utilize a participating ambulance company to avoid balance billing. We are also encouraging hospitals to provide choices to their patients, as there are multiple companies that provide this type of service.”

Bob Houhanisin is the director of public safety for Farmington. He said that Farmington supplies police, fire and basic EMS services to residents, and he described how the process works if there is a medical emergency in the city.

“Our police officers are trained to a minimum of a medical first responder,” Houhanisin said. “If we need advanced life support, we need to contact a third-party provider. Two years ago that was Community EMS. About 18 months ago, two years ago, they were acquired by Superior EMS.”

Houhanisin expanded on his explanation.

“When … someone calls 911, we contract with (the) Farmington Hills Police Department to provide our dispatch coverage; so they would receive the 911 call, and then they would dispatch our police officers to respond and they would dispatch Superior EMS to respond. And then we would provide first response care to the patient until the ambulance arrived, and then the ambulance would take over and transport the patient to whatever hospital is appropriate,” Houhanisin said.

Superior’s local base is in Southfield, although emergency personnel can respond from various locations in the area.

Houhanisin is aware of the large bill that Power received.

“That’s outside of our hands, because it’s a service that’s provided by Superior. Therefore, we don’t have a whole lot of control over billing,” Houhanisin said.

Houhanisin said that Farmington has an “agreement” with Superior, but not a contract.

“For the last how many years prior to my even starting here, we used Community EMS,” Houhanisin said. “They were based out of Southfield (and) provided advanced life support services to a few other communities as a nonprofit, and then they were acquired by Superior. We continued the same agreement with Superior because they’re right down the road, and we have a good business model with them right now.”

Houhanisin was asked if Superior is the only option Farmington residents have.

“That’s who we have an agreement with — it’s not the sole provider,” he said. “We have a mutual aid agreement with (the) Farmington Hills Fire Department, so if we get on-scene and there’s something like the ambulance for Superior’s gonna be delayed or if it’s coming from far away, we have a mutual aid agreement with (the) Farmington Hills Fire Department, and they will respond and provide advanced life support and transportation for us.”

In regard to what emergency responders Farmington residents are most likely to see, Houhanisin said, “It’s overwhelmingly Superior.”

“We don’t have to call Farmington Hills very often,” he said.

Houhanisin discussed whether or not Farmington pays Superior for providing ambulance services in the city.

“Right now, we do not pay Superior for their services; we just have an agreement that says when we have an EMS call within the city of Farmington, we contact Superior and they respond as our partner,” he said.

In regard to the possibility of Farmington Hills becoming the primary emergency services provider in Farmington, Houhanisin said that the city is looking at all options and that nothing is off the table.

“We’re trying to determine what the best service is for the residents of Farmington, based on service and cost and overall product provided,” he said. “I’m in the process now of working with Superior to make sure that we are providing the best service to the residents of Farmington, and I don’t wanna speak before I have all my ducks in a row, for lack of better term, and have all the correct information on what that service is until I get a report to the City Council. … It’ll be a group conversation. Then we will do a presentation to our City Council, and then a decision will be made collectively. It’s my intention to give City Council all the information so they can answer any questions, and I can answer any questions they have of me.”

Farmington City Manager Dave Murphy said that the city doesn’t want to “overburden the Hills.”

“That would be a rather large expense, I think, to (the) city,” Murphy said. “It’s something we’d have to look into, but they’re not going to provide the service for free — although Superior is.”

According to Houhanisin, there is no time frame as to when a decision about a primary ambulance service provider may be made.

Farmington Hills Fire Chief Jon Unruh stated that, on average, his department transports 5,000 patients to local hospitals annually.

“We do charge the patient’s insurance company for transport fees,” Unruh stated via email. “The fees are under the suggested ranges based on (the) State of Michigan, Federal and Local insurance carrier fee schedules. The amount that insurance companies pay is based on each individual’s policy coverage that they are provided. The average transport fee ranges between $400 and $1,000 based on the level of care that is required.”

From Murphy’s perspective, residents aren’t too concerned about what ambulance service provider responds when there is an emergency.

“When a loved one goes down, I don’t think you’re worried about too much who’s gonna cover it, if it’s this ambulance service or that ambulance service— you just want public safety, and you want somebody to respond,” he said. “The ambulance service is the ambulance service in that area. It’s not like you can go to Burger King or Wendy’s or McDonald’s — it’s just the one. If I were a resident and that happened to me or I was worried about it, I would maybe call over to Superior or to Blue Cross and say, ‘OK, if my wife or my husband, my father, my mother, whatever, is in need of an ambulance, is everything covered or can you give me a breakdown as to what is or what isn’t?’”

When there is an emergency, there is a good chance that residents will see Farmington Public Safety personnel prior to an ambulance arriving.

“All of our officers are cross-trained in police, fire and EMS services,” Houhanisin said. “So we carry AEDs, we carry medical care, we carry oxygen; we can help mitigate the scene prior to the ambulance getting there, because our response time is roughly two minutes— less than two minutes, to any EMS call within the city. So if it’s a CPR run, if it’s a choking run, if it’s something that we can really make a difference on, then we send our officers on every call to help triage and mitigate. … The Farmington Public Safety Department is committed to providing the best service to its residents.”

Power said that it was “pretty terrifying” to get the bill for her ambulance ride.

“I haven’t heard from the ambulance company since December,” she said. “I wrote them a letter. … I don’t know what’s gonna happen. I haven’t paid ’em anything.”