At Tuesday’s meeting of the Washington County Board of Supervisors it was decided to pursue a planned independent audit of the billing department of the Washington County Ambulance. Board of Supervisor Ambulance Liaison Jack Seward Jr. presented a pair of agencies as options to conduct the audit, Page Wolfberg and Wirth of Mechanicsburg, Pennsylvania and Fitch and Associates of Platte City, Missouri. Audit procedures from both entities would include: An on-site examination of Washington County Ambulance billing practices that would take one to two days, conducted by one to two employees from the outside agency, a forensic analysis audit of claims which conforms to the Federal Offices Inspector General Program by selecting 30 random claims and analyzing their handling from start to finish, a final power point presentation made via zoom to represent their findings and online and in-person training in compliance with the National Academy of Ambulance Compliance.

Initial estimated cost for Page, Wolfberg and Wirth was $14,000 to $15,000, but their quote did not include the forensic audit, which was an additional $5,000, online or in person training cost, the depth of which would be based on audit findings. Those additional costs would increase their quote to roughly $19,000 to $20,000 plus transportation, meals or lodging. Initial estimated cost for services from Fitch and Associates was $16,500, which included everything listed except for online or in-person training afterward, transportation, meals or lodging. Supervisors Seward and Richard Young shared the importance of having this examination conducted. Seward stated, “The thought behind this is that it’s a new Ambulance Department, it doesn’t have the history that it did for 30 years prior, with new employees, new billing office, new billing systems, and after two years, maybe it’s time to go ahead and have it looked at by an outside source to say, ‘yes everything is going perfectly fine’ or ‘we have some places where we could improve things to get a better return on your money, better collections, to get something else’. The Ambulance Department and Ambulance Director operates under the license of a Medical Director, which is a Medical Doctor. He’s pretty much in charge because  it’s his license everybody is operating under, so if he says this is a thing we ought to do, then I think we ought to do it, and these are the two best choices that we have.”

Young added, “The Medical Director asked us to do this.”

The Ambulance Department operates under the license of Medical Director, Dr. David Nacos with Washington County Hospital and Clinics, who has made prior recommendations for the audit. Plans to pursue the audit had been initiated over the summer of 2022 and prior. The board chose to pursue an agreement for the work with Fitch and Associates, with final details to be presented at a future meeting.