HAWLEY - Hawley Ambulance & Rescue Company is looking to upgrade its level of licensed service, from Basic Life Support (BLS) to Intermediate, a step below full Advanced Life Support (ALS). Company Chief Bryan Utegg explained that this may not occur for a couple years; the law permitting it was passed this year but the state is working out the licensing requirements.
    He said that they already have a couple certified paramedics within the company, including himself.   
    The Intermediate stage would permit administration of intravenous and drugs to the patient on the way to the hospital.
    Utegg said they wish to avoid the potential "ALS wars" that have occurred elsewhere, with the growth of competition among ALS providers.
    At the Hawley Council meeting, June 11, Council agreed at the request of Hawley Ambulance, to change designation of primary ALS response from Pike County ALS to "Nearest Available." Council will issue a letter to the ambulance company to forward to the Wayne County Communications Center.
   This designation will serve to direct the "Com Center"in an emergency, to automatically dispatch the closest available ALS agency to assist Hawley Ambulance when a patient being transported requires ALS care.
    Pike County ALS no longer has a billing agreement with Hawley. Without a billing agreement, a patient using Medicare or Medicaid gets a bill direct from Pike County ALS for the paramedic service provided. If  Pike had a billing agreement, then Pike would send a bill through Hawley Ambulance.
   All other, private insurance companies allow ALS to bill the insurance company but Medicare/Medicaid won't pay ALS, Utegg explained. Medicare/Medicaid will only pay the BLS company that does the transport, in this case, Hawley Ambulance.
   Utegg said that their basic BLS fee is $350. Medicare will pay Hawley Ambulance about $180. Hawley Ambulance could in turn ask the patient to pay the rest, but does not. "We write it off," Utegg said.
    Just using an example, with a billing agreement with the ALS company, the bill sent to Medicare might be $700 for both the BLS and ALS services given. Medicare may pay $500; Hawley then splits the difference and would pay $250 to the ALS.
   Without a billing agreement, the ALS company is free to send a bill to the patient that is considerably more, to cover expenses.  The patient on Medicare gets the bill since Medicare won't take the bill from the ALS service. If it were a private insurance company, the ALS could bill the insurance company.
    The problem for the patient is that many of those on Medicare- age 65 and over- cannot afford the big bills, Utegg stressed. Some of them may need to go the hospital once or twice a month, he said. If the ALS bill is over a thousand, the price to go to the hospital quickly becomes sky-high for them.
    A recent example, he said, was a woman in Hawley who had fallen to the floor and was there 10 hours before being found. When she was rescued, she asked that an ambulance not be called because she could not afford it. "That should never happen," Utegg remarked.
   Hawley Ambulance does have billing agreements in place with Wayne Ambulance, Pennsylvania Ambulance and Atlantic Ambulance.
   Utegg stated that Wayne Ambulance is planning to designate an ALS unit in this area committed to Hawley Borough, Palmyra Township (Wayne) and Lackawaxen Township. Once that is in place, Utegg said Hawley Ambulance will ask Borough Council to change primary designation to Wayne Ambulance for ALS.
     In that case Wayne would be dispatched to a Hawley call first. but if not available, the closest ALS company that can respond would be sent. That could still include Pike County ALS.
     Kyle Wright, Director of Pike ALS, told The News Eagle that they have a "compassionate billing policy" which allows patients who meet certain income guidelines or lack insurance, to eliminate or reduce their bill.
   He said that the ALS bill could range from $100 to over $1,000, depending on the treatment given and if the patient is transported.
       Pennsylvania Ambulance is a company based in Dunmore that is the former owner of Wayne Ambulance, Utegg said.  Pennsylvania Ambulance also wants to serve in the region.
   Atlantic Ambulance has a unit based in Lords Valley but no longer has one stationed in the Wallenpaupack area, Utegg noted.