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City Council Meeting <br />Aug. 12. 2002 <br />Page 6 <br /> <br />The city has to write that off. Councilwoman Neeley wanted to know if the <br />city is caught in the same catch twenty-two as the hospital. Mr. Klinkerman <br />said yes, the very same thing. He said that any insurance program that has to <br />do with federal or state dollars, you are locked in, they tell you what they will <br />pay. Mr. Klinkerman explained further that the citizens are paying for indigent <br />healthcare that is needed. He said that as of today the city has billed about 2.4 <br />million dollars, but when the public insurance providers are telling you will <br />have to write off a certain dollar amount, which is thousands of dollars as there <br />is a disproportionate number of over-65 year old people than the rest of the <br />state of Texas, along with the indigent people. He said this was considered a <br />long time ago with an understanding that the City of Paris and Lamar County <br />has a lot of older poorer people than other areas in the country. That is the <br />reason why the city has never had a large focus on user fees because how tough <br />does the City make it for these older people. <br /> <br />Mr. Klinkerman advised that the EMS department fights with insurance <br />companies everyday. He said, ~If someone calls an ambulance for a little old <br />lady who has passed out, and, when the ambulance gets there and she is now <br />conscious, the insurance companies do not like to pay for that type of call." <br /> <br />Mr. Klinkerman explained that normally the billing clerks have to invest eight <br />to ten hours gathering paper work such as medical records, doctor' s statements <br />of medical necessity and things of that nature just to get that type of claim <br />collected. <br /> <br />Councilwoman Neeley wanted to know if that comes under the administrative <br />cost that he was talking about earlier. Mr Klinkerman advised that the <br />administrative fees he was talking about earlier were for someone to do the <br />EMS payroll, someone to pay the bills for EMS, someone to manage th <br />personnel records, someone to do the contracts, someone to keep the EMS <br />records. <br /> <br />The cost factors are all added together, subtract the user fees from that and then <br />the split between the city and county occurs. Mr. Klinkerman stated that <br /> <br /> <br />