Ambulances from private ambulance companies Rural Metro and Falck line up in front of the ambulance bay at Providence Regional Medical Center Everett in 2015. The two companies, along with American Medical Response and Northwest Ambulance, are the four private companies that operate in Snohomish County. Everett Fire is increasing its own rates to more closely match the prices charged by other area fire districts.
Doug Ramsay
EVERETT — Getting a ride in an Everett Fire ambulance will now cost more.
The City Council just approved a set of rate increases to help Everett Fire match what other fire agencies in the region charge.
For Everett, a basic EFD ambulance ride will be $680, up from $488. An ambulance ride providing first-level advanced life support services will cost $890, up from $694; second-level advanced care will cost $980, up from $800. Second-level advanced care is for serious medical needs, such as needing defibrillation or chest compressions during the ride.
The per-mileage rate will be $18.50.
So, imagining someone has a heart attack at the Everett Mall, their advanced care ambulance ride to Providence hospital might create a $1,128 bill.
Health insurers pay toward medical transportation within the guidelines of your policy.
Generally, “the insurer pays the allowed amount and it’s applied to deductibles,” said Stephanie Marquis, a spokeswoman for the state’s Office of the Insurance Commissioner.
Medicaid and Medicare, for example, have caps on medical transportation payments that do not always cover the whole bill.
When that happens, the city doesn’t pursue residents to collect the remaining debt on the bill, city chief of staff Lyle Ryan said. (The collection practice is also known as “balance billing” or “surprise billing,” where the insurance company covers less than the whole bill and passes the rest on to the consumer. Usually, it’s because the bill is from an out-of-network provider.)
Medical transportation doesn’t fall under the state’s new law against “surprise billing,” Marquis said. She said the Legislature may look again on this issue. Federal legislators, meanwhile, are considering regulations to cap ambulance-by-air charges.
Everett Fire last modified its transportation rates in 2017.
The department’s Assistant Chief of Administration, Rich Llewellyn, said he doesn’t think rate increases will factor into whether someone calls 911 when they need an ambulance.
“The EFD has raised its rates in the past (as recently as January of 2017) and experienced no noticeable decrease in ambulance transports,” Llewellyn said by email.
The increases mean Everett Fire’s rates are now priced comparably. In Snohomish County, fire agencies charge an average of $677.28 for basic-life support transportation (BLS), $985 for first-level advanced life support (ALS) and almost $1,080 for second-level advanced life support, from figures provided by the department. The average per-mile charge is $18.48.
The department’s emergency medical services personnel respond to an average of 16,000 to 20,000 calls annually, from its records and past city documents.
In 2019, it responded to 19,973 EMS dispatches in total: 7,888 were ALS dispatches and 12,085 were BLS dispatches, from figures provided by the department.
The fire department contracts with Northwest Ambulance to transport some low-need patients.
The private ambulance company’s contracted rate is $895 for a basic ambulance ride arranged by Everett Fire. Everett Fire arranged about 400 of these rides during last year, from figures provided by the department.
Northwest Ambulance charges $2,105 in the rare event it takes you on an advanced life support (ALS) ride that needs a nurse on-board. “NW Ambulance’s ALS service within the City is limited to interfacility transports, such as from Providence to Harborview,” Llewellyn said.
The company’s per-mile rate is $19 under the Everett contract.
Everett Fire arranged the contract to ensure a backup company is dedicated to carrying local patients. It’s a sole-provider contract where Everett patients are prioritized. Before, Everett Fire called its list of ambulance companies trying to match one with a patient.
Northwest Ambulance pays the city about $39,600 annually to administer the contract and receive dispatches.
The department’s EMS system operates on an $11 million budget. Medical transportation represents about $1.5 million in service fee revenue annually, according to the city budget.
