Climbing fuel prices are driving up the costs of providing ambulance services, but two companies in the Syracuse area are finding different ways to deal with the increase.

TLC Medical Transportation Services Inc. and TLC Emergency Medical Services Inc. announced this week that they have increased rates for basic and advanced life support ambulance services for private pay customers, the result of skyrocketing diesel fuel costs that hovered around $4.25 a gallon last week, according to gasbuddy.com.

“It isn’t something we wanted to do,” said TLC President David J. Butler. “But we must earn a living and meet our cost of doing business, so we had no choice but to raise rates.”

TLC Director of Operations Lon Fricano said the base rate for advanced life support ambulance services through TLC is now $835, up from $715. The cost of basic life support in a TLC ambulance is now $525, previously $495, he said, and the per-mile cost has gone up a quarter to $12.25 from $12.

Those rates will be felt by the uninsured paying out-of-pocket for medical care, and those with heath insurance that might not cover ambulance service. Medicare and Medicaid clients who use TLC services will not experience raised rates, because the cost to those customers is controlled by the federal and state governments.

“No one should be denied an ambulance,” Fricano said. “You’ve got to treat people whether they can pay or not, and we’re happy to do that. Everybody gets treated the same.”

Michael Addario, division general manager for Rural/Metro Medical Services, said because most reimbursement rates are fixed, raising the rates wouldn’t necessarily mean a higher income.

Rural/Metro has experienced rising costs, too, Addario said, but has tried to find ways to deal with them without passing the costs onto patients.

While they’re finding different ways to streamline business, both Addario and Fricano pointed out that ambulance providers are not compensated by Medicare and Medicaid for the full amount it costs to care for those patients.

For example, Addario said that Medicare pays a flat rate of $395.67 for emergency ambulance services.

“This is all an ambulance service will get regardless of retail pricing,” Addario said. And Medicare will only pay 80 percent of that amount, while the remaining 20 percent is supposed to be paid by the customer.

“They’re going to reimburse what they’re going to reimburse,” Addario said. Sometimes patients will have a secondary insurance to pick up the remainder that Medicare or Medicaid doesn’t cover, he added — but sometimes they don’t.

Fricano said on average TLC does not get paid for about 40 percent of the services it bills for.

Dealing with deficiencies

Charging patients more money for services won’t increase those reimbursements, so to deal with increased costs Rural/Metro has switched from paper to electronic filing systems and tried to make its fleet more fuel efficient.

Diesel prices are a big factor in rising costs for ambulance service providers.

Maintaining an optimal temperature within the cabin of an ambulance requires the vehicles to almost constantly consume fuel, magnifying the impact of rising fuel costs.

But on top of gas prices, government-mandated but expensive upgrades to ambulance fleets and strict regulations dictate how ambulance providers are able to absorb price changes, Fricano said.

Those factors lead to a cost-shift phenomenon that drives up prices for private-pay customers in some situations.

Addario pointed out that petroleum-based products, which include many medical supplies, have also increased in price.

Stellar service comes standard

Addario said that in spite of the higher costs of providing ambulance services, the quality of care patients receive would not be impacted.

Both Rural/Metro and TLC received awards earlier this month for the quality of service they provide to the area.

Rural/Metro EMT-Paramedic and assistant supervisor Nicolas Corbishley was recognized as an outstanding employee by the statewide United New York Ambulance Network.

Three TLC medics, Ed Binns, Mike Keegan and Jay Symonds, also received UNYAN Outstanding Employee awards. TLC CEO David Butler received the UNYAN Ron Kintz Award of EMS Excellence.