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Commissioner Wheeler felt what Commissioner Scurlock said about subsidizing the uninsured is correct, but he also felt that by not redoing our billing, we are in actuality subsiding the insurance companies because they set a fee and pay schedules based on averages. Therefore, by other counties taking advantage of this and us not taking advantage of it, we are, in effect, subsidizing the insurance company. Commissioner Wheeler felt it is very important that we redo our billing operation. Commissioner Scurlock stressed the point is that when we took on ALS, the budget was 1.3 million, and you are looking at about 1/4 of a mill in ad valorem taxes. Administrator Chandler further clarified that at'budgettime, the overall expense for ALS was 1.9, and we are anticipating generating $560,000 in revenue. That differential is what we are looking at in General Fund revenues. He felt another point that needs to be brought out is that better than 600 of the runs we have are for people who are insured under Medicare, and the federal government will only pick up "X" percent of that amount. Director Wright confirmed that 2/3, or 660, of our runs are related to Medicare. Commissioner Scurlock asked how much we are doing in billing the supplemental insurance companies. He noted that the hospitals are extremely effective in pursuing that option. Director Wright pointed out that a subsidiary of the hospital does their billing, and it is those same experts that are doing the billing for us, but Chairman Eggert wondered if they have the same motivation. Administrator Chandler informed the Board that his informa- tion is that if the patient has supplemental insurance, we pick up an extra $30-40 above the $140. Chairman Eggert commented that she asked right in the beginning if we would be better off having an in-house person 1 -- doing these claims rather than going to a company like' this. This is being evaluated as we go along, and so far it seems to be ,JAS! 21 „ Boor. f F..0U@