By Mike Kruzman /

EMS runs and payments that go to collections will now have an additional charge tacked on to help the county offset costs.

Last month, the Livingston County Board of Commissioners approved a new collections agency, Merchants & Medical, to handle unpaid bills from Emergency Medical Services.

EMS Director David Feldpausch, in a memo to the Board, explained that Merchants & Medical had mentioned that the county can legally add an additional charge to all accounts that get sent to them for collections. At their online meeting, Monday, the Board authorized a 25% charge onto accounts going to collections, with added assurances that proper notice is given to all clients who may be charged. Livingston County EMS had traditionally absorbed those costs themselves.

In his memo, Feldpausch writes that the fee will not cover all of the county’s costs in these cases, as the collection agency fee is applied to the entire balance. He notes they will still lose a small amount on each recovery. If the account goes to legal, the county’s fee goes up to 50%, but they cannot increase what they charge the patient after it goes to collections.

Feldpausch said that while they do their best to avoid it, this charge will go a long way in reducing their costs by passing on those fees to patients who have not responded to their invoice process. He told the County General Government Committee at an earlier meeting that they never send accounts to collections in less than 90 days, always do at least 3 mailings, and it really depends on the response they get. If they are able to make contact, there are options for making payments, including no-interest monthly payments for 2 years, to help keep accounts from going to collections.

Commissioner Doug Helzerman said many people don’t realize that there is a bill that comes after ambulance rides, and that is probably at the base of the problem.

Feldpausch said in 2019 they sent 1,072 accounts to collections seeking $450,000.