If you're unwise enough to attempt to scale Mount Washington and Pittsburgh paramedics have to come to your rescue, there's a fee for that.
And if you require a cervical collar and an ambulance trip to a hospital, the city charges a fee for that, too.
Pittsburgh City Council introduced legislation Tuesday to hike a number of emergency medical fees, raising the basic life support fee 40 percent, from $500 to $700. Fees for extrication would be increased to $750 from $700, as would fees for cervical collars, which would go to $40, from the current $35.
But if and how the fee hikes will impact patients is still not clear. It will likely depend on a number of factors, including whether that patient is a city resident and if insurance companies decide to pass on the fee increase to their subscribers. It's also unclear how much extra revenue the city will raise from the increase, because insurance companies might not pay the full amount.
Mark Bocian, acting chief of Emergency Medical Services, said the fees remained static since 2004 and felt the hike was long overdue. He said surrounding communities have raised their fees and he said it would be fair to make the city's rates comparable.
"We were way behind [what other] communities charge the insurance companies," he said.
Michael Weinstein, a spokesman for Highmark, declined to comment on Tuesday's bill, but said, "In general, we generally have concerns about any action that would result in much higher health care costs for our subscribers."
Complicating matters, the city's emergency medical services is not an "in-network" provider for any insurance company. Health care providers that are in-network have accords with insurance companies to be reimbursed a specific amount for procedures. But absent those agreements, things are less certain -- and often more costly.
Instead, the city bills individual patients when they're treated by paramedics, and patients in turn file claims with their insurance companies. The companies then send checks to the patients, who are supposed to turn them over to the city. Chief Bocian said insurance companies don't always pick up the full tab, depending on the plan that covers the patient.
For city residents, this isn't a problem. But nonresidents are expected to pay whatever portion of the bill isn't covered by insurance, so the fee hike could hit them especially hard. Similarly, for uninsured patients, city residents pay nothing. But uninsured nonresidents have to cough up the full amount.
Councilwoman Theresa Kail-Smith, chair of the public safety committee, said she needed to have several questions answered before she backed the bill.
"If it's just to add money to the general fund and just to make more money, then I don't know if we need that," she said. But "if it's to sustain the work of EMS," she said she'd support it.
Moriah Balingit: email@example.com, 412-263-2533 or on Twitter @MoriahBee. First Published June 25, 2013 2:15 PM