Minutes August 1, 2005
CITY OF DENTON CITY COUNCIL MINUTES
August 1, 2005
After determining that a quorum was present, the City Council convened in a Special Called
Meeting on Monday, August 1, 2005 at 11:30 a.m. in the Council Work Session Room.
PRESENT: Mayor Brock; Council Members Heggins, Kamp, Montgomery, Mulroy, and
Thomson.
ABSENT: Mayor Pro Tem McNeill
1. The Council received a report, held a discussion, and gave staff direction regarding
Emergency Medical Services (EMS) Billing and outsourcing opportunities.
Laura Behrens, Administrative Assistant-Fire Department, presented information regarding the
emergency medical services billing. She reviewed the EMS billing history and the method of
billing since 1992. Billing methods included a flat method that was a single flat charge for all
ambulance services, based on total operating expenses from the prior fiscal year and did not
account for allowable adjustments. The conventional method billed on set rates, mileage and
supplies, the amounts were based on Medicare rates or rates of neighboring agencies, was used
by most agencies and full cost recovery was difficult. Umbrella billing used pre-set or defined
targets considered reasonable and customary by insurance companies, differentiated billing
between insurance companies and patient direct allowed for more cost recovery and required
intense research and application of statistical methods to be successful. The current Denton
method of billing included a flat rate plus mileage plus supplies. Denton?s EMS billing currently
had one of the highest collection rates compared to other agencies with in-house and outsourced
billing. She reviewed current EMS financial statistics dealing with operational costs,
administrative costs, and average cost of ambulance run and average cost of recovery per call.
Council discussion included:
Philosophy of sending engines out on calls with ambulances.
Consider having ambulances at each station so as not to send out engines with
EMS calls.
Only dealing with cost of recovery of ambulance costs and not with cost of
engines provided.
Number of times ambulance goes out with no services provided.
Behrens continued that all payers were billed the same and remaining balances after payment
were forwarded to secondary insurance or the patient. Staff currently worked with 10 major
insurance companies but also had 500 miscellaneous insurance companies on file. There
currently was a 3% denial rate on submitted insurance claims. After reviewing internal
procedures and surveying neighboring cities, it was determined that there were ways to improve
billing methods. Intermedics was a firm that was being considered for Denton?s EMS billing.
Using that firm?s billing methods, there would be a 22.8% impact on insurance billing, a greater
cost recovery, differentiated billing of insurance and private pay, the tracking of insurance
information through daily searches resulting in increased billing, statistical gathering, and
addressing identified needs within the department. Outsourcing would provide increased
revenue, would be more efficient with effective use of personnel, provide improved statistical
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August 1, 2005
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information, maintain compliances and provide cost savings. Items to consider included closeout
of the current system, perceived loss of personal service, longevity of the outsourcing company,
rates that would be dependent on industry standards with possible fluctuations, and collections.
Council discussion included:
If the service were outsourced, what would be the number of full-time employees
to reassign ? one full-time employee would be maintained to work EMS
billing/liaison with outsourcing firm.
Consider providing information on how savings would be realized.
Why were the co-pays waived - city residents already paid taxes so the co-pay
was waived. This was a potential issue to consider, as there might be a substantial
increase in ambulance costs.
Find out more information regarding the denial of insurance claims.
Consensus of the Council was that while there appeared to be a potential benefit to outsourcing,
more information was needed with proposals from several companies.
2. The Council received a report, held a discussion and gave staff direction regarding the
Denton Open Space Concept Plan.
Janet Fitzgerald, Director of Parks and Recreation, stated that the Denton Comprehensive Plan
envisioned an extensive system of open spaces for recreation, wildlife enhancement, and flood
control. She reviewed the amount of open space in Denton today and the definitions of parks,
open space, riparian and floodplains, Cross Timbers land, and agricultural lands.
Council Member Heggins left the meeting.
Fitzgerald continued with setting priorities. One was assessing the threat and resource values of
land in and around Denton. Threats included areas that were most likely to be developed and
potentially eliminate open space. Resources included areas that remain undeveloped and held
value as open space. Major recommendations included continue trails or trail corridors, continue
with regional park acquisition, protect and restore ecosystem habitats, and encourage scenic
corridors. Another priority was the urgent category that included environmentally sensitive land
that was under immediate threat of development. Near term priority categories were sites that
were zoned for high intensity development that should be monitored for any indication of
imminent planning applications. Near term general areas included Milam Creek Tributary, upper
reaches of Hickory Creek, Briarcliff Park area, Cross Timbers and Lake Forest Park area. Long-
term priority category included larger tracts of land that were not zoned for intensive use, but
which might be developed over longer periods of time and should be considered for
environmental overlay zones. These areas could be restored as prairie, maintained as riparian
areas, or set aside as wooded preserves in the context of the overall development. Unique or
opportunity priority areas included occasionally particularly desirable sites that would become
available for acquisition and would be of substantive interest. A summary of potential
implementation strategies included the transfer of development rights, conservation easement
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August 1, 2005
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purchase, land trust donations, fee simple purchase, open space bonds funded by property tax or
dedicated sales tax.
Council questioned why priority locations were removed from the document.
Fitzgerald indicated that there was a concern that land values would be affected if specific sites
were pointed out causing the land to be used in that manner. She continued that the
recommendation was to develop a five year action/implementation plan after the adoption of the
Open Space Concept Plan to include review of the organization to allow for the coordination of
the plan rather than hiring of additional staff, evaluate the Park Land Dedication and
development ordinance to include trail funding, and provide a red-line document prior to any
public hearing at city council meetings.
With no further business, the meeting was adjourned at 1:20 p.m.
_____________________________________
EULINE BROCK
MAYOR
CITY OF DENTON, TEXAS
_____________________________________
JENNIFER WALTERS
CITY SECRETARY
CITY OF DENTON, TEXAS