Litchfield Switches Ambulance Billing After Residents Wrongly Sent to Collections

Litchfield City Council Meeting | July 16, 2026

Article Summary: The Litchfield City Council approved a professional services agreement with Paramedic Billing Services, Inc. to take over fire department ambulance billing at 4.0% of collections, after the current provider’s service declined and residents were referred to collections despite having paid.

Ambulance Billing Key Points:

• Paramedic Billing Services, Inc. (PBS) of Elmhurst will bill for the Litchfield Fire Department at a fee of 4.0% of collections, comparable to industry standards per the packet.
• Under the outgoing provider, payments made directly to the city were not timely applied, resulting in residents being referred to collections despite having already paid.
• The agreement runs three years, automatically renewing in one-year terms, with 90-day termination without cause.
• All ambulance revenue continues to be deposited into a city-controlled account, with no added city personnel or capital costs.

LITCHFIELD — The Litchfield City Council on Thursday, July 16, 2026, unanimously approved a resolution authorizing a professional services agreement with Paramedic Billing Services, Inc. to provide ambulance billing for the Litchfield Fire Department, ending an arrangement that city documents say produced a year of billing problems for residents.

Alderperson Marilyn Sisson made the motion, seconded by Alderperson Sara Zumwalt. There was no discussion before the roll call vote.

According to a background memo in the agenda packet, the city contracted with Andre’s Medical Billing in 2019 for ambulance billing. In 2024, Andre’s was acquired by EMS-MC, which assumed the existing agreement. The transition was initially seamless because the city kept its longtime account representative, the memo states, but approximately one year ago the city was assigned a new representative, and since then the fire department has experienced “a noticeable decline in customer service, communication, and overall account management.”

The memo details the consequences: payments made directly to the city that were not timely applied to patient accounts, “resulting in residents being referred to collections despite having already made payment,” and a significant increase in ambulance accounts billed directly to patients before all available insurance information had been identified and verified. Department personnel spent considerable time helping residents resolve billing issues, the memo states, adding that because ambulance billing is often a citizen’s final interaction with the fire department after a medical emergency, its quality “directly reflect[s] on the City of Litchfield.”

In response, the fire chief evaluated multiple ambulance billing providers — reviewing proposals, contract terms and service capabilities and contacting Illinois fire chiefs using the proposed vendors for references. PBS was identified as best suited to the city’s expectations, the memo states, citing its multi-layer insurance verification and demographic validation process, including electronic eligibility tools and pre-billing reviews to identify coverage before a patient is billed, along with dedicated account management, customized financial reporting and recorded customer service calls.

Under the agreement, the city pays PBS 4.0% of all payments collected, which the packet describes as comparable to current industry standards. All revenue remains in a city-designated, city-named account, with monthly accountings due by the 15th. The initial term is three years, automatically renewing for one-year terms, and any party may terminate without cause on 90 days’ written notice. The agreement includes a HIPAA business associate agreement and a $100 fee per court appearance by a PBS employee in collection actions. The city administrator, fire chief and finance consultant recommended approval.