Over 15K Winnipeg ambulance bills from last year remain unpaid: report

A city report found about 43 per cent of ambulance bills issued last year by the City of Winnipeg are still unpaid.

The report was commissioned by council in January. It called on the city’s public service to find the average number of unpaid ambulance bills per quarter, reasons why the bills are unpaid, and ways to improve communication on billing to increase the number of fees collected by the city.

The city provides ambulance services on behalf of Shared Health. Once a person is transported by ambulance, the city invoices customers for a share of the cost of ambulance services.

The report found as of March, there were 15,927 unpaid invoices from 2022, with the majority issued in the fourth quarter of that year.

“The reasons for invoices remaining unpaid are difficult to ascertain without communication from customers whose invoices remain outstanding,” the report says.

“However, given the financial and health circumstances of many of our customers, it is likely that a lack of available income will be the cause.”

Rita Paynter is one of those people as she needed an ambulance ride in the winter.

"I got sick. I'm on lots of medication for pain control, mental health and for cancer. I also have osteoarthritis in my hips," said Paynter.

She said she is having trouble getting a $250 bill for the ambulance paid because of a delay involving two government agencies. She says she can't afford to pay out of pocket.

"People who have disabilities and people that are Aboriginal with no advocate have a hard time getting things done."

The Winnipeg Fire Paramedic Service (WFPS) believes a factor in the number of unpaid bills is that many people are living below the poverty line – some with significant health issues – and don't have the means.

"Unpaid bills do have an impact on the bottom line and the ability to deliver the service," said WFPS Chief Christian Schmidt.

"Nobody budgets for this type of expense. There's a lot of expenses that people have to manage."

Staff also explored how to better communicate fees to ambulance users.

The report said email could be used instead of Canada Post. However, it notes this would require paramedics to obtain the patient’s email address, and there are concerns this won’t be viable or reliable, as some don’t have access to email and invoices could end up in junk mail folders.

Currently, initial invoices are always provided on paper.

The report also says the cost of switching to registered mail would likely not be supported by Shared Health ‘given the financial pressures faced in funding the service generally’.

The report notes if all initial invoices were sent by registered mail in 2022, it would have cost an additional $328,190 compared to the regular cost of $35,890.

According to the city, ambulance transport costs decreased by more than 50 per cent a few years ago after a government initiative to reduce fees in Manitoba. That meant a switch from $529 to $250 for ambulance transports.

However, the report notes this incentive doesn’t allow fees to be nixed because of financial hardship.

The WFPS did note that over time, more than 70 per cent of all bills are eventually paid.