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NYS Comptroller


Audits of Local Governments and School Districts

Report Highlights

City of Norwich - Emergency Medical Services Billing (2019M-112)

Released: August 16, 2019 -- [read complete report - pdf]

Audit Objective

Determine whether City officials effectively managed emergency medical services (EMS) billing.

Key Findings

  • The EMS Department did not bill for 614 incidents resulting in $417,600 of unbilled medical services and inaccurately billed 9 incidents totaling $8,300; this equates to approximately $200,000 in lost revenue at the current rate of collection.
  • No one reconciles the billings to the medical services provided.
  • The EMS Department had 903 unserviceable incidents resulting in approximately $400,000 in unrecoverable costs.

Key Recommendations

  • Ensure that all services provided are billed appropriately in accordance with the adopted rate schedule.
  • Routinely reconcile billings to medical services provided.
  • Consider addressing whether the EMS Department should bill for unserviceable incidents.

City officials disagreed with certain aspects of our findings and recommendations, but indicated they have initiated corrective action. Appendix B includes our comments on issues raised in the City’s response letter.


The City of Norwich (City) is located in Chenango County. The Common Council (Council) is composed of six Aldermen responsible for overseeing the City’s operations and finances. The Mayor serves as the chief executive officer and is responsible for the day-to-day operations. The Director of Finance serves as the chief fiscal officer and is responsible for the City’s general financial management.

The City established an EMS Department for the purpose of providing emergency medical treatment and/or ambulance transportation for patients. The City contracts with a third-party vendor to bill patients for services provided and a third-party collection agency to collect delinquent billings. The Fire Chief is responsible for planning, coordinating and evaluating EMS operations, and establishing procedures to implement directives from the Mayor and Council.

Quick Facts
2018 Fire/EMS Department Appropriations$1.4 million
EMS Billings During Scope Period$3.8 million
EMS Collections During Scope Period$1.3 million
EMS Incidents During Scope Period4,579

Audit Period

January 1, 2017 – October 31, 2018

Local Government and School Accountability Contact Information:

Phone: (518) 474-4037; Email:
Address: Office of the State Comptroller, Division of Local Government and School Accountability
110 State Street, 12th Floor; Albany, NY 12236