Watertown City Council Approves PCC Billing Contract to Boost Ambulance Revenue Collections for Fire Rescue
Northeast Radio SD News – Watertown, SD - The Watertown City Council on Tuesday unanimously authorized City Manager Alan Stager to execute a new billing services agreement with PCC Billing. This Castlewood-based company will take over all ambulance billing operations for Watertown Fire Rescue beginning October 1, 2026.
The decision follows two years of declining revenue collections under the city’s current billing provider, EMS/MC, which purchased ImageTrend Bridge Billing in 2024. According to the agenda document, EMS/MC has
“demonstrated inadequate ambulance revenue collections over the past two years,” prompting city staff to seek a more effective alternative.
Chief Rowland: Current Billing System Has Become “Inadequate”
Watertown Fire Rescue Chief Don Rowland presented the item, explaining that the department’s accounts receivable have grown due to poor collection performance.
“Unfortunately, they’ve developed an inadequacy to collect for us over the last couple years,” Rowland said. “It’s developed into more of an outstanding AR situation that we’re in right now.”
Rowland said PCC Billing has a strong regional reputation and a long track record of successful ambulance revenue collection.
“They’ve had a successful track record over the last few years… their performance is highly documented,” he said. “They have numerous clients throughout the region as well as other ambulance providers.”
Agreement Terms: 5.75% of Net Collections
Under the agreement, Watertown Fire Rescue will pay PCC Billing a base fee of 5.75% per month of net collections, according to the attached contract. The fee structure is outlined in the agenda document:
“Watertown Fire Rescue agrees to pay PCC a base Fee of 5.75% per month of net collections.”
The contract also establishes PCC Billing as the exclusive provider of ambulance billing services for the city beginning October 1, 2026, with a three‑year initial term and automatic two‑year renewals unless terminated with 90 days’ notice.
Councilman Dan Schutte asked Rowland whether other communities had seen measurable improvements after switching to PCC.
Rowland responded that both Mitchell and Rapid City Fire have reported
“a 10 to 15, even 20% increase in ROI, return on investment,” noting that those departments saw “a substantial uptick in ambulance net collections within the first year.”
Schutte inquired further on whether the higher fee would be offset by increased revenue.
Rowland offered an example:
“If we were to get another additional $150,000 in one calendar year, it would cost us an additional $8,000 based on the numbers. We’re talking 5.75% per a dollar… So we’re going to see a significant amount of revenue increase based on going with this new client.”
Councilman Doug Allen asked which other agencies rely on PCC Billing.
Rowland listed several:
· Spearfish Ambulance
· Numerous basic life support providers statewide
· Providers in Iowa, Nebraska, and Minnesota
He estimated PCC serves “20 to 30, 40” South Dakota ambulance providers.
Allen also asked about EMS/MC’s client base. Rowland said the company is large but struggles with customer service.
“If you call EMSMC… they might be on the phone for 15 minutes to an hour and might not even talk to a live person,” Rowland said. “Whereas these folks… they’re going to get a live agent within seconds.”
City Manager Alan Stager added his own concerns about the city’s current billing outcomes.
“I’ve always been perplexed by the amount of ambulance write‑offs that we have month to month,” Stager said. “It really is symptomatic of a billing process that has been broken.”
Stager emphasized that PCC Billing focuses on billing—not collections—and follows the “prescriptive methods of creating an appropriate bill,” which he said is essential for navigating Medicare, Medicaid, and private insurance requirements.
He also noted that Travis Smith, president of PCC Billing, was present in the council chambers.
Mayor Ried Holien called for a motion to authorize the agreement.
The motion was made by Councilman Schutte and seconded by Councilman Kyle Peters.
With no opposition, Holien declared: “Motion carries.”
PCC Billing will begin managing all ambulance billing operations for Watertown Fire Rescue on October 1, 2026, with the city expecting improved collection rates, reduced write‑offs, and better customer service for residents who receive ambulance transport.
