As of Jan. 1, the Mathews Volunteer Rescue Squad will start billing patients for the cost of rescue calls not covered by insurance payments.

“We don’t want to do it; we’ve been fighting it for years,” said Neal Hudgins, chairman of the squad’s board of directors. “But we’ve got to do something.”

Hudgins said that the organization lost $100,000 during the past fiscal year after all expenses had been paid, and it can’t continue operating at a loss.

Although Mathews is a volunteer squad, the organization began insurance-only billing a number of years ago to help cover the cost of having a paid crew on duty during the day. If the insurance didn’t pay the entire bill, no one pursued the patient for the balance. But that will change now, said Hudgins, because insurance companies are no longer paying a substantial portion of the cost of a rescue call.

The typical basic life support call costs $400, Hudgins said, while advanced li...