RALEIGH, N.C. — Negotiations are under way between Wake County and the state's largest private insurance company about a dispute involving ambulance service and how much the insurance company will pay.

Blue Cross Blue Shield of North Carolina used to fully cover 911 ambulance service, but changed its rate structure within the past year. The insurance giant says it notified Wake County about the change in January 2005. Wake County, however, says it was never adequately notified about the change.

For each ambulance ride, Wake County is now collecting just a percentage from the insurance company, leaving a $260,000 shortfall among the county's eight emergency squads.

Chris Creech, the chief of Garner EMS & Rescue, says what Blue Cross doesn't pay will now have to be paid for by either patients or the county.

"What it would mean, and most likely would mean, is that it would require more of our tax dollars to support the 911 system countywide," Creech said.

Blue Cross spokeswoman Laurie Clowers says the company is trying to work out the dispute with the county and later this week will present to the county a counterproposal.

Clowers, however, would not specify the details of the proposal, citing ongoing contract negotiations.

"As with any disagreement over reimbursements, we are going to meet with them," Clowers said.