EMT Ambulance...................In it for life!  

Understanding the Patient Billing Process
 

EMT’s Billing and Payment Policy:

About a week after receiving care from EMT, a patient will receive a billing statement for services provided. The bill will provide an itemization of the services provided and the fees charged. Payment of the account is required within 30 days of receipt of the bill.

Most private insurance purchased individually or through an employer group plan and government medical coverage such as Medicare and Medicaid will cover medically necessary emergency and non-emergency ambulance transportation. As a courtesy to our patients, EMT will submit a claim to our patients’ insurance.  If a patient has coverage, it is important to provide all of the coverage information to the paramedic or EMT at the time of service or to the Patient Business Services offices as soon as possible after receiving services.

If a patient does not have insurance coverage of any kind, the bill for EMT services will be due directly from the patient. Payment is due immediately upon receipt of the bill. EMT will accept a patient’s personal check, Visa or MasterCard.  A patient also may make payment arrangements by phone by contacting EMT’s Patient Business Services at 1-888-689-6446, or by email at: Billing@emtambulance.com
 

Answers to your Patient Billing Questions

Why Do we require your Signature prior to non-critical Treatment?

All patients are required to provide signatures that acknowledge consent to treatment and transportation, provide authorization to submit a bill on your behalf, assign your benefits to EMT allowing your insurance to pay us directly, and acknowledge receipt of EMT’s HIPAA Privacy Policy. HIPAA is a set of federal guidelines which all healthcare providers must follow.  HIPAA requires all medical providers to gather the signature acknowledging we provided you with a copy of your rights under the HIPAA PRIOR to providing services unless a immediate life threat is present. Also EMT will not be able to submit a claim to your medical insurance carrier without a signed authorization from the patient or guardian. Failure to provide a signed authorization will also require EMT to seek payment directly from the patient or guarantor.

How are Privately Provided Emergency Service Different?

Unlike certain other public services that are supported by tax revenue, private ambulance services are generally only funded by user fees. Tax payers fund public services such as fire and police protection whether they use those services or not. Private ambulance services are typically not subsidized by tax revenue and rely solely on user fees when patients use ambulance transportation services. Under a private ambulance service system, you only pay for those services when you use them.  This is generally a more efficient system.

In several jurisdictions the local government has contracted with EMT to provide emergency paramedic and ambulance transportation service for their community. When you call 9-1-1 for a medical emergency in one of these communities, EMT will respond to your call for help.

Does My Insurance Cover Non-Emergency Services?

EMT provides comprehensive non-emergency transportation services to patients who need to be safely transported from one location to another. Insurance plans may cover medically necessary non-emergency transports, but your insurance carrier will determine whether or not ambulance transportation is justified as "medically necessary" according to their own specific criteria. It is important to check with your insurance provider to understand and comply with all requirements for authorization and qualification for non-emergency transportation.  Sometimes your call to them with supporting information may help encourage them to pay the bill on your behalf. 

What Does Medicare Cover?

In general, Medicare will cover medically necessary ambulance transportation to the nearest appropriate medical facility.  Most Emergency ambulance transportation generally will qualify for Medicare coverage if the transport is a result of a sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity such that the absence of immediate medical attention could reasonably be expected to result in placing the patient’s health in serious jeopardy, impairment to bodily function, or serious dysfunction to any bodily organ or part. Medicare requires that ambulance transportation be medically necessary and reasonable. To be medically necessary, Medicare requires that the use of any other method of transportation could be hazardous to the patient’s health, whether or not any other methods of transportation are available. To be reasonable, for example, Medicare requires the patient to be transported to the nearest appropriate facility for treatment.

Non-Emergency Ambulance Transportation:

Certain medically necessary non-emergency ambulance transports are covered by Medicare, but wheelchair services are not covered a benefit under the Medicare program.  Some non-emergency ambulance transports may require a certification of the medical necessity signed by your physician. Medicare will not pay for ambulance transportation to a particular hospital or facility that is not the nearest appropriate facility, or for the convenience of the patient, the family or physician. In general, Medicare will not pay for non-emergency ambulance service unless the patient is unable to get out of bed without assistance, and unable to walk, and unable to sit in a chair or wheelchair, and/or that transportation by any other means would pose a hazard to the patient’s health.

For both emergency and non-emergency transportation service, Medicare will pay 80% of the allowable rate. The remaining 20% will be due from you. If you have secondary insurance coverage, EMT will submit a claim on your behalf as a courtesy, but you are responsible for assuring timely payment by your secondary insurance carrier.

What Does Medicaid Cover?

While Medicare is a Federal program for qualified citizens over the age of 65, and for certain other qualified disabled citizens, Medicaid is a State program intended to assist medically indigent citizens. Because the Medicaid program is administered by each State, the coverage of medical services, including ambulance transportation, varies from state to state. You should check with your Medicaid program to understand coverage for ambulance transportation. In general, the Medicaid program requires that all ambulance transportation meet certain medical necessity criteria.

What Does Insurance Cover?

Insurance coverage varies widely from policy to policy. It is important that you review your insurance coverage to be sure that your policy provides ambulance transportation coverage and understand the limitations and requirements of your coverage. You should be sure to obtain authorization prior to receiving services from EMT if required by your policy. Please contact you insurance carrier if you have questions about your coverage. If your policy does not provide 100% coverage for ambulance transportation, you may be required to pay a deductible or co-payment as directed by your plan. Payment of all deductibles and co-payments are due immediately upon receipt of the bill. 

As a courtesy to our patients, EMT will submit a claim to your insurance if you provide your coverage information to us at the time of service or to the Patient Business Services office immediately after receiving service. Please be aware that as the policy holder, you are responsible for assuring timely payment by your insurance carrier. If your insurance carrier fails to adjudicate and/or pay your claim within the legally specified time frame which is typically 30 to 45 days from receipt of the claim, EMT will seek payment directly from you.

What If No Coverage Exists?

If you don’t have any insurance coverage of any kind, the bill for your services will be due directly from you. If you have a membership with our service in place prior to calling for our services, and your services were medically necessary, you will owe us nothing. 

How Does EMT Set its Fees and Rates?

Ambulance provider fees typically include a base charge for the transport, a mileage fee, and charges for any procedures, supplies or medications used. Your bill will provide an itemization of each of these charges incurred in your treatment and transportation.

Ambulance provider rates are determined by many factors such as the cost of providing the service and other economic forces in the community. EMT’s rates are both competitive for your community and they meet all applicable local, state and federal limitations, regulations and approval. EMT’s rates also meet all guidelines supported by the American Ambulance Association.

Unable to pay the bill you received?

If you are unable to make payment on a bill for service from EMT, please contact us for affordable monthly payment arrangements.  We are here to work with you! Call or email our billing department at 1-888-689-6446 or email Billing@emtambulance.com

We also offer memberships which can eliminate out of pocket expenses for medically necessary use of our services.  Membership prices range from $10-$25 per year for an entire family.  Memberships can not be purchased for services already performed.  SORRY!

To have a membership mailed to your home, please contact our dispatch center at 800-739-7661 or email Memberservices@emtambulance.com

Send mail to Webmaster@emtambulance.com  with questions or comments about this web site.
Copyright © 2005 Emergency Medical Transport, Inc. Canton, Ohio
Last modified: February 21, 2006