Ambulance Fee Info
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Ambulance Fee for Service, what you need to know�
What is Ambulance Fee for Service and why is Page County implementing this program?
Ambulance Fee for Service is the process of obtaining financial reimbursement for the cost of providing medically necessary ambulance transportation. Medicaid, Medicare and most other private insurance policies (health, automobile, and/or homeowners) already allow for reimbursement for this service. Page County is implementing this program to seek reimbursement of the cost of providing these services which will help offset some of the operational expenses for providing a combination volunteer and paid Fire, Rescue and Emergency Services system while giving some relief to the general fund and ultimately to the taxpayer.
What are the charges for emergency medical transport services?
(a) Basic Life Support: $400.00. Services for Basic Life Support are medical treatment or procedures provided to a patient as defined by the National Emergency Medicine Services (EMS) Education and Practice Blueprint for the Emergency Medical Technician (EMT)-Basic.
(b) Advanced Life Support Level 1: $500.00. Services for Advanced Life Support Level 1 shall be medical treatment or procedures provided to a patient beyond the scope of an EMT-Basic as defined by the National EMS Education and Practice Blueprint.
(c) Advanced Life Support Level 2: $600.00. Services for Advanced Life Support Level 2 shall be services provided to a patient including any of the following medical procedures: 1. Manual defibrillation/cardioversion; 2. Endotracheal intubation; 3. Central venous line; 4. Cardiac pacing; 5. Chest decompression; 6. Surgical airway; 7. Intraosseous line; or, 8. Administration of three (3) or more medications.
(d) Ground Transport Fee: $10.00 per statute mile from the location of the incident scene to a hospital or other facility where a patient is transported.
When is Page County implementing the Ambulance Fee for Service Program?
The Ambulance Fee for Service Program will start on October 1, 2007.
Will I have to pay for services if the ambulance does not transport me?
No. If you or family members are not transported, there will be no bill for services rendered. Ambulance fee for service is based on what is called “loaded service”, whereby someone is actually transported.
What is the Compassionate Billing Policy?
(1) No one will EVER be denied necessary medical transport service due to either their inability to pay or a lack of insurance.
(2) Compassionate billing is intended to eliminate or minimize out-of-pocket expenses for ambulance services for those that do not have the means to pay. Priority may be given to county residents.
(3) Any person receiving emergency medical transport may submit a waiver request form stating a financial hardship. Appropriate financial documentation will be required.
What happens if I do not have insurance or cannot afford to pay for ambulance service?
All patients who do not have any insurance can submit a waiver and fees may be waived as pursuant to the Compassionate Billing Policy.
What if my insurance company will not cover my ambulance transport bill?
Insured patients, who are residents of Page County, are not responsible for any ambulance transport service fees not paid by their insurance carrier or carriers. All other patients are responsible for ambulance transport service fees not paid by their insurance carrier or carriers unless otherwise waived as provided in the Compassionate Billing Policy. Patients are not responsible for any amount of the ambulance transport service fees adjusted by insurance carriers as a result of state or federal regulations or by agreement with Page County.
How does the Ambulance Fee for Service program help the volunteers?
New funding made available through Ambulance Fee for Service will be used to assure adequate resources to volunteers, helping them to continue to provide the best possible service to the County�s citizens. The primary goal of all Page County emergency personnel is for the public to receive the best emergency service possible.
Are other localities near Page County implementing an Ambulance Fee for Service Program?
Yes. Similar programs have been implemented within Spotsylvania, Winchester, Waynesboro and Warren County. The Shenandoah County agencies are in the planning phase of implementing this type of program.
How will the billing process work for the Ambulance Fee for Service program?
Page County contracts this service out to a private company to handle the billing process. After patient care is provided, insurance information will be obtained routinely, often at the hospital. Page County will waive co-payments and deductibles for County residents. Non-insured residents will receive an initial statement from the billing company, while insured residents will receive an explanation of benefits (EOB) from their insurance company. All patients may apply for the hardship waiver, if needed.
Will visitors and non-County residents be charged a co-payment for ambulance service?
Yes. Only County residents will have their co-payments and deductibles waived.
Will my health insurance premiums increase as a result of Ambulance Fee for Service billing?
Unfortunately, health insurance premiums continue to rise regardless of whether or not a community decides to bill for EMS transports. Such factors as prescription-drug coverage, litigation, technology improvements in the medical field, and depressed insurance company investment returns have resulted in escalating health insurance premium costs. However, ambulance transport costs represent less than 1% of health care expenditures. Many other local governments in Virginia have implemented a revenue recovery program for ambulance transport fees, and they have reported no evidence that EMS billing increases health insurance premiums.
What type of information will I have to give when an ambulance arrives?
Individuals using the Emergency Medical Service are asked to provide any insurance information you have at the time of service, whenever possible. Attending to the patient�s medical needs will always be the first priority.
What if I’m not able to provide the necessary insurance information to an ambulance when it arrives?
If your insurance information is not available at the time of service, the billing company will attempt to obtain the information at the hospital. If the information cannot be obtained, you may receive a letter asking you to provide the information. You can contact the billing office to provide the information. When the billing office receives the information, your insurance will be billed. You will not receive any further correspondence or bills until the insurance company has made a determination on your claim.
Who is the Third-Party Billing Contractor that the County is using for Ambulance Fee billing?
Page County will be using Diversified Ambulance Billing of Virginia Beach, Virginia for billing services. They can be contacted (800)355-1753 or on the Internet at www.dabill.com.
If I don’t have health insurance, can any other types of insurance pay for ambulance service?
Many automobile insurance policies and homeowners’ insurance policies provide some form of coverage if the insured was injured and required transport by ambulance. We recommend that citizens review their insurance coverage to verify their limits of coverage under each policy. In speaking with the billing contractors, they routinely bill health insurance first, followed by auto insurance and lastly any other form of insurance.
How much revenue will be generated by the Ambulance Fee for Service program?
Staff has estimated that approximately $300,000 to $400,000 in revenue may be generated for the full first fiscal year.
Won’t people hesitate in calling for emergency services if they can’t pay or if they’re uninsured?
Some residents have expressed concern regarding individuals who cannot afford to pay for this service and/or do not have any form of insurance. Specifically, they feel individuals will hesitate in calling for EMS services when they have an emergency. Ability to pay will NEVER be considered when providing service. When residents need emergency assistance, they should call 911 without hesitation. Also, based upon the localities we have contacted, they have all reported that there has not been a decrease in call volume and in most cases call volume has increased.
Who will I call if I have a question regarding billing or insurance coverage of ambulance services?
The billing company will have customer service representatives to address your questions. If you wish to speak with someone locally, you can contact the Department of Fire & Emergency Medical Services at (540) 743-4142.
Will uncollected debts for ambulance service be sent to a collection agency?
Page County�s billing company will not pursue payment recovery through a debt collection agency without the expressed authorization of the County Administrator or his designee.
Will the County waive out-of-pocket expenses related to revenue recovery if they meet the criteria?
There has been discussion among staff regarding an Office of Inspector General (OIG) opinion that surfaced last year. This opinion relates to the jurisdiction being able to use any taxes (real or personal property) to qualify as the co-pay for County residents. It is the intent of the County to utilize the OIG opinion for County residents, so the out-of-pocket expense for the co-pay will not need to be paid by County residents.