Billing Questions

Subscription Questions

General Questions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Billing Questions

 


 

·         Will Bellefonte EMS file my ambulance transport claim with my insurance company?

 

o   Bellefonte EMS as a courtesy to our patients will submit electronic or paper claims to your insurance carriers(s). Medicare claims will automatically be filed for you.  Your assistance is needed to ensure that we have correct information regarding the insurance plan that is in effect at the time of your ambulance service.  There is no way for us to know in advance if your carrier covers emergency or non-emergency ambulance transports, we suggest you contact your carrier to confirm your coverage.
 


·         How long will it take for my insurance to pay?

 

o   After the claim is submitted and received by the insurance carrier, their processing time is typically 30-45 days from the date of the claim being received by them.  Our practice is to send a matching patient bill when we bill commercial insurances that send the check directly to patient.
 


·         I received a bill for ambulance transport and a check from my insurance company, why did I receive a bill and what do I do with the insurance check?

 

o   We third-party bill your commercial or Medicare insurance for you as a courtesy.  Some insurance carriers will pay the policy holder directly instead of the healthcare provider.  We will usually mail an invoice to patients with those types of insurance several days before you receive an insurance check in the mail.
 

o    Once you receive that insurance check you may endorse it “deposit only, payable to Bellefonte EMS’ and mail or drop it off at our business office.  If it is more convenient, you may deposit the insurance check and pay by credit card or personal check to Bellefonte EMS for the full amount.  In either case, please include a copy of the Explanation of Benefits (EOB) that will be attached to the insurance check with your payment.   
 


·         I received a bill for para-transit or wheelchair/stretcher van transport, does my insurance pay for this type of transport?

 

o   Wheelchair and stretcher para-transit van transports are not covered by Medicare or Medical Assistance insurance.  Most commercial insurance policies also do not cover non-emergency  para-transit or ‘wheelchair van’ services; please consult your insurance carrier in advance to determine if coverage may be available for your particular insurance plan.
 


·         Where do I send my payments?

 

o   You may drop off or mail your payment to our business office at the address below.  Our normal business office hours are usually Monday-Friday 8:30am-4:30pm.  On occasion then office may be closed if all of our staff are out of the office responding to emergency ambulance incidents.  We realize that this may be an inconvenience, please understand that we may be responding to assist your neighbor, friend, or family member with a medical emergency.
 

o   Bellefonte Emergency Medical Services
Attn Billing Department
369 Phoenix Avenue
Bellefonte, PA 16823
 


·         Can I make partial payments?

 

o   Bellefonte EMS is very willing to make payment arrangements with any patient having an outstanding bill that insurance does not cover.  Patients or their representatives are able to contact the billing office during regular business hours from 8:30 a.m. to 4:30 p.m., Monday through Friday.  Bellefonte EMS strives to aid patients and families by accepting reasonable payments on a regular basis.  Patients should contact our office upon receipt of the initial invoice to discuss the need for payment arrangements instead of waiting until accounts become delinquent.  This enables all involved to successfully handle the unexpected financial burden an unexpected injury or illness may create.
 


·         What is the difference between Basic Life Support (BLS) and Advanced Life Support (ALS) ambulance transports?

 

o   Bellefonte EMS is a Pa. Department of Health licensed BLS ambulance service.  Depending on circumstances encountered during your emergency, such as the severity of your medical condition, the assistance of an ALS unit staffed with a paramedic may be needed to provide more advanced treatment prior to arrival at the emergency department.  A paramedic typically arrives at the scene, begins treatment and then accompanies patient to the hospital in the BLS ambulance.  Medicare insurance requires that the BLS ambulance and ALS unit jointly invoice Medicare instead of each agency submitting separate invoices.  Once Medicare reimburses us, the monies received are split so that both the BLS and ALS agencies receive a portion of the reimbursement for services provided, all of which is seamless for the patient.
 


·         Does Medicare pay for Ambulance transports?

 

o   Medicare Part B pays for "Medically Necessary" emergency ambulance transports as long as certain conditions are met. Essentially, Medicare will pay for ambulance transportation during a medical emergency.   Non-emergency ambulance transports need to meet Medicare’s definition of “Medically Necessary” with most transports from one hospital to another hospital with a level of care or one that is able to provide specialized treatment not available at the primary facility.  Please consult your health insurance policy for more information regarding their criteria for medical necessity and covered services.

 


·         What does “Medically Necessary” mean?

 

o   For Medicare to pay for ambulance transportation it must be medically necessary. This means that in an emergency it must be as a result of a sudden onset of a condition of sufficient severity that any other form of transportation would place the patient's health at risk. In the case of non-emergency transportation the transport must be to obtain a necessary medical evaluation or treatment and the patient must be unable to get out of bed without assistance and unable to walk or sit in a chair and any other form of transportation would present a risk to the patient's health or safety.

 


·         Does Medicare pay for service in full?

 

o   Medicare will pay 80% of the allowed amount for covered ambulance services. You or your supplemental insurance will be responsible for the remaining 20%.

 


·         Why do you need a signature to bill my insurance?

 

o   Your signature authorizes Bellefonte EMS to release your pertinent health information and to submit your claim to your insurance carrier for reimbursement.

 


·         What happens if my insurance carrier, including Medicare, denies my claim?  What options do I have?

 

o   If your insurance carrier including Medicare denies your claim, you as the patient have the right to file an appeal with your insurance carrier.  Bellefonte EMS will assist with this process if our help is needed; contact our billing office for assistance and more information.

 


·         Does Bellefonte EMS file claims to my secondary insurance?

o   Yes, if you have a secondary insurance.  The amount paid along with a copy of the Explanation of Benefits (EOB) from your primary insurer must be provided to our office for us to forward to the secondary insurer.  Medicare claims are automatically crossed over to your secondary carrier in most cases, but if it is an insurer not on the Medicare crossover listing, we will file the secondary claim as a courtesy for our patients.
 


·         What is an Advanced Beneficiary Notice (ABN)?

o   Medicare requires healthcare providers and suppliers to notify you if the provider believes that a service you have requested will not be covered.  We are also required by Medicare to notify you of the reason why the service is expected to not be covered as well as an estimate of how much you may have to pay for the service, if you still desire to receive the service.  The Advance Beneficiary Notice (ABN) is the form that is used to provide this notice.  It also allows you to indicate if you want the service, whether or not you want us to try to bill Medicare for it so that you can get the right to appeal Medicare's decision if they determine the service is not covered.
 


·         Do you accept credit card payments?

o   Bellefonte EMS will gladly accept credit card payments.  Please telephone or stop by our business office during normal business hours.
 


·         What if I do not have insurance?

o   If you do not have any insurance to file a claim, you may contact our office to arrange a payment agreement.  Our annual Subscription membership provides complete coverage for any ambulance emergency transport for patients that do not have health insurance coverage available.  Subscriptions go into effect after the application and payment of associated fees are received by our business office and cannot be backdated after services have already been provided.   
 


·         Does Bellefonte EMS have a collection process?

o   Yes.  Bellefonte EMS relies on fee-for-service reimbursement for 90% of our annual operating budget.  We do not receive any tax-based funding from local municipalities.  Therefore, your cooperation is greatly needed to help us remain in operation for both today and to guarantee our stable operation for the future.  By paying your invoice in a timely fashion, Bellefonte EMS is able to continue providing a quick response to the next emergency with reliable vehicles, equipment, and well-trained personnel.  In order to responsibly operate the organization, we must attempt to collect all monies due for services rendered.  We encourage all patients that may have difficulty paying for services to contact our billing office immediately after receiving the first invoice to discuss the matter and possibly establish a suitable payment arrangement.

 



Subscription Questions
 


·         I have a Bellefonte EMS ambulance subscription, what does it cover?

 

o   The ambulance subscription acts as additional insurance by covering any patient co-pays or annual deductable that may be required by your commercial health insurance carrier.    Additionally, the subscription program generates revenue that Bellefonte EMS utilizes to update equipment, supplies, and to provide training opportunities for our personnel.   Bellefonte EMS will still invoice your commercial health, Medicare, or automobile insurance carriers if have a current subscription.  If your insurance carrier mails the ambulance reimbursement payment directly to the patient, the patient is still obligated to forward those dollars to Bellefonte EMS.

 


·         What are the effective dates for my subscription membership?

 

o   Our annual Subscription membership is effective for the calendar year of January through December 31.  Annual subscription notices are usually mailed to each household in our primary response area in late November of each year.  If you did not receive one, please contact our business office and one will be sent.  The subscription is effective from the time it is received in our office and is not able to be back dated if purchased after an ambulance transport.

 


·         Should I purchase an “Individual” or “Family” subscription?

 

o   Annual Bellefonte EMS Ambulance Subscriptions are available for $32.00 for an individual and $45.00 for family and are for the calendar year.  The “Individual” subscription is for an individual adult that may or may not live alone.  The “ Family” subscription includes  a legal spouse and/or children under 19 years old or full time student living in the same household and still considered  a ‘dependant’ as defined by the IRS.

 


          How are my donation dollars used?

 

o   Your donation dollars are greatly appreciated and assist us to update equipment, provide educational opportunities for our staff, and improve our ability to provide quality patient care for the community.  We appreciate your monetary gift and work hard to ensure that your donations are used in a meaningful manner.  Bellefonte EMS is a recognized 501(c)3 non-profit organization by the IRS.

 

o   You may also wish to consider Bellefonte EMS during your estate planning to provide a meaningful gift in the future.  Please consult your attorney or financial planner to discuss available options and methods to designate estate funds to support the continued growth and improvement of Bellefonte EMS in the future.   
 


·         What is a para-transit van transport? Is it covered by the ambulance subscription?

 

o   Para-transit van transport is a non-emergency  transport by wheelchair or stretcher.  This type of transport is not covered by ambulance subscription.  Due to our PUC regulations, we cannot offer free or reduced rates to our members of the ambulance subscription. 
 


·         I haven’t received a membership card in the mail.

 

o   In an effort to reduce postage and printing costs, Bellefonte EMS no longer provides a membership card as part of the annual program.  Your cancelled check or cash receipt will serve as proof of membership.  You will NOT need to show proof of membership at the time of an emergency or when transported, this can be handled if needed afterward with our Billing Department staff.
 


·         Will Bellefonte EMS still transport me if I don’t have a membership?

 

o   Certainly!  Bellefonte EMS will gladly respond to, evaluate, treat and transport any request for emergency assistance.  The annual membership subscription will help you to offset any ‘out-of-pocket’ expenses not covered by your health insurance plan.
 


 

General Questions

 


 

                      How are my donation dollars used?

 

o   Your donation dollars are greatly appreciated and assist us to update equipment, provide educational opportunities for our staff, and improve our ability to provide quality patient care for the community.  We appreciate your monetary gift and work hard to ensure that your donations are used in a meaningful manner.  Bellefonte EMS is a recognized 501(c)3 non-profit organization by the IRS.

 

o   You may also wish to consider Bellefonte EMS during your estate planning to provide a meaningful gift in the future.  Please consult your attorney or financial planner to discuss available options and methods to designate estate funds to support the continued growth and improvement of Bellefonte EMS in the future.   

 


·         What is the difference between an EMT and Paramedic?

 

o   Emergency medical technicians (EMT) are basic level care providers whereas paramedics are advanced care providers. EMTs are trained to provide important treatments such as; controlling bleeding, bandaging wounds, splinting broken bones and performing CPR. The EMT training program is 128 hours in length, while the paramedic training is an additional 1 -2 years.  A paramedic is an advanced level care provider. Paramedics are able to deliver more advanced treatments such as: starting IVs, administering medications and evaluating cardiac activity. Serious injuries and illnesses require many times require this advanced level of care.  EMTs and Paramedics are required to successfully complete multiple hours of continuing education each year.
 


·         When should I call 911?

 

o   In the Bellefonte area, residents and visitors are encouraged to call 911 for an emergency event that may need an immediate response by an ambulance, fire department or police.  The Centre County 911 Center is operated by Centre County Government and serves all of Centre County. 

 

o   It is impossible to list or describe every potential scenario of when to call 911.  Some common emergencies include; vehicle or pedestrian accidents, chest pain, difficulty breathing, stroke, seizures, an unconscious person, diabetic emergency, allergic reaction, broken bones, significant pain of an unknown cause, uncontrolled bleeding, drowning, overdose or poisoning, suicidal thoughts or actions, electrical shock, any event or injury that is reasonably believed by the patient or bystander to be potentially life or limb threatening, or serious enough that moving the patient or any other method of transport or waiting would be harmful.  When in doubt, call 911.
 


·         Why does a police officer or fire truck sometimes arrive at my home with the ambulance?

 

o   Depending on where you live, a local police officer or fire department may also be dispatched to assist Bellefonte EMS when responding to an emergency incident.  Both Bellefonte Borough and Spring Township Police departments have police officers with medical training and equipment, including Automatic External Defibrillators (AED).  Howard Fire Company and Citizens Hook & Ladder Fire Company in Milesburg both operate Quick Response Service (QRS) units with medically trained personnel and equipment that may arrive prior to the ambulance to begin live-saving treatment as soon as possible.  By working together, we are able to reach you quickly in your time of need and initiate medical treatment when precious seconds count the most. 

 

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