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. |
