 |
 |
 EMS billing FAQs
At Cherryvale Fire-Rescue we understand the financial
difficulties that can come following emergency medical care. Our Business
& Billing Office personnel do all that they can to assist patients through the
process of insurance reimbursement and billing. Please feel free to
contact our offices if you have any questions, or utilize any of the links
below. Our staff can assist you with processing your insurance claims,
making payment arrangements, or seeking solutions to your
Frequently Asked Questions: "Why didn't Medicare cover my ambulance bill?" Unfortunately, Medicare does not always cover ambulance charges to the hospital. It is important to remember that medicare is a benefit, not an insurance plan. Medicare determines whether an ambulance trip is "medically necessary" by an established set of guidelines. Many factors contribute to this decision by Medicare. Some of these factors include: 1) Did the patient's condition at the time 911 was called
warrant immediate medical attention? Remember, this decision is made by
Medicare, not be the 2) Could the patient have been taken to a hospital by any other means of transportation other than an ambulance? 3) If the patient was being transferred from one hospital to another hospital by ambulance, could the patient have received the same level of required care from the transferring hospital? Also in many cases Medicare will not pay for transport from a "greater" facility to a "lesser" facility, which includes being transported from a hospital back to a residence. "What do I do if Medicare does not pay my ambulance bill?" If Medicare does not cover your ambulance bill, you have the right to file with Medicare for a Medical Review. This process is explained in the Medicare Remittance Notice that the patient receives from Medicare in the mail. When filing for a Medical Review, it is recommended that the patient provide the following documents to Medicare: 1) A letter from the patient's family physician explaining why the ambulance transport was medically necessary 2) Copies of the patient's ambulance transport medical records. The patient may contact the Cherryvale Fire-Rescue billing office at 800-538-8278 to obtain a copy of his/her records. 3) Copies of the patient's medical records from the hospital that the patient was transported to 4) A letter from the patient explaining why 911 was called for medical assistance.
Filing for Medical Review does not guarantee that Medicare will reverse their original decision, but is an option to all patients covered through Medicare. "Why wasn't a claim filed with my secondary insurance company after Medicare denied my claim?" Most patients have insurance coverage secondary to Medicare. However, most of these secondary insurance policies are Medicare Secondary Supplement Policies, such as Blue Cross & Blue Shield Plan 65. These secondary insurance coverage plans will ONLY cover balances AFTER Medicare pays their coverage rates. Therefore, if Medicare does NOT cover the charges, then neither will most of the secondary insurance plans. "The hospital filed with my insurance company, so why didn't Cherryvale Fire-Rescue?" If a patient receives a bill for their ambulance transport without insurance being filed, it is most likely because the EMS Billing Office does not have complete insurance information on file for the patient. Please contact the Billing Office at (800) 538-8278. Once all insurance information is on file with our billing office, we will gladly file a claim with your insurance provider.
|
 |
 |
|
|
|