EMS Billing FAQ's
What is EMS billing? EMS billing is a service fee charged by The Township for ambulance transportation (paramedic or EMT) to a hospital facility, calls for assistance, disregards and non-transports.
Why does The Township charge for EMS services? Most people have insurance, either private or Medicare. Their premiums pay for medical transportation based on regional prevailing rates. The Township is joining most area communities in seeking alternate sources of funding already available.
Who will be billed? We will bill only the insurance carriers of the Township residents who are insured or have Medicare coverage and only when they are transported to a local emergency room. You may receive a statement, but you will not be billed. If you live in the Township and don't have health insurance, we will not bill you. There will be no out-of-pocket money from residents. Non-residents will be billed whether or not they are insured.
Who receives the ambulance bill? For those who live in The Township, the ambulance bill goes directly to third-party payers. Third-party payers include Medicare, Medicaid, and private health insurers. You may receive an Explanation of Benefits (EOB) from your insurance carrier. This is not a bill. Your insurance carrier may not reimburse the township for the full fee, but rest assured you are not responsible for this difference if you live in the Township. For those who do not live in the Township, the initial ambulance transport billing goes directly to a third-party payer, if available. If Medicare, Medicaid, or a private health insurer does not pay the bill, the individual is billed. How does it work? Our crews will simply ask you a few questions. If Medicare covers you, you will be asked to sign a form allowing us to bill Medicare. Our billing service handles the rest. If you are unable to sign the form when you are transported, the Ambulance Crew and the Hospital staff will sign verifying why you were unable to sign and that you were transported to the hospital emergency department.
How much does it cost? It depends on your level of care, but the township will invoice Medicare or your insurance carrier reasonable and customary rates for this area.
Will EMS Billing increase local insurance rates? No. These costs have been built into your premiums for many years. More than eighty percent (80%) of the nation’s fire departments that transport patients to the hospital bill for these services. Ambulance costs are less than one percent (1%) of health care expenditures. Insurance Rate increases are driven by drug costs, technology, and research. Billing at the allowable costs will have negligible impact on insurance premiums.
What if my insurance doesn't pay or only pays a portion of the fee? If you are a township resident, you are not responsible for any co-pays, deductibles, or any fees not covered by your insurance provider. I’m an uninsured resident; how will my bill be handled? You will be contacted by mail or phone by Medicount Management, our billing vendor, to verify your insurance status. When this is verified, the bill will be written off.
Will visitors or non-residents be charged for co-payments and/or deductibles? Yes, only “Political Subdivision” residents are eligible to have their co-payments and/or deductibles waived. How will my privacy be protected? All Township personnel as well as The Billing Management employees have been trained in patient privacy and in the Health Insurance Portability and Accountability Act (HIPAA) and will strictly adhere to those standards.
What will EMS Transport Billing income be used for? Funds received through EMS Transport Billing will be used per Ohio Revised Code 505.84. The Board of Trustees may establish reasonable charges for the use of fire and rescue services, ambulance services, or emergency medical services. The board may establish different charges for township residents and nonresidents, and may, in its discretion, waive all or part of the charge for any resident. The charge for ambulance transportation for nonresidents shall be an amount not less than the authorized Medicare reimbursement rate. Except as provided in section 505.441 of the Revised Code, charges collected under this section shall be kept in a separate fund designated as "the fire and rescue services, ambulance services, and emergency medical services fund," and shall be appropriated and administered by the Board. The fund shall be used for the payment of the costs of the management, maintenance, and operation of fire and rescue services, ambulance services, and emergency medical services in the township. If the fire and rescue services, ambulance services, and emergency medical services are discontinued in the township, any balance remaining in the fund shall be paid into the general fund of the township.
You may direct questions to the Fire Chief, Tom O'Brien 740.938.2021.