Billing and Payment

 

• Any person that needs emergency medical attention and transportation to a local emergency facility will be billed for the transport. The patient transported or the legal guardian of the patient, if a minor, is ultimately responsible for all billed charges.

• In order for the ambulance service to bill your insurance company, you must complete the required Ambulance Signature Requirement Form at the time of service or mail it to 911 Billing Services and Consultants, Inc, PO Box 589, Madisonville, KY 42431.

• When CCAD transports you, the EMS field staff will complete a Patient Care Report. The EMS field staff will document the information concerning your condition, with the medical assessment and care rendered to you.

• CCAD transports must follow Federal Government Guidelines for the billing and coding (categorizing medical conditions) of ambulance patients. Our billing staff will use the information documented on the run form to determine the appropriate diagnosis and procedure codes that apply to your ambulance transport.

• If you have NOT been previously transported by CCAD and complete Medicare or insurance information was not obtained at the time ambulance service was provided an invoice will be sent to you, along with a request for your insurance or Medicare information. Please complete the form and return it to our office. Our address is listed above.

• If CCAD has previously transported you, and we have current Medicare or insurance information in our billing system, one of the following will occur:

  • Unfortunately, not all claims filed are paid by Medicare or insurance companies. Medicare and insurance companies have their own specific criteria for payment of claims, and not all transports meet their criteria, which may result in a denied claim. There are specific procedures for re-filing claims, and you may want to consult with either Medicare or your insurance carrier for further information and assistance.

  • Our business office specialists are very knowledgeable and experienced in the procedures for re-filing claims. They may be able to assist you in the re-filing process. You may call our office at 888-344-9614, for more information.

• For other billing questions, please check the FAQs below or call our office at 888-344-9614

 

FAQS

 

Payment Related

Did you receive my payment?

 

A: It takes a few days for your check to reach our post office box and to be processed by our office. Please allow one week before contacting us to determine if we received your check. In order to verify that a payment was received and applied to your account, you will need to call our office at 888-344-9614. If you paid online, your online payment receipt will serve as proof of payment.

 

Can credit card payments be made? Over the phone? Online?

 

A: We accept Visa, Master Card and Discover credit cards for payment. You can use your credit card to pay your bill online by clicking on the "online payment" link at the top of this page. Payments by credit card can also be made via phone by calling 888-344-9614.

Can partial payments be made and can I set up a payment plan?

A: Payment plans are available in certain specific situations such as an outstanding balance. Payment can be made in full, or, if preferred, we will accept partial payments on a monthly basis. To set up a partial payment plan, please call 888-344-9614, and ask the billing agent to set up a monthly installment payment plan that is comfortable for you. The agreed upon amount will be entered into our system and a monthly bill will be sent to you.

 

For any other questions related to payment, call 888-344-9614.

 

Insurance Related

 

Why didn't my insurance pay for ambulance transport?

A: There are many different reasons why an insurance company may deny coverage for ambulance transport. Insurance coverage for ambulance transport depends on the benefits defined in the insurance policy, which may be determined by the insured individual's employer. Some insurance companies only pay for ambulance transport if the patient is admitted to the hospital. Additionally, some insurance companies will not pay for an ambulance transport that results from an automobile accident unless they have received a letter stating that the driver does not carry a medical payment benefit on their auto policy. This letter is often called a "no med-pay letter" or "declaration page." Insurance companies may apply the ambulance bill towards the annual deductible and therefore will not issue payment to the ambulance provider. If there is a payment discrepancy, we encourage you to call your insurance carrier for clarification of coverage. The majority of health insurance and state assistance HMO carriers have strict filing limits. If you have retained an attorney, they need to be aware of the filing time limits and limitations. It is essential that you respond to us within 30 days with regard to insurance or attorney information, whichever applies. Failure to do so will result in the patient assuming responsibility for payment of the bill.

Why does the patient need to provide secondary insurance information?

A: In many cases, Medicare automatically crosses over the co-insurance amount of an ambulance claim to the secondary insurance carrier after making their payment. However, this does not happen in all cases. Providing your secondary insurance information will allow us to bill your insurance carrier directly, without the need to bill you for the co-insurance amount.

Why does the patient need to provide the date of birth of the insured?

A: Several pieces of personal information are required before we can or will access patient accounts. This measure is taken in part to protect the privacy and security of patient and financial information. Additionally, insurance carriers have very specific information that they require from us to verify the insurance coverage is in place for their members. This information includes full name, social security or member ID number, date of birth and address. Providing this information allows the insurance company to confirm that information on the ambulance claim does, in fact, relate to the correct member. Please see the homepage of our website for our HIPAA and Social Security Number Protection Policy.

I gave my insurance information to the hospital so why doesn't the ambulance service have it?

A: The ambulance service employees often gather insurance information independent of the hospital staff. The hospitals will occasionally provide us with information if we are unable to obtain it at the time of service. But often times it is more efficient to call the patient for their insurance information. If the insurance information is not obtained from the patient or family member, the bill for ambulance service will be sent to the patient. To supply us with your insurance information, please call us at 888-344-9614.

Why is the patient being billed when the patient did not call 911 (example: the patient did not want to go to the hospital)?

A: Patients that are intoxicated, under the influence of drugs or alcohol or otherwise impaired have diminished rights in regards to refusing ambulance transportation. Law enforcement and certain specially trained clinicians have the right to send an individual in their care or custody to the hospital against their will. This does not mean the patient is not obligated to pay for the service as it was deemed medically necessary by an appropriate person. If the patient did not meet the criteria above and is not a minor, there is an expectation that the patient would exercise their right to refuse treatment and transport at the time of service. If the patient did not exercise your right to refuse treatment and transport at the time of service, the patient or the patient's insurance is responsible for payment of the ambulance bill.

For any other questions related to insurance, call 888-344-9614.

 

Signature Related

 

Why didn't the crew ask for patient's signature?

A: Ambulance crews are instructed to obtain the patient signature in every circumstance where it is possible and appropriate to do so. There are several circumstances where this proves impossible, including when the patient is unconscious or has an altered level of consciousness when the patient is receiving aggressive and/or sensitive medical treatment, language barriers, operation barriers such as high ambulance call volume and other similar reasons.

Why do you need a signature to bill insurance?

A: Medicare and most types of insurance require the signature of the patient in order to be able to bill them for services rendered. Signing for the transport will expedite this process and allow us to bill the insurance and not the patient. In many cases, if the patient signature is not on file the bill becomes the responsibility of the patient. A signature form is available for download at the top of this page.

For any other questions related to payment, call 888-344-9614.

 

Medicare-Related

 

Why won't Medicare pay my non-emergency ambulance bill?

A: Medicare Part B only covers ambulance transportation in an emergency or when any other form of transportation would endanger your health. It does not cover non-emergency transportation between home and a doctor's office, for patient/family convenience, for physician preference or convenience or for elective use of an ambulance when not medically necessary.

Why doesn't Medicare cover excess mileage?

A: Medicare will only cover the mileage charge for patient's transported within the medical service area of the point of origin. If you were transported beyond this medical service area, the excess mileage is the responsibility of the patient.

How is excess mileage determined?

A: Generally there are two basic mileage payment determinations according to Medicare guidelines: 1. Hospital to healthcare facility: if the patient is going to a skilled nursing facility or other healthcare facility, Medicare will pay for the mileage from the point of origin to the closest appropriate facility with an available bed within the discharging hospital's service area. If the destination facility is outside of this service area, Medicare will only pay for transportation to that closest facility. The patient is responsible for mileage incurred beyond this point. 2. Hospital or healthcare facility to private residence: In cases where the patient's destination is a private residence, the mileage is calculated from the destination (the residence) to the nearest hospital that would have been able to treat the diagnosis related to the patient's admission.

 

Motor Vehicle Related

 

Why can't my health insurance be billed when transported due to a motor vehicle accident?

A: Insurance coverage for ambulance transport depends on the benefits defined in the health insurance policy, which may be determined by the insured individual's employer. Some insurance companies only pay for ambulance transport if the patient is admitted to the hospital. Additionally, most insurance companies will not pay for an ambulance transport that results from an automobile accident unless they have received a letter stating that the auto insurance for the vehicle you were in does not carry a medical payment or personal injury protection (PIP) benefit on the policy. This letter is often called a "no med-pay letter" or copy of the declaration page will also suffice. We then need to submit a copy of this letter or declaration page to the health insurance as proof there is no medical coverage on the automobile insurance policy. Insurance companies may apply the ambulance bill towards the annual deductible and therefore will not issue payment to the ambulance provider. If there is a payment discrepancy, we encourage you to call your insurance carrier for clarification of coverage. The majority of health insurance and state assistance HMO carriers have strict filing limits. If you have retained an attorney, they need to be aware of the filing time limits and limitations. It is essential that you respond to us within 30 days with regard to insurance or attorney information, whichever applies. Failure to do so will result in the patient assuming responsibility for payment of the bill.

Why does the patient need to provide auto insurance information when involved in a motor vehicle accident?

A: Medical coverage on your auto insurance is an option you may include in your auto policy. We must file proof, in the form of a letter, with health insurance carriers that no automobile medical coverage exists before they will issue payments related to your automobile accident. This letter is often called a "no med-pay letter" or "declaration page."

Why isn't the responsible drivers insurance being billed?

A: The insurance of the responsible party (or other third party, such as a commercial operator) is not generally billed by ambulance providers. These insurance from these third parties generally only makes payments to the claimants in the form of a settlement. Any contracts or agreements that are entered into between the patient and the third party insurance will not include the ambulance provider.

 

For any other questions related to payment, call 888-344-9614