EMS Billing

Who Do I Contact for Questions About Billing?

The Plain Township Fire Department’s medical billing services are coordinated through Change Health Care.

If you have a question about billing you have received contact:

Change Health Care customer service at (843) 428-2553.

Why Bill for EMS Services

Many fire departments and districts in this region have historically provided EMS transports for free. Several of these fire departments have just recently realized that they were not acting in their citizen’s best interest by providing this “free” service. They are now beginning to understand that it was not a “free service”, but one provided by the tax dollars, levy funds and private or corporate donations from the people in their community.

In order to place the cost on the actual user, (many times a non-resident and non-tax payer or supporter) many communities are considering billing insurance providers for EMS transport services. They are doing this to lessen the burden on the taxpayer, levy supporter or donator. These steps are being recognized by the public, as an effort by government officials to be more fiscally responsible for the money entrusted to them.

Fire Departments and government officials are becoming much more educated about today’s health care environment and its impact on the local economy. They are realizing that most of their citizens are already insured in some way and that a portion of their insurance premium is usually set-aside for ambulance transport. They now understand that if they are not billing these insurance providers for the EMS transport, they are in fact giving away their citizens money and allowing them to be billed twice. (Once by local and federal taxes, ect. and once by Insurance Premiums*)

*This uncollected money is being utilized by these companies to expand their operation in other communities or as profit sharing with their stockholders.

Local communities should bill the insurance providers for EMS transports and utilize those profits to lessen the burden on their taxpayer, levy supporter or donator. This would allow local departments to use those funds in “their” community to offset operating costs or improve fire and EMS services to “their” citizens. In essence, this constitutes cost-shifting and shows that local governments and fire agencies can be cost effective and efficient.

FAQ's About EMS Service

Are we really a free service?

Not because our billing! Throughout the country, you are in a minority! Most insurance programs have transport fees set aside in their budget. When these funds aren’t used they can be converted to profits for their shareholders or investments in other communities.

How does the township currently fund the Fire Department’s Emergency Medical Services operation?

It is funded from the Township’s Fire Levy. The majority of the fire fund comes from property taxes.

Is this a free service?

No! Everyone has operating costs that are paid by taxes, levys or donations.

How does the township currently fund the Fire Department’s Emergency Medical Services operation?

It is funded from the Township’s Fire Levy. The majority of the fire fund comes from property taxes.

Is this the right thing for my community?

Yes! We are trying to offset our operating cost for our citizens with the money they have already paid to an insurance company, shows that we are managing their money appropriately.

Will the program change a citizen’s ability to receive emergency medical services?

No. Every citizen will continue to have access to emergency medical care regardless of insurance status.

What will happen when a citizen calls 911 for emergency medical services?

An emergency vehicle from the township and/or a nearby jurisdiction will respond. A trained medic will examine the patient and provide emergency medical services and, if necessary, provide transport to the hospital. If the citizen is able, he/she will be asked for insurance information. If this is not possible, three (3) notices will be sent in an attempt to get insurance information.[/accordion-item][/accordion]

How do I know if I will receive a bill, or not?

If you are not transported, there is no charge. The chart below lists the possible billing and non-billing categories:

Billing Chart

Twp. / Village Resident Non-Resident
Patient has Medicare Waive co-pay requirement Pays co-pay
Patient also has Medigap insurance Waive co-pay requirement Pays co-pay
Patient has Medicaid No co pay or coinsurance No co pay or coinsurance
Patient has commercial insurance Waive co-pay or coinsurance Pays co-pay or coinsurance amount
Patient is uninsured Waive fee Bill patient for full amount*
Transport provided through automatic response agreement Follow policies of transport’s jurisdiction Follow policies of transports jurisdiction

 

Can we make an agreement with another jurisdictions NOT to bill their residents, when we respond into those jurisdictions on mutual aid?

No, we cannot enter such agreements based on federal guidelines.

Will we be charged for a transport between medical facilities, doctor’s office, urgent care?

Yes. Categories described in the Billing Chart above will apply.

Will we be charged for a transport between medical facilities, doctor’s office, urgent care?

Yes. Categories described in the Billing Chart above will apply.

What is an EMS Third Party Reimbursement Program?

It allows the township to bill private insurance companies and Medicaid or Medicare to recover some of the costs necessary to staff and equip an Emergency Medical Services (EMS) program.

 Why did we pick Med3000 to do my EMS transport billing?

Med3000 has the Fire and EMS experience to help you answer these questions and also provide you with the billing and information services that will help you to become a more cost-effective and efficient provider.

EMS Billing Resolutions

Resolution No. 120503

December 5, 2001 The Plain Township Board of Trustees approved: Resolution No. 120503 Mr. Shoemaker made a motion to establish charges for ambulance and emergency medical services pursuant to Ohio Revised Code #505.84 (Refer to Resolution No.011205C attached) Mr. Shoemaker seconded the motion. Roll call vote: Mrs. Bobb-Aye, Mr. Cameron-Aye, Mr. Shoemaker-Aye. [/accordion-item][/accordion]

Resolution No. 120504

Mr. Cameron made a motion to approve the hiring of MBI Solutions to administer and collect the charges for Township Ambulance and Emergency Medical Services (Refer to Resolution No. 011205D attached). Mrs Bobb seconded the motion. Vote taken: Mr. Shoemaker-Aye, Mrs. Bobb-Aye, Mr. Cameron.

Ohio Revised Code 505.84 Charges for Emergency Service

Ohio Revised Code 505.84.

Charges for fire and rescue, ambulance, and emergency medical services.

As used in this section, “authorized medicare reimbursement rate” means such rate established for the locality under Title XVIII of the “Social Security Act,” 49 Stat. 620 (1935), 42 U.S.C.A. 301, as amended.

A board of township 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 that, if prior to September 9, 1988, the board had different charges for residents and nonresidents and the charge for nonresidents was less than the authorized medicare reimbursement rate, the board may charge nonresidents less than the authorized medicare reimbursement rate.

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.

Contact Information

Plain Township Fire Department

9500 Johnstown Road
New Albany, Ohio 43054

firedept@plaintownship.org

614-855-7370

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