Understanding EMS Billing

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Understanding EMS Billing

• Medical Billers and Coders

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Also known as ambulance or paramedic services,
Emergency Medical Services (EMS/EMAS/EMARS) is
the service used in case of an immediate medical
requirement. It is especially dedicated to
providing out-of-hospital acute medical care and
providing transport to patients who are
critically injured or ill and cannot transport
themselves. These services are also known as
ambulance/emergency/rescue/first-aid or life
squad/services.
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EMS uses specially trained people (e.g.
paramedics) and equipment to provide immediate
medical assistance to a patient who might need it
at home before being transported to the emergency
room of a hospital. In addition, EMS provides
inter-facility transport. EMS also constitutes of
emergency medical technicians (EMTs) who do
precise rescue jobs and answer calls.
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The entire EMS system comprises private and
public organizations, communication and transport
networks, hospitals and rehab centers,
physicians, nurses, administrators and government
officials, and the public who knows when to call
whom. EMS also works with fire and law
enforcement services. But the most important is
the ambulance organization.
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EMS Billing Like other services, EMS requires
billing too. For any calls for assistance,
non-transports disregards, or usage of ambulance
transportation (paramedic or EMT) to a hospital
facility, a service fee is charged. This fee for
medical transportation is usually included in the
premiums that people pay for their insurance
through a private organization/Medicare/Medicaid
(insurance premiums are driven by drugs,
research, and technology and include the EMS
costs). These services are usually billed to the
insurance payer (Medicare, Medicaid) when a
patient uses the ambulance transportation
facility to a local emergency room and has health
insurance.
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For a private insurance agency, the patient might
have to pay co-pay or deductible and/or if there
is a difference in coverage. In some cases, if
the insurance does not pay the full amount, the
patient does not have to pay the difference
(residency status). But in the case of
non-residents, they need to pay the difference.
Again, if the resident does not have insurance,
the bill could be written off after verification.
All other non-residents will be responsible for
co-pays and deductibles. According to
caldwellcountync.org, The EMS Billing Department
follows the Centers for Medicare and Medicaid
Services (CMS) Fee Schedule for Payment of
Ambulance Services as described in Volume 67,
Number 39 of the Federal Register.
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The billing process is quite simple. A form is
filled by the resident (patient) which allows the
hospital facility to bill the insurance provider
for the services rendered. If the patient is
unable to sign, the ambulance crew and the
hospital staff sign the bill to confirm the
transportation. And a fire truck, which comes
with an ambulance, is not charged. Sometimes, the
patients protected health information (PHI)
could be used for taking payments/charges for an
ambulance. The funds from EMS transport billing
are used in EMS and for operations of the
fire-rescue department. Integrated with other
services, EMS is designed to uphold and enhance
the health and security of the community.
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