Ambulance Billing: What You Need To Know By: Rhonda L. Holtsclaw PIO Franklin Township Fire Department There have been many questions asked about how Franklin Township Fire Department handles their billing for ambulance transports. The billing is divided into Advanced Life Support transports and Basic Life Support transports. The bills are also divided into Medicare/Medicaid Insurance claims and other insurance. Basic Life Support Transports (BLS) is those that do not require a paramedic providing patient care. This means an EMT-Basic technician is on board and provide basic skills ranging from splinting, bandaging, to administering oxygen. EMT-Basics are not allowed to do advanced skills such as IV’s, heart monitoring or drug administration. BLS transports can include any of the following: sprains, strains, sick person, headache, and more. These are based on Marion County protocols that are established by selected physicians from all area hospitals that all transporting ambulances must adhere to. The cost of a BLS ambulance transport ranges from $230.00-$325.00. Advanced Life Support Transports (ALS) is those that require a paramedic providing patient care. Paramedics provide advanced treatment such as IV’s, heart monitoring and drug administration. ALS transports can include any of the following: Chest Pain, Shortness of Breath, Cardiac Arrest, Seizures and more. These are also based on Marion County protocols. An ambulance invoice for an ALS transport can range from $330.00-$450.00. If you compare a private ambulance service to a township ambulance service the billing is very different. The private ambulance service bills by itemizing all treatment given. Common billing practices for ambulance transport by private ambulance services include: administering oxygen, heart monitoring, any drugs given and all equipment needed for IV’s. Recent figures from a private ambulance service for a cardiac arrest response including all treatment given to the patient ranged from $800.00 - $1,400.00 compared to the department’s cost of $330.00-$450.00. The amount billed to the patient by the department assists in offsetting the costs to operate an ambulance but in no way covers all costs incurred by the department for treatment and transport. The Township Board in 2001 approved an additional charge of $35.00 if the patient does not reside in the Franklin Township. The Franklin Township Fire Department has recently been approved by the Township Board to bill for ALS intervention runs where no transport occurs. These runs include Diabetics and Asthma patients for example. The department encountered a large number of runs last year that required ALS intervention. Once the patient received treatment and was feeling better, refused transport. In these cases the department still incurred costs that were not billed. One common drug used in these treatments costs $120.00. These patients will now be billed $95.00 for treatment given and this will assist in offsetting the cost of the drugs given to the patient while on scene. During the treatment period ambulance crews will obtain all insurance information from the patient. This is turned into the billing clerk of the department where it is invoiced to the patient. Due to the large number of private medical insurance carriers currently the only insurance that is billed direct by the fire department is Medicare/Medicaid. If you do not have Medicare/Medicaid you will be sent an invoice and it is the patient’s responsibility to submit the claim to their insurance company. The township will provide an invoice that has all the information needed for the patient to file a claim with the insurance company, which will include all the medical code diagnosis needed by the insurance company. Billing the insurance companies for all patients would result in the department needing additional office staff to bill all of the various insurance companies, resulting in an increase in costs to the department that would have to be passed on to the patient. Also, due to new Federal and State Regulations on patient confidentiality, the fire department could be held liable is information is released to the insurance company without patient approval. If anyone has questions regarding their ambulance bill the department encourages them to contact Carolyn at 780-1700 ext. 10.