Will EMS file a claim with the insurance company?
As a courtesy, EMS will file the claim if complete insurance information and a signature to pay the provider are received. EMS has 90 days from the date of service to file the claim to private insurance companies and Medicaid. If the insurance information is not received in enough time to allow for timely filing the patient will have to file the claim themselves.
Does the City accept retroactive Medicaid?
According to the Texas Medicaid Provider Procedures Manual Vol. 1, September, 2012, “If a person is not eligible for medical services under Texas Medicaid on the date of service, reimbursement for all care and services provided must be resolved between the provider and the client receiving the services. Providers are not required to accept Medicaid for services provided during the client’s retroactive eligibility period and may continue to bill the client for those services.” As of October 1, 2012, the City of Beaumont declares that it is under no obligation to accept Medicaid for services provided during the client’s retroactive eligibility period and may continue to bill the client for those services.
Why am I receiving a bill when I gave my insurance information to the paramedic?
The paramedics’ number one priority is the treatment and care of the patient. Sometimes complete insurance information is not documented.
How much will my insurance pay?
Insurance companies pay claims based on the type of coverage each individual policy provides. To determine this you must read the contract you have with your insurance company.
Medicare and Medicaid will absolutely not pay if you are not transported to a hospital. Medicare and Medicaid will also not pay if you are transported and they do not consider the reason for the transport to the hospital as life or limb threatening. Beaumont EMS does balance bill for any unpaid amount not received from the insurance company.
Why am I getting a bill when my insurance paid?
Beaumont EMS balance bills for all non-Medicare, Tricare, VA, Medicaid and Worker’s Compensation insurers. We do not have contracts with private insurance companies therefore we do not waive any unpaid portion of the bill.
If I was involved in an automobile accident, what insurance information do I need to provide?
Auto insurance, if you have personal injury protection (PIP), would be the primary insurance to file. If there is no PIP then submit your medical insurance information.
If I was injured on the job, what information do I need to file a claim?
We need the name of the employer, their physical business address and the name of their worker’s compensation carrier.
Can EMS reduce the bill?
As a governmental agency, Beaumont EMS is not able to adjust an outstanding balance and the State Constitution prohibits us from forgiving any debts that are owed.
The Texas Constitution: Article 3 – Legislative Department, Section 55 – Release or extinguishments of indebtedness to State, County, Subdivision, or Municipal Corporation. The Legislature shall have no power to release or extinguish, or to authorize the releasing or extinguishing, in whole or in part, the indebtedness, liability or obligation of any corporation or individual, to this State or to any county or defined subdivision thereof, or other municipal corporation therein, except delinquent taxes which have been due for a period of at least ten years (Amended Nov. 8, 1932).
The patient has passed away, what do I do with the bill?
If the patient has a surviving spouse, the spouse is responsible for the bill. If the patient had insurance we will file the claim and balance bill the surviving spouse. If the patient is not survived by a spouse the executor of the estate is responsible for ensuring payment. If there is no estate, no insurance and no spouse the account is put on an indefinite hold. We must receive documentation that there is no means to pay the account and a copy of the death certificate.
Does Beaumont EMS bill the person that causes the accident if it was not the patient’s fault?
No, Beaumont EMS only bills the person that used the service.
I did not call EMS, why am I receiving a bill?
If you were provided a service that has a fee, you will be billed. You have the right to refuse treatment and transport.
What is the cost of being treated and/or transported by EMS?
- Cost is based on the type of service that was provided, either Advanced Life Support (ALS) or Basic Life Support (BLS). There is also a difference if the patient was transported or not.
- Cost can be as low as $165.00 for an aid at scene to a minimum of $740.00 for a BLS transport for only one mile. Fees are approved by the City Manager.
Where can I find the fees for EMS Service?
- Assessment – No Transport $165.00
- BLS Emergency Transport $725.00
- ALS-1 Emergency Transport $775.00
- ALS-2 Advanced Life Support $775.00
- Mileage – per mile $15.00
Why is there a charge when I pay city taxes?
- The cost to operate Beaumont EMS is funded by the various revenue sources of the City of Beaumont, in addition to fees charged to the patients who use the services.
- Beaumont EMS takes all 911 calls seriously, and therefore when anyone initiates a call to 911 the emergency system is activated to dispatch a “unit” to the patient. This takes an ambulance unit “out of service” to respond to any other 911 calls, meaning they cannot go on any other emergency calls until they are “cleared” with the patient and with 911 dispatch. Therefore, that unit is being dispatched solely for the patient’s care and safety; that unit thus became unavailable to any other calls. There is a cost for the activation of the emergency system, the dispatching of a unit and the medical assistance provided to the patient.