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1. If I don't have health insurance, will other types of insurance pay for EMS services?

Many automobile and homeowners' insurance policies provide coverage for EMS transports. We recommend that individuals review their insurance policies and coverages. The County's billing services company will bill health insurance first, followed by auto insurance and then any other insurance that may apply.

2. How will billing-for-EMS-services work?

Beginning August 1, 2010, Madison County will generate a bill each time EMS services, including ambulance transports, are provided to a patient by the staff of the County's Department of Emergency Medical Services ("MEMS"). Madison County has contracted with Ambulance Medical Billing  (view the company's website for more information) to handle the billing process. Following receipt of EMS services, a patient will receive correspondence from Ambulance Medical Billing asking for confirmation of residence address and insurance coverage. Once information about a patient's insurance coverage has been verified, a claim form will be forwarded to his insurance provider, Medicare, or Medicaid as may be applicable. Patients themselves will not be billed until all insurance options have been exhausted.

3. If I have an outstanding unpaid balance, will I be refused ambulance service?

No. All patients will be treated and transported and no person will be denied service due to any delinquent accounts. Emergency service providers who respond to your call will have no knowledge of who has paid and who has not paid.

4. If Madison EMS comes to my house but I don't need an ambulance transport, will I receive a bill?

No. Fees for EMS services will be billed only if you are transported by ambulance.

5. What are the billing rates for EMS services?

Madison County will charge a fee of $13.00 per mile for each ambulance transport and a fee of $425 to $775 for EMS services provided in connection with the transport, depending on the level of EMS care required by the patient. There are three levels of EMS care: (1) Basic Life Support (BLS); (2) Advanced Life Support-1 (ALS1); and (3) Advanced Life Support-2 (ALS2).  Madison County's fees are established by a resolution of the Board of Supervisors, consistent with rates allowed by the Center for Medicare and Medicaid Services (CMS) for our geographic region.

6. What if I don't have insurance and am unable to pay, or I have insurance but am unable to pay any balances due?

No one will ever be denied treatment or transport based on his or her ability to pay. If a patient receives a bill that he/she is unable to pay, the patient should contact the billing services company to apply for a financial hardship waiver. A financial hardship application form will be sent out by the billing services company, upon request by an individual.

7. When will a financial hardship waiver be granted?

A financial hardship waiver will be approved if an applicant demonstrates that his or her household income, based on the applicable family size, is at or below 300% of current federal poverty guidelines.

8. Will I be billed for amounts not covered by insurance?

A County resident will be billed only to the extent of his or her Medicare, Medicaid or other health insurance coverage. Any remaining cost-sharing amounts (e.g., co-payments, deductibles) will be waived for County residents. If you are a County resident who is not covered by Medicare, Medicaid or any other health insurance coverage, charges for EMS services will be waived.  If you are a non-resident, then your insurance company will be billed and you will subsequently receive a bill for applicable cost-sharing amounts remaining after insurance claims have been processed. Any non-resident who is without any form of insurance coverage will be billed for the entire amount of the EMS services delivered. If a patient who receives a bill is unable to pay, then the patient may apply for a financial hardship waiver.