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Ambulance Service FAQ

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Q: What is EMS transport billing (fee for service), and why is the City of Surprise implementing this program?

A: EMS transport billing (fee for service) is the process of obtaining financial reimbursement for the cost of providing medically necessary ambulance transportation. Medicaid, Medicare, and most other private insurance policies (health, auto, and homeowner) already allow for reimbursement for this service. The City of Surprise is implementing this program to seek reimbursement of these funds that will help supplement some of the operational expenses for providing Fire, Rescue and EMS system while giving some relief to the general fund and ultimately the taxpayer.

Q: When did the City of Surprise begin billing for EMS transport?

A: The program was authorized to begin August 4, 2015 by the Surprise City Council and will be activated in November 2015.

Q: How is charging for EMS transport authorized?

A: On January 20, 2015 the Surprise City Council amended Municipal Code Chapter 18 Sec. 2, to permit such action.

Q: What are the charges for EMS transport?

A:

The City will charge a fee of $997.05 per Advanced Life Support (ALS) transport, $888.15 per Basic Life Support (BLS) transport, $20.67 per mile traveled to the hospital.

Q: Doesn’t an EMS billing system amount to “double taxation?” As a property owner, I am already paying taxes that fund emergency medical services through the fire department.

A: No. Charges for medical transport services result in revenues that should actually decrease the tax burden for Surprise residents. The fees are paid in part by insurance coverage by residents and non-residents alike. In addition, those persons who do not pay city taxes will also be bearing their share of the costs of the services that are funded by the city. Like citizens of Surprise, those residing outside of city limits will be billed for any balance due.

Q: Why am I being billed for ambulance transport service? Isn’t the service free?

A: Each year the City of Surprise’s emergency call volume increases by approximately 5% – in 2014, the Surprise Fire-Medical Department received over 14,000 calls for assistance and the cost of delivering critical emergency services approaches $18 million annually including personnel, training, equipment and apparatus. This is a special revenue fund with a goal of keeping the program cost neutral to not burden the tax payers. We will bill insurance carriers for a portion of these services. The demand for, and cost associated with, providing this essential service will continue to rise as our population grows.

Q: How does billing work?

A:

The City of Surprise has contracted with an independent EMS transport billing company to manage fee recovery. The company, ImageTrend, is required to adhere to stringent rules concerning patient confidentiality, professionalism, and courtesy in the administration of the EMS transport billing program. All patients, residents and non-residents will also be billed for balances due accordingly.

Q: How will insurance information be obtained?

A: Patient care and attending to a patient’s needs are always the most important priorities in EMS. Fire department Emergency Care Technicians may seek patient insurance information at the appropriate destination site and time provided. After transport, the independent billing company will work with the transported patient and the receiving hospital to obtain the necessary information. This may include a written request for authorization to bill the patient’s insurance but this is not a bill or request for payment. Upon receipt, the company will submit a claim to the insurance carrier. No further correspondence should be received until the insurance company has made a determination of payment.

Q: Will I have to pay for the service at the time it is provided / rendered?

A: No. No payment will be expected at the time of transport and all patients will be transported regardless of insurance coverage or their ability to pay.

Q: Will an EMS transport billing system result in higher health insurance premiums?

A: Generally, health insurance plans and federal programs, such as Medicare, already provide coverage for medical transport. Therefore, the City implementing this charge should have no direct impact on health insurance premiums. It is a coverage that is being paid for and is being used for the transport of individuals within the city limits of Surprise, currently provided by Rural/ Metro Southwest. Health insurance premiums are based on many factors. The State Insurance Commission controls insurance premiums and reviews proposed changes quarterly to prevent abuse by insurance companies.

Q: How will my privacy be protected?

A: Federal HIPAA laws are strictly followed by the Surprise Fire-Medical Department. All Department members are trained in patient privacy matters as part of their yearly EMS training. Each individual that is transported by The Surprise Fire-Medical Department will be informed of their rights and receive a copy of their Privacy Rights at the hospital. HIPAA Notice of Privacy Practices

Q: I am a City resident and I do not have insurance of any kind. Will I receive a bill?

A: No person will ever be denied EMS transport regardless of their ability to pay. City resident as well as non-city residents will receive invoices, and the City will attempt to collect the sums due.

Q: If a resident has reached an insurance limit for EMS transport for the year, and additional services are required, will they get a bill for the services, or can the fee be waived?

A: Historically, this has not been an issue based on various insurance carriers and most, if not all, policies do not place a limit on medically - necessary transports related to EMS service.

Q: Will the billing company send uncollected transport fees to a collection agency?

A: Yes, City of Surprise residents will have an unpaid transport bill sent to a collection agency if a plan for payment is not determined.

Q: Will the EMS transport billing program disproportionally affect those most in need of the service – specifically the elderly, working poor, and chronically ill?

A: No. First and foremost, anyone who calls 911 will be provided service regardless of their ability to pay. Second, City residents have been paying many of the same fees charged by Rural/ Metro Southwest and that were not covered by insurance. Third, a compassionate billing program will be put into place to serve as a safety net for individuals struggling financially. Fourth, federally supported Medicare and Medicaid programs are specifically designed to assist such groups by providing health care coverage when commercial insurance is unaffordable.

Q: Who will I call if I have a billing or insurance problem?

A:

The EMS billing company (ImageTrend) has customer service representatives to address billing and insurance questions through a toll-free number. The number to call with questions is 833.469.7789 opt. 1. If you have any questions or concerns, you may contact the Fire-Medical Department at 623.222.5005. You can also email the Fire-Medical Department with questions / concerns at Ambulance.Billing@surpriseaz.gov

Q: As a citizen, if I call 911 for someone else, am I responsible for any bill resulting from an EMS transport, even if I am not the person transported?

A: No. The fee relates to the person who is transported by ambulance.

Q: Will the ability to pay be considered when providing service? I fear that some people will delay in calling for EMS services based on their ability to pay for such services.

A: Although this is a perceived fear, extensive evidence from other agencies who have implemented a billing program have found such statements to be completely FALSE. The ability to pay will never be considered when providing service. When citizens need emergency assistance, they should call 911 immediately. The program is not intended to decrease call volume in any way.

Q: Have other localities implemented a successful EMS transport billing (fee for service) program?

A: Yes. Similar programs (unique to their demographic landscape) have been proposed or implemented in the City of Phoenix, North County Fire District and the Daisy Mountain Fire District. Sources indicate that between 70-85% of all EMS services nationwide bill as a means of cost recovery / service enhancement.

Q: If an out-of-City ambulance responds into the City and provides EMS transport, what billing policy applies?

A: The City enters into mutual aid agreements with surrounding jurisdictions. In those instances when an out-of-city ambulance responds to a call within Surprise city limits and then transports a patient to the hospital, the billing policy of the out-of- city ambulance applies. The City of Surprise cannot affect the policy of another jurisdiction. Vise- versa the City of Surprise will also seek cost recovery when it responds outside of the city to other areas requested by those jurisdictions.

Q: Will an EMS transport billing system result in a loss of volunteers in City of Surprise?

A: The City is fortunate to have a dedicated cadre of well-trained and active volunteers and does not expect any decrease in volunteerism associated with an EMS transport billing system, despite a downward trend in volunteerism nationwide. The City of Surprise will always support a Fire/Rescue system that promotes volunteerism, as it continues to develop a delivery model that ensures continuity of care and consistency. One of the goals of the program is to promote volunteerism through shared training oppertunities and support.