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Q: What are the charges for Treat and Refer?

A:

The City will charge the Arizona Health Care Cost Containment System (AHCCCS) a fee of $203.80 per event for the following events: Response and Treatment, No Transport; Treat at home, refer to Primary Care Physician/specialist; Treat at home, refer to Crisis Response; Treat at home, refer to Behavioral Health Provider; Treat at home, refer to Urgent Care. These fees became effective on 10/01/2016. Questions about AHCCCS Fee-for-Service reimbursement rates can be Emailed at FFSRates@azahcccs.gov.

Q: How does Treat and Refer billing work?

A:

The City of Surprise has contracted with an independent EMS billing company to manage fee recovery/billing. The company, AMB, is required to adhere to stringent rules concerning patient confidentiality, professionalism, and courtesy in the administration of the EMS transport and Treat and Refer billing program.

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 an appropriate time while service is being provided. After the service incident, the independent billing company, AMB, will work with the Surprise Fire-Medical Department and the health information exchange following the notice of health information practices to obtain the necessary information to work directly with the insurance provider. Upon receipt of necessary information, the billing company will submit a claim to the insurance carrier. At that point, no further correspondence should be received until the insurance company has made a determination about payment.

Q: I am a city resident and I do not have insurance of any kind. Will I receive Treat and Refer Service?

A:

No person will ever be denied Treat and Refer service regardless of their ability to pay.

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

A:

The EMS billing company (AMB) has customer service representatives to address billing and insurance questions through a toll-free number. The number to call with questions is 844.889.7701. If you are not satisfied, you may contact the Surprise Fire-Medical Department at 623.222.5054. You can also email the Surprise Fire-Medical Department with questions / concerns at medicalservices@surpriseaz.gov

Q: If an out-of-city fire department responds into the City and provides EMS service, is treat and refer an option and what billing policy applies?

A:

Out-of-City fire departments are not currently offering Treat and Refer service. In the instance when another jurisdiction or agency responds to a call within Surprise city limits to provide emergency medical service, the end result may include on-scene treatment either with or without transport to a hospital. If there is a transport to the hospital, the billing policy of that ambulance applies to the services rendered. If there is no transport to the hospital, the out-of-city fire departments are not currently charging for the response. The City of Surprise cannot affect the policy of another ambulance company. Vise- versa the City of Surprise will also seek cost recovery when it responds outside of the city to other areas when requested.