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1. Why does Caldwell County charge ambulance fees?

To reduce the tax cost of emergency medical services (EMS) for county residents; without ambulance fees, the cost of providing emergency medical care would fall completely on the residents of Caldwell County. Caldwell County EMS Division has charged ambulance fees for more than thirty-five years. The Caldwell County Commissioners authorized such fees to offset the tax cost of providing EMS to residents and visitors. While taxes provide the majority of operational funding, ambulance fees collected from EMS Billing, assist Caldwell County in providing the highest level of care to the citizens and visitors of our County.

2. What types of fees are charged and how much does an ambulance ride cost?

The EMS Billing Department follows the Centers for Medicare and Medicaid Services (CMS) "Fee Schedule for Payment of Ambulance Services" as described in Volume 67, Number 39 of the Federal Register. The new fees became effective July 1, 2018, enacted by the Caldwell County Commissioners, recommended by the Chief of EMS and Emergency Services Director and include the following:

• BLS Non-Emergency Transport: $450 is charged to patients receiving "basic life support" (BLS) level care. Basic life support (BLS) is transportation by ground ambulance vehicle and the provision of medically necessary supplies and services, including BLS ambulance services as defined by the State. The ambulance must be staffed by an individual who is qualified in accordance with State and local laws as an emergency medical technician-basic (EMT-Basic). These laws may vary from State to State or within a State. For example, only in some jurisdictions is an EMT-Basic permitted to operate limited equipment onboard the vehicle, assist more qualified personnel in performing assessments and interventions, and establish a peripheral intravenous (IV) line.
• BLS Emergency Transport: $525 is charged to patients receiving "basic life support" (BLS) level care. When medically necessary, the provision of BLS services, as specified above, in the context of an emergency response. An emergency response is one that, at the time the ambulance provider or supplier is called, it responds immediately. An immediate response is one in which the ambulance provider/supplier begins as quickly as possible to take the steps necessary to respond to the call.
• ALS Non-Emergency Transport: $470 is charged to patients receiving "advanced life support" (ALS) level care. Advanced life support, level 1 (ALS1) is the transportation by ground ambulance vehicle and the provision of medically necessary supplies and services including the provision of an ALS assessment or at least one ALS intervention.
• ALS Emergency Transport: $625 is charged to patients receiving "advanced life support" (ALS) level care who are in need of immediate, emergent transport. When medically necessary, the provision of ALS1 services, as specified above, in the context of an emergency response. An emergency response is one that, at the time the ambulance provider or supplier is called, it responds immediately. An immediate response is one in which the ambulance provider/supplier begins as quickly as possible to take the steps necessary to respond to the call.
• ALS-2 Transport: $780 is charged to patients receiving extended "advanced life support" (ALS) level care. Advanced life support, level 2 (ALS2) is the transportation by ground ambulance vehicle and the provision of medically necessary supplies and services including (1) at least three separate administrations of one or more medications by intravenous push/bolus or by continuous
• infusion (excluding crystalloid fluids) or (2) ground ambulance transport, medically necessary supplies and services, and the provision of at least one of the ALS2 procedures
• Specialty Care Transport (SCT): $755 - SCT is the interfacility transportation of a critically injured or ill beneficiary by a ground ambulance vehicle, including the provision of medically necessary supplies and services, at a level of service beyond the scope of the EMT-Paramedic. SCT is necessary when a beneficiary's condition requires ongoing care that must be furnished by one or more health professionals in an appropriate specialty area, for example, emergency or critical care nursing, emergency medicine, respiratory care, cardiovascular care, or a paramedic with additional training.
• Treat No Transport: $100
• Mileage: $10.50 per loaded mile is charged to all patients transported by ambulance. Transport mileage is measured from the incident location to the receiving hospital.

Please call our Department at 828-757-1279 or 828-757-1336 for additional information.

3. A fire truck came with the ambulance. Do I get charged for that too?

No. The Caldwell County EMS Billing only charges fees for treatment and/or ambulance transport. Fire trucks can respond to 911 calls faster than ambulances, meaning emergency personnel get to you quicker. No fees are charged for this service by our agency.

4. Why did the ambulance crew ask me for my personal information?

To verify your identity and prevent fraud. Because the Department charges fees for service, ambulance crews are instructed to verify patient identity including name, social security number, birth date, home address and telephone number. They also may ask for health insurance, automobile insurance or employment information, depending on the situation. Our Department requires identity verification to protect patients from fraud and to assure, if possible, you are covered by healthcare or other insurance.

5. Will my health insurance pay my ambulance bill?

In most cases, if the incident is classified as an emergency situation, yes. Patients who are covered by Medicaid or Medicare programs generally will have no out-of-pocket expenses related to ambulance bills. Patients who are covered by private healthcare insurance may be required to pay a co-pay or deductible expense, and/or the difference in coverage. This is entirely dependent on your insurance coverage and agency.

• More information relating to Medicare
• More information relating to Medicaid

6. What happens if I don’t have healthcare insurance?

We can help you! If you are transported by our agency without healthcare insurance, and you are not eligible for Medicaid, please call 828-757-1424 and ask to speak with a billing specialist. Our billing office staff will provide you with information on setting up a payment plan and any other options available.

7. What is the telephone number for ambulance billing questions?

For all questions related to ambulance billing including insurance, payment and hardship assistance, please call 828-757-1279 Monday through Friday (excluding holidays) between the hours of 8 am and 5 pm EST.

8. What is the payment mailing address and contact information for ambulance billing?

Please mail all correspondence concerning ambulance billing, including payments, forms, letters and other correspondence to:

Caldwell County Ambulance
P.O. Box 2200
Lenoir, NC 28645

Make checks payable to Caldwell County Ambulance

Main Phone: 1-877-200-9364
Medical Records Information: 828-757-1279
HIPAA Information: 828-757-1279

9. How can I find out more about HIPAA and Privacy?

Caldwell County EMS and Caldwell County EMS Billing may use your protected health information (PHI) for purposes of securing payment of ambulance charges. This may include submitting insurance claims, submitting claims to other third parties identified as responsible for payment of charges, or mailing you an invoice requesting payment. Claims for payment of charges may be submitted directly or through the use of a third-party billing company and/or clearing house. Follow-up use of PHI for payment purposes may include management of billed claims for services rendered, medical necessity determinations and reviews, insurance company appeals, utilization review, and collection of outstanding accounts. Designated agency personnel, including contractual personnel, may review and use PHI to verify your eligibility for certain services including eligibility for "hardship" classification, medical assistance programs, or other special designations.