Some people may wonder why am I receiving a bill for ambulance service?
The answer is simple. In recent years the call volume for our agency has increased. With that increased call volume comes increased budget demands. In an effort to keep this burden off the taxpayer the Village decided to start billing for EMS Services in 2011. We can proudly say that with our recent partnership with EMR billing services the Cobleskill Rescue Squad is completely self sufficient. We generate enough funds to pay back our approved budget as well as generate extra funds. The hope being that with these extra funds when the time comes to replace equipment or even an ambulance there is already money set aside for these projects keeping this burden off the taxpayers.
How is the bill determined?
When an EMS crew from Cobleskill is dispatched for a 9-1-1 call we have to create a PCR or Pre-Hospital Care Report. This document serves two purposes. First and most importantly it serves as a legal document and official record of the incident. A copy of this document goes to the hospital to which you were transported for their records and background information on what happened prior to your arrival and another copy is sent to the NYS DOH Bureau of EMS for record keeping in case the related incident is ever moved to a court room setting.
The second purpose of the PCR is based on the documentation it generates a bill for services. Depending on the nature of the call will determine the base price of the bill. For example if the call is a BLS or Basic Life Support call the average fee for those services is $400 just for being there. Where as if it is an ALS or Advanced Life Support call meaning the need of a Paramedic is determined the average base fee is $800. Then other items get added to that bill based on certain treatments or medications given. If transported there is a set rate per mile that gets added into the bill as well. All these things added together will determine the overall amount for services rendered for that one EMS call.
I know what your thinking? Sounds expensive how is anyone supposed to pay for that out of pocket?
The answer to that question is you shouldn't have to. Once the PCR is completed and submitted electronically the billing company takes all the data and compiles the bill. From there based on information from our documentation and information provided by the hospital your primary insurance carrier gets the bill. EMS services is covered by most if not all private insurers as well as Medicare and Medicaid. If you are involved in a Motor Vehicle Accident we will gather at least your car insurance provider and any treatment/transport should be covered through your No Fault Insurance. In general your insurance carrier should pay all or at least a majority of the bill for any and all EMS calls. Unfortunately there are times where the insurance carrier doesn't cover all or any of the costs of the ambulance.
What happens then?
If remaining parts or the total bill gets pushed back to you there are options. At that point you would contact the billing company with the number provided on the bill. From there payment plans or other options can be discussed.
Can I refuse an ambulance?
The answer is yes. However, it is not always advisable. Many people will refuse to be transport due to the fact of poor or no insurance. As mentioned before there are options and if it is a true emergency no one should ever let that determine the need for emergency treatment/transport. However, it is your right as an individual to refuse as long as the situation is acceptable.
Are there times I can't refuse?
Most certainly there are. The two most common situations where you can't reuse are you are a minor which by NYS DOH standards is anyone under the age of 18. If you are in an accident or an ambulance is called and you are 17 or younger you don't have the right to refuse transport and as EMS providers we are required to transport you. The only person that can override that decision is a parent or legal guardian. They are allowed to refuse on your behalf if they are present.
The second most common situation is you are determined to not be of sound mind at the time of the call to make a proper judgement. This can be a result of head injury that results in you not being fully alert and oriented to your surroundings. It could be a result of possible drug/alcohol use/overdose. This would put you in a mental state that could be determined to be not of sound judgement. Even if you are experiencing a diabetic emergency it can alter your mental status to where you must be transported to the hospital. It's nothing personal but it's the law and all NYS DOH EMS providers are bound by the laws and regulations.
I hope this clears up some of the mystery and common questions in regards to the billing practices of our agency. Any further questions can be directed towards us through the contact us section of this website or your best bet is contact the billing agency directly.
Thanks for your support and understanding.