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1. Understanding EMS
Billing
Medical Billers and Coders

2. Also known as ambulance or paramedic services,
Emergency Medical Services
(EMS/EMAS/EMARS) is the service used in case
of an immediate medical requirement. It is
especially dedicated to providing out-of-hospital
acute medical care and providing transport to
patients who are critically injured or ill and cannot
transport themselves. These services are also
known as ambulance/emergency/rescue/first-aid
or life squad/services.

3. EMS uses specially trained people (e.g.
paramedics) and equipment to provide immediate
medical assistance to a patient who might need it
at home before being transported to the
emergency room of a hospital. In addition, EMS
provides inter-facility transport. EMS also
constitutes of emergency medical technicians
(EMTs) who do precise rescue jobs and answer
calls.

4. The entire EMS system comprises private and
public organizations, communication and
transport networks, hospitals and rehab centers,
physicians, nurses, administrators and
government officials, and the public who knows
when to call whom. EMS also works with fire and
law enforcement services. But the most
important is the ambulance organization.

5. EMS Billing:
Like other services, EMS requires billing too. For any
calls for assistance, non-transports disregards, or
usage of ambulance transportation (paramedic or
EMT) to a hospital facility, a service fee is charged.
This fee for medical transportation is usually included
in the premiums that people pay for their insurance
through a private organization/Medicare/Medicaid
(insurance premiums are driven by drugs, research,
and technology and include the EMS costs). These
services are usually billed to the insurance payer
(Medicare, Medicaid) when a patient uses the
ambulance transportation facility to a local emergency
room and has health insurance.

6. For a private insurance agency, the patient might
have to pay co-pay or deductible and/or if there is a
difference in coverage. In some cases, if the
insurance does not pay the full amount, the patient
does not have to pay the difference (residency
status). But in the case of non-residents, they need
to pay the difference. Again, if the resident does not
have insurance, the bill could be written off after
verification. All other non-residents will be
responsible for co-pays and deductibles. According
to caldwellcountync.org, ‘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.’

7. The billing process is quite simple. A form is filled by
the resident (patient) which allows the hospital facility
to bill the insurance provider for the services rendered.
If the patient is unable to sign, the ambulance crew
and the hospital staff sign the bill to confirm the
transportation. And a fire truck, which comes with an
ambulance, is not charged. Sometimes, the patient’s
protected health information (PHI) could be used for
taking payments/charges for an ambulance.
The funds from EMS transport billing are used in EMS
and for operations of the fire-rescue department.
Integrated with other services, EMS is designed to
uphold and enhance the health and security of the
community.

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