Stafford County will begin charging fees for emergency medical transports on October 1, 2006, but individuals will not see any disruptions in the emergency response services provided by rescue personnel.

“No one will ever be denied medical transport because they cannot pay or do not have insurance,” said Rob Brown, Stafford’s Fire and Rescue Chief. “Everyone who requires an ambulance for an emergency will be transported as quickly as possible to the appropriate medical facility for treatment, just as they are today.”

The difference between service now and beginning on October 1 is that individuals will receive a bill for the ambulance ride. Most insurance companies, as well as Medicare and Medicaid, have already designated funds in their programs for ambulance transport. However, the County has developed a Compassionate Billing Policy to protect patients who are uninsured or underinsured. County residents without health insurance may claim financial hardship by submitting a good-faith statement about their household income. They are not required to provide banking information or tax records. Stafford County residents with a household income below $100,000 may also qualify for a waiver of ambulance fees. Non-residents transported by county ambulance will receive a bill, but they may apply for a financial hardship waiver.

Patients who are transported to a hospital or other treatment facility will be billed according to one of the following categories: Insured (County Resident or Non-Resident): the appropriate insurance carrier will be billed.

• Uninsured County Resident: The Compassionate Billing Policy (see below for explanation) allows for a waiver of emergency transport fees for eligible uninsured patients. A statement showing a zero balance will be issued to the individual who received emergency medical transport.

• Uninsured Non-Resident: A bill will be sent to the patient transported. Individuals who have the ability to pay will be expected to do so. Patients who can prove financial hardship in accordance with the Compassionate Billing Policy may qualify to have the fees waived.

• Patients will be asked to provide writteninformation about their insurance, such as an insurance card, to determine who will be billed for the ambulance service. If patients have insurance, their companies will be billed, and copies of invoices will be sent to the patient. When the charges for insured patients exceed the limit allowed for one calendar year and no other insurance coverage is available, the difference will be waived. 

The amount of the fees charged will be based on the level of care a patient receives during transport. The fees are based on rates set by the Centers for Medicare and Medicaid Services, a division of the U.S. Department of Health and Human Services. The following definitions apply:

• Basic Life Support: $350.00. Basic Life Support is provided for non life-threatening conditions. Examples include the application of splints or providing oxygen.
  

• Advanced Life Support Level 1: $450.00.  Examples of this type of support include electronic monitoring of heart palpitations or intravenous fluid replacement.

• Advanced Life Support Level 2: $550.00. Advanced life support is provided to patients with life-threatening medical conditions who may require, for example, surgical airways or the administration of three or more medications.

• Ground Transport Fee: $9.00. This fee will be assessed for each mile a patient is transported by ambulance.

In some cases, Medicaid, Medicare and insurance companies will pay only a portion of the bill. Patients with this coverage will not be required to pay any outstanding balances. Stafford residents who pay taxes and the elderly and disabled who qualify for real estate tax relief will not be billed for co-pays and/or deductibles for ambulance service.

If an insurance company determines that transport by ambulance was not medically necessary, the billing company will verify the information that was submitted and resubmit the claim. If the insurance carrier still determines that the transport was unnecessary, the County Administrator or his designee will review the case for possible waiver of the fees.

The Ambulance Fee Cost Recovery Program is designed to obtain funds for the County that insurance companies, Medicare and Medicaid have already designated for transport by ambulance. Individuals with these types of coverage are already paying for ambulance service. The fees are not an extra charge, and no one’s insurance premiums or taxes will increase as a result of the new program. The program is expected to generate approximately $1.9 million in revenue for the County the first year, which will be used to offset the costs of personnel, ambulance and equipment replacement, and supplies.

For more information about the Ambulance Fee Cost Recovery Program, please call the Fire and Rescue Department at (540) 658-7200.

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