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Tax Administration - Ambulance Billing

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1. I thought this service was covered in my tax bill, no one ever told me there was a charge.

Charging for emergency services became effective for Orange County in October 1996. Your tax dollars are used to support the cost of providing ambulance service around the clock. The fees are used to offset the cost for providing emergency medical services to county citizens and to citizens that are not county residents. In addition to tax dollars, Emergency Services also seek federal funding to support operation cost. Ambulance fees assures compliance with applicable federal requirements and cost principles associated the those resources.

2. Does Orange County Emergency Medical Services bill medical insurance?

Yes. Orange County Emergency Medical Services bills Medicare, Medicaid and private insurance.

3. What if the insurance information was not given at the time of service?

If the information is not collected during your initial contact with EMS personnel, you will receive a statement of charges from Orange County EMS along with a patient insurance form (PDF). You are encouraged to complete this form so we will have all the pertinent information needed to file your claim correctly. Please include the following information: The policy number, subscriber identification number, group number, insured name and complete mailing address of the insurance company. 

Please mail, fax or email the completed form to our office promptly as this information is time sensitive. Please mail your completed form to the address found on top of the document. If you prefer, you may fax your form to 919-644-3091 or email the Tax Office an electronic copy. If insurance information is not provided within 6 months of the date of service, we may not be able to file your insurance due to timely filing limitations.

4. What if I never received a bill for this service? I did not realize there was a charge.

Emergency Medical Services (EMS) bills are mailed to the address given at the time of transport. Unless your bill is returned mail, we have no indication that you did not receive it. If your bill is returned, it is noted in our billing system, researched for a better address and re-mailed. We make every attempt to send bills and notifications to our patients. If you fail to receive your bill at the address you provided during the transport, you are still responsible for the charges.

5. Will you file with my insurance company for this bill?

Yes. Our office will file claims to your insurance company. We must have a signed medical release form from you on file. We may file up to the deadline imposed by the insurance companies. Medicare will accept claims up to 12 months from the date of service; Medicaid has a deadline of 12 months from the date of service. Private insurance companies require that the claim be filed within 6 months of the date of service. VA claims must be submitted within 30 days of the date of service.

6. Why did my insurance company mail the check to me?

Some insurance companies send checks directly to the policy holder. We will bile claims as a courtesy for the patient. It is the responsibility of the patient to make sure the bill is paid in full.

7. What if I gave my insurance information at the hospital and the insurance paid them. Why did you not file with my insurance?

Orange County Emergency Services is not connected with the hospital or its database. Therefore, we are unable to obtain that data from the hospital. You are our only source for your insurance information, and you must provide us with it in order for us to file your claim.

8. This is a Workman’s Compensation claim. Why are you billing me?

The patient is responsible for providing the Workman's Compensation company's name, address and claim number in order for us to file the claim with them.

9. How much time will Orange County EMS allow me to pay my ambulance bill?

Once your bill is active in our system, you will have 30 days to make a payment.

10. Can I make monthly payments on my account?

Yes. You can make monthly payments. However, you must be consistent with your payments. If you are unable to make a payment, you must call us in advance.

11. What if I want to dispute the charges or services?

If you disagree with charges on your bill, please contact billing at 919-245-2100 option 3. To dispute services, please contact the EMS Administration Office at 919-245-6124 to file a formal complaint.

12. The last time I was transported the charge was different. Why did this transport cost more?

There are different levels of service. Total charges are established according to the level or service and/or the mileage provided during the transport.

13. What are your fees for the level of service provided?

Charges are as followed:

• $150 Treatment Non-Transport
• $225 Treatment Non-Transport Level 2
• $568 Basic Life Support
• $675 Advanced Life Support
• $976 Advanced Life Support Level 2
• $12.00 per mile

These rates are subject to change.

14. Where should I mail my payment?

Make payments out to:

Ambulance Service EMS
Orange County Revenue
P.O. Box 8181
Hillsborough, NC 27278

15. Who do I make the check payable to?

Make checks payable to Orange County Revenue - Ambulance Service EMS

16. Can I pay with a credit card?

Yes. Please call 844-435-3981 and use your run number as the tax bill number. 

If you have issues with processing your credit card payment, please call the customer service number 888-891-6064 option 1 for assistance.

17. Can I setup my payments through Automated Draft?

No. We do not process automated drafts, but you may setup automated payments with your bank through Bill Pay. Please contact your bank for assistance.

18. Will my credit be affected if I fail to pay this bill?

We do not report to the Credit Bureaus, but we may take legal action by garnishing wages if bills are unpaid.

19. Do you offer discounts?

Orange County EMS is a government agency and a Medicare provider. Federal law prohibits this.

20. What if I can not pay the bill?

If you are experiencing financial hardship, and you are a current Orange County Resident, we have a program called EMS Assistance that is offered through the Orange County Department of Social Services (DSS). If your balance is your true balance after all insurance has been processed and resources considered, DSS will make a determination based on income to see if you qualify. If approved, your bill will be covered through this program. If you are interested, please download the Consent of Release Form (PDF) and either mail, fax or email to our office. Our mailing address is located at the top of the document. You can fax your completed form to 919-644-3091 or email the Tax Administration. Once we receive your form, you account will be placed on hold until DSS accepts or denies your request for assistance based on qualification. You will be notified once a decision is made.

21. What if I did not call the ambulance, but was transported. Am I responsible for the bill?

All Orange County EMS bills are considered the responsibility of the patient because the service was provided for the patient. The patient may reach out to the party that contacted the ambulance service to discuss options, but the patient remains primarily accountable for the bill.

22. Does Medicare pay for ambulance transportation?

Yes. When a patient's condition is such that the use of another method of transportation is medically inadvisable. Transportation must be deemed reasonable and medically necessary.

23. What if I was not transported?

If Orange County EMS was dispatched and offered a billable service such as a 12 lead EKG or administered medication, you may receive a bill for treatment non-transport. The fee for treatment non-transport is $150. For treatment non-transport level 2, the fee is $225.

24. Does Medicare pay for non-transports?

No. Non-transports are not a covered service with Medicare and many other insurance plans. As a courtesy, we will file non-transports to your insurance for consideration. Any balance remaining after insurance has processed our claim will become the responsibility of the patient.

25. What information is required by Orange County EMS before Medicare can be filed?

Orange County EMS must have the patient's authorization on file or the patient's authorized representative consent on record in order to file to Medicare.

26. Does Medicare pay this service in full?

No. Medicare will only pay 80% of the approved amount. The patient or their supplemental insurance will be responsible for the balance or co-insurance amount.

27. What if Medicare denies my claim? What options do I have?

Everyone has the option to appeal the claim within six months from the denial date. There are two ways to appeal either a Medical Necessity form completed by the doctor and / or a written letter form the patient.These are to be submitted to:
Medicare's Appeal Department.

Related Documents

• Medicare Level 1 Appeal Form (PDF)
  
• Medicare Links for Appeal Guidance
  
  

28. Does Orange County EMS file supplemental insurance?

Yes. When you provide Orange County EMS with your primary insurance information, please notify us that you also have supplemental insurance as well. We will need your supplemental policy information such as policy number, group number and the mailing address.

29. Can Orange County use legal measures to collect my Ambulance Fee?

Legal process can be pursued 120 days after transport if no insurance payment is pending and/or there has been no response made by you to the bills that we have sent out.

30. What is the garnishment process?

After 150 days of inactivity, the account becomes subject to garnishment.

31. How can I stop the garnishment process once it has begun?

The account must be paid in full to stop the process.

32. What happens if there is an overpayment on my account?

We will promptly process the necessary paperwork for a refund.

33. How long does a refund take to receive?

Anywhere from 2 to 3 weeks.

34. What if I do not have insurance?

We are happy to work with you by setting up a payment arrangement.

35. What if my bill is related to a traffic accident?

It is the patient's responsibility to provide liability information. Attorneys can request records and bills by faxing a consent of release documentation to 919-644-3091.

36. What methods of payment do you accept?

We accept cash, money orders, Master Card, Visa, American Express, or Discover.

37. What is your physical location?

To pay in person or speak to a representative about your bill, our physical location is:
Gateway Building
228 S Churton Street
Hillsborough, NC 27278

38. What if I move? Am I responsible if I do not receive a bill?

Yes. You are still responsible for your bill. It is your responsibility to notify us with your updated address.