EMS Billing

The Fallston Volunteer Fire and Ambulance Company (FVFAC) system of providing Emergency Medical Services (EMS) is focused on delivering world-class patient care: regardless of anyone’s ability to pay for such service. As each year goes by, the number of people living in Harford County and neighboring areas continues to rise. Consequently the number of medical emergency responses and our expenses also increase. By volunteering our time to answer these emergency calls, we help to reduce the cost of living for those residents in the Fallston area.

The implementation of an EMS transport billing (fee for service) program has no effect on the quality of care provided. The program will be transparent and a system of checks and balances will be established to ensure that all citizens are treated professionally, courteously, and with compassion.

No citizen will ever suffer financial hardship as a result of an EMS transport.

We will respond promptly, perform competently, and be courteous.

What is EMS transport billing (fee for service) and why has the FVFAC implemented this program?

EMS transport billing (fee for service) is the process of obtaining financial reimbursement for the cost of providing medically necessary ambulance transportation. Medicaid, Medicare, and most other private insurance policies (health, auto, and homeowners) already allow for reimbursement for this service. The FVFAC has implemented this program to seek reimbursement of these funds which will help to cover our operational expenses for providing EMS services while giving some relief to our general funding sources and ultimately, to the citizens and taxpayers

Doesn’t an EMS billing system amount to “double taxation?” As a property owner, I am already paying taxes that fund emergency medical services through Harford County’s financial support of the Harford County Volunteer Fire and EMS Association.

No. Charges for EMS transport services result in revenues that should actually decrease the tax burden for Harford County citizens. The fees are paid as part of insurance coverage for County citizens and non-citizens alike. In addition, those persons who do not pay County taxes but require FVFAC EMS services will also be bearing their share of the costs of the services that are otherwise funded by the County. For Harford County citizens, the taxes paid will be considered as payment for establishing the EMS service in their community.

Why am I being billed for EMS (ambulance) transport service? Isn’t the service free?

Each year our emergency call volume increases – and the cost of delivering critical emergency services increases as well. These costs include training, equipment, apparatus, and facilities in addition to personnel costs to supplement our volunteers. In order to partially recoup costs and help ease the burden on taxpayers and property owners, we bill insurance carriers. The demand for, and cost associated with, providing this essential service will continue to rise as Harford County and the regional population continues to grow.

How does EMS transport billing work?

The FVFAC has contracted with an independent EMS transport billing company to manage our fee recovery program. The company is required to adhere to stringent rules concerning patient confidentiality, professionalism, and courtesy in the administration of the EMS transport billing program. For those Fallston area residents that have contributed to the FVFAC Ambulance Club Fund Drive for the current year, your donation will be considered as payment for any portion of the fee that is not covered by your insurance.

How will insurance information be obtained?

Patient care and attending to a patient’s needs are always the most important priorities in EMS. If the patient’s insurance information is not available at the time of the transport, as is often the case, the independent billing company will work with the transported patient and/or their representative to obtain the necessary information. This may include a request, mailed to the patient’s address, for correct insurance information or an authorization to bill the patient’s insurance carrier. Upon receipt of the correct insurance information, the billing company will submit a claim to the insurance carrier.

Will I have to pay for the service at the time it is provided / rendered?

No. Absolutely not! No payment will be expected at the time of transport and all persons will be transported regardless of insurance coverage or their ability to pay.

Will an EMS transport billing system result in higher health insurance premiums?

Generally, health insurance plans and federal programs, such as Medicare, already provide coverage for medical transport. Therefore, implementing this charge should have no direct impact on health insurance premiums. It is a coverage that is being paid for but was not being utilized by emergency service providers such as FVFAC. Health insurance premiums are based on many factors. The State Insurance Commission controls insurance premiums and reviews and proposed changes quarterly to prevent abuse by insurance companies.

How will my privacy be protected?

Federal HIPAA laws related to patient confidentiality are strictly followed. All FVFAC EMS care providers are trained in patient privacy matters as part of their EMS training. Information related to patient privacy regulations is available from and will be distributed by our EMS crews.

If I call 911 for EMS care and I do not have insurance of any kind, or my insurance carrier will not cover the claim for the transport, will I receive a bill?

You will receive a statement from the billing company that will ask for your insurance information and will reflect the total billed amount for the transport to the hospital. If your insurance company has denied your coverage for this service, and /or you have a deductible, a co-pay, or have no insurance you will receive a request for payment. However, no person will ever be denied EMS service including transport to a hospital regardless of their ability to pay.

Will the billing company send uncollected transport fees to a collection agency?

No. Absolutely not! Patients transported by FVFAC ambulance to a hospital will never have an unpaid transport bill sent to a collection agency.

Who will I call if I have a billing or insurance problem?

The EMS billing company has customer service representatives to address billing and insurance questions through a toll-free number and the internet. The number to call with questions is 1-800-369-7544 (M-F 8:30 am until 4:30 pm). If you are not satisfied, you may contact FVFAC EMS Assistant Chief Michael Kalck by email at emschief@fvfac.org.

What happens if I call 911 and do not need to be transported? Will I be billed?

No. A fee will only be imposed if you are transported to a hospital. You will, however, be required to sign a refusal of care form releasing the medical providers and the FVFAC from any liability arising from your refusal to accept transport to the hospital.

Have other fire departments and jurisdictions in this region implemented an EMS transport billing (fee for service) program?

Yes. Similar programs have been proposed or have been implemented in Anne Arundel County, the City of Annapolis, Baltimore City, Baltimore County, Carroll County, Cecil County, Fort Meade, Frederick County, Montgomery County, and Prince Georges County. Sources indicate that between 70-85% of all EMS services nationwide bill for service and/or transport to the hospital as a means of cost recovery / service enhancement.

If an ambulance responds into or from another County and provides EMS transport, what billing policy applies?

The FVFAC, as well as all other Harford County Volunteer Fire and Ambulance Companies, have mutual aid agreements with all surrounding jurisdictions. In those instances when an ambulance responds into another county and transports a patient to the hospital, the billing policy of the transporting ambulance applies. FVFAC policies cannot vary due to the policies of another jurisdiction. In addition, Federal Medicare/Medicaid requirements stipulate that FVFAC cannot bill for patient transports on a selective basis. All patients that are transported must be billed for service. FVFAC will seek cost recovery when it responds outside of Harford County

How does this program benefit the Volunteer Fire Fighters and Fire Companies in Harford County?

Funds made available through EMS transport billing are used to support your Volunteers by maintaining existing facilities, providing personal protective equipment, replacing disposable supplies, obtaining fuel for apparatus and provide training. The Harford County Volunteer Fire and EMS Association and Harford County have expressed support of an EMS transport billing program.

I have always contributed to my local volunteer fire company? Will they still need my donation?

Yes! All Harford County Volunteer Fire Companies and those in neighboring jurisdictions use donations to make capital purchases (fire apparatus), make improvements to existing facilities, and plan for long term financial growth. Your donations make it possible for volunteer fire companies to remain a vibrant part of our emergency services delivery system throughout the region.

To request copies of EMS transport billing statements or for Attorney requests for EMS documents please email your request to Jessica Blake at 14988@fvfac.org. Please include all pertinent information including return address and telephone number.