Emergency Medical Services Billing Frequently Asked Questions
What are Emergency Medical Services?
Prince William County Fire and Rescue EMS resources provide high quality medical care to our residents and visitors through a two-tiered EMS system where both basic life support and advanced life support is provided on a 24/7 basis.
What is the EMS Billing program?
The EMS billing program is a revenue initiative for emergency medical incidents which result in the transport of a patient to a hospital. The patient’s health insurance company will be billed for services rendered similar to the process hospitals or doctors use now. Transport services are already included in insurance premium calculations. Not billing for these services which are already paid for results in the County losing legitimate revenue.
Why begin the EMS fee now?
Prince William County has grown tremendously over the decades and that growth has placed service delivery demands on our system. The new economic reality requires us to evaluate every possible option for stabilizing revenue while considering the amount of tax burden placed on our citizens. The majority of the surrounding jurisdictions already have an EMS billing program in place. The Prince William County Board of Supervisors and the Department of Fire and Rescue implemented the EMS billing program on July 1, 2011.
How will this fee impact service?
This program will not impact the service that Fire and Rescue provides. Emergency medical care and transport of our residents and visitors remains the top priority of Fire and Rescue. EMS will always be provided without regard to anyone’s ability to pay.
How will my insurance company be billed?
Prince William County will seek to bill the appropriate third party payer for transported patients by using a third party billing company to perform the specialized service of insurance billing. Your insurance company will pay the bill in the same manner other medical bills are paid.
What if my insurance company won’t pay?
The billing approach Prince William County will use is described as a “compassionate” approach meaning the direct financial impact to County citizens is minimized. Any remaining co-payment or deductible after the insurance company has been billed will not be charged to the County resident.
What if I have Medicare?
Medicare will pay 80 percent of the allowable charge for medically necessary EMS transports. For County residents the remaining co-payment or deductible will not be charged.
Will I have to show proof of insurance before Fire and Rescue will transport me?
No. Emergency medical services and transport will be provided in the same way it has always been. Billing activities will be performed after any medical treatment has been provided and the emergency has been stabilized.
How will my privacy be protected?
The Health Insurance Portability and Accountability Act (HIPAA) ensures patient information is protected. The County will be a covered entity under HIPAA’s privacy and security regulations and will continue to adhere to these standards.
How will the revenue generated by the EMS Billing program be used?
The Fire and Rescue Association Board of Directors will provide recommendations to the County Executive and the Board of County Supervisors for its consideration. These recommendations will address system wide EMS delivery needs.
Where can I get more information?