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Chief Stone: How The Los Alamos County Ambulance Service Works

on July 3, 2015 - 10:48am
Los Alamos County ambulance fleet. Courtesy/LAFD
 
By BENJAMIN S. STONE, NRP
Division Chief  Emergency Medical Services
Los Alamos County Fire Department
 
When someone calls 911 for a medical emergency, emergency medical technicians and paramedics respond to your call. Often, this results in an ambulance transport to the emergency room.

Such a transport raises many questions for the patient and the family. Who is in charge of determining whether the emergency trip to the hospital was necessary? Who pays for the ambulance, the crew, and the equipment during the trip to the hospital? How are these costs set and by whom?

The Los Alamos Fire Department (LAFD) responders have one job to do, and that is to provide prompt medical attention and, if necessary, transport to the most appropriate hospital. Determining whether the ambulance ride was an emergency, as well as the fee schedule, is left to entities outside the Fire Department.

Costs for services are based on the level of service provided and mileage. This amount is dictated by the New Mexico Public Regulatory Commission, following the State Wide Ambulance Tariff. See http://www.nmprc.state.nm.us/transportation/docs/ambulancetarrif09.pdf.

The PRC approved the State Wide Ambulance Tariff as a means to regulate and unify ambulance costs across the state eliminating the variability of bills from each service. Currently, greater than 95 percent of the emergency medical service providers in New Mexico bill expenses based on this tariff.

Bills to the patient are not sent by or collected by the Los Alamos County or the Fire Department. The LAFD Emergency Medical Service utilizes a third party billing company contracted by the County of Los Alamos. That company is Ambulance Medical Billing (AMB) based in Paducah, Ky.

Once the medical report is complete, the LAFD submits the patient care report to the third party billing company. The Fire Department does not determine who is deemed eligible and what insurance carriers cover under “medically necessary treatments.”

The individual insurance companies and insurance regulations govern that decision. The Fire Departments job it to document what was found and the treatment administered. The mission of LAFD is to provide the best patient care possible in every situation.

For questions, comments or concerns, visit http://www.losalamosnm.us/fire/Pages/EMS.aspx, or contact EMS Senior Office Specialist Marisha Griego at 505.662.8310 or EMS Division Chief Benjamin Stone 505.662.-9376

Frequently Asked Questions:

  • What Happens after I receive ambulance services?

After receiving ambulance services from the LAFD, you may receive a bill for the total amount owed. (Applicable rates are included below.) You may submit your insurance information directly to the billing company. Once they receive your insurance information, they will promptly present the total amount owed to your insurance provider and attempt to collect payment. They will forward any unpaid balance to you. You are responsible for any balances owed after the insurance has paid.

  • Why do I have to pay?

The County does not levy any tax payer assessments to cover the cost of ambulance services. Any services provided are supported by user fees. This limits the cost of services to only those who use it. The fees for service are set by tariff as approved by the State of New Mexico’s Public Regulation Commission and the county’s Governing Body.

  • What if I do not receive a bill?

The County will charge all customers for services rendered. Our EMTs make every effort to collect as much information as possible at the time services are rendered. However, it is not always possible to collect enough information for the Billing Company to locate a customer. If you have not received a bill within 30 days of receiving services, contact a representative at:

AMB MARS
P.O. Box 9150
100 Fulton Court
Paducah, KY 42002-9200

Toll Free: 800.749.7026
FAX: 270.744.8642

or visit http://ambulancerevenue.com/

  • Do I have to accept EMS services?

No. You have the right to refuse any treatment. If the ambulance crew is turned away before making patient contact, you will not receive a bill, as no services will have been provided.  If you refuse transport to the hospital, but received an assessment by LAFD EMTs you will receive a bill following the New Mexico Ambulance Billing Tariff guidelines. You will also be required to sign a release form acknowledging that you have refused the LAFD’s services.

  • Do I have to pay the entire balance at once?

If you are uninsured, your insurance denies your claim or a balance remains after your insurance has paid, you will be responsible for the balance in full. Contact AMB MARS for payment plans.

  • What if I cannot afford my bill?

Several options are available, including establishing a payment plan as described above. In addition, programs such the Los Alamos Health Care Assistance Program exist to help. The Los Alamos County Health Care Assistance Program is a County program funded by the gross receipts tax and administered by the Los Alamos County Council. The Health Care Assistance Program reimburses contracted providers for the care and treatment of qualified individuals. Further information can be found at Health Care Assistance.

  • What if I wish to dispute my bill?

All disputes must be submitted in writing. The EMS Division will research the history of the case and examine the nature of the dispute and then respond with a written determination. Such written determination shall be final. Submit disputes to LAFD at:

ATTN:   LAFD EMS Division
            999 Central Ave Suite 200
            Los Alamos New Mexico 87544

or visit www.losalamosnm.us/fire/Pages/EMS.aspx

  • What are current ambulance billing rates?

Visit http://www.nmprc.state.nm.us/transportation/docs/ambulancetarrif09.pdf


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