Hampden EMS Subscription Service

Hampden Township EMS Services and Subscription Program
Posted on 09/12/2019
Newspaper photoHAMPDEN TOWNSHIP EMS SERVICES AND SUBSCRIPTION PROGRAM

Over the years, many insurance companies have changed their policies in regard EMS services that are covered.  They have either have reduced the amount that they will reimburse Ambulance and Advance Life Support (ALS) providers or deny the claim outright.  Medicare specifically, has denied or reduced coverage that, in the past, they approved.

WHAT DOES THIS MEAN TO YOU:
1. Subscribers to Hampden Township EMS will receive “medical necessity” services, and Hampden Township will accept what Medicare and Insurance Companies pay, as payment in full.  You will not be responsible for any co-payments.
2. Non Subscribers to Hampden Township EMS are responsible for ALL charges, co-payments, deductibles and denials.

LET’S EXAMINE THE POSSIBILITIES:
An ambulance call with ALS (Paramedics):

-Hampden EMS Base Fee:            $700.00
-Mileage Fee (Avg. Cost):          $60.00
-Oxygen and Supplies:                  $50.00
-Geisinger/Holy Spirit ALS Fees:  $1,300.00
-Total Service Fee:             $2,110.00

-Payment from Insurance:               -$ 450.00

AMOUNT YOU OWE:              $1,660.00 (As a Nonsubscriber to Hampden Township EMS)

Amount you WOULD OWE:             $0.00 (As a Subscriber to Hampden Township EMS)

The bottom line speaks for itself!

Subscribers are also subscribers of Geisinger EMS (which provides Advance Life Support) which will cover any ALS services which many insurers now deny.

Individuals should also be advised that Hampden Township EMS has a ‘Non-Transport Medical Assist Fee’ of $200.00 per response for any calls which do not include transport of the patient to a medical facility regardless if medical care is rendered.  This is necessitated due to the activation of the EMS crews which incurs significant cost even before services are rendered.  In addition, providing non-transport medical assists makes our EMS crews unable to respond to urgent medical emergencies, thereby creating a public safety concern for the community as a whole. 

Examples of ‘Non-Transport Medical Assist’ services include, but are not limited to: lift assists, patient refusals, wellness checks, and all other non-transport EMS services. The ‘Non-Transport Medical Assist Fee’ will be invoiced to the patient’s insurance company. However, if not covered by insurance or subject to a deductible, it will be the patient’s responsibility to pay the amount, in full, even if you are a subscriber of Hampden Township EMS.  Individuals who subscribe to Hampden Township EMS WILL NOT receive a waiver of this fee and will be personally responsible for payment of the full fee if not covered by insurance.

Question: What should I do if my insurance company sends a check to me for payment of services provided by Hampden Township EMS?

Answer: Reimbursement checks, or payment in the same amount, must be sent immediately to Hampden Township EMS for payment of services rendered.  If this is not done, your subscription will be terminated immediately, and you will be held responsible for payment of all outstanding balances which will be pursued by an outside billing service.

Question: What is not covered by a subscription?

Answer: The following services ARE NOT covered by your subscription.  Non-Transports which do not meet medical necessity criteria; any charges related to excessive mileage or other non-covered charges for transports, which are based solely on patient and/or physician preference and Non-transport medical assistance.

Question: Why should I be a subscriber to EMS if I have Medicare or other insurance?

Answer: First, your subscription assures that you will not be held responsible for any additional invoices for emergency medical service regardless of your insurance coverage for medical necessity services.  (Most insurance plans will not cover 100% of your EMS claim. Medicare and some other insurance plans do not cover Advance Life Support if you are not a subscriber.)


UNLIMITED NUMBER OF EMERGENCY CALLS THAT MEET MEDICAL NECESSITY.
Medical Necessity Medicare, Medicaid, as well as many commercial insurance companies require that the transport provided to the recipient meet specific criteria for medical necessity and must be a covered service. The criteria specifically requires that the patient could not have been safely transported by other means. Each ambulance transport is evaluated to establish whether it meets this criteria. If the transport or service does not meet medical necessity criteria or is considered non-covered, the claim, if submitted, must be submitted to the respective insurance carriers as non-covered.  The patient has the right to appeal this determination by contacting their insurance carrier directly.

ADVANCED LIFE SUPPORT (ALS)
Forty dollars ($40) of your membership fee is allocated for Advanced Life Support (ALS) provided by Geisinger EMS.  Your membership covers the basic fees for this service, which averages $1,300 per response.

ROUTINE TRANSPORTS
This service is provided by outside agencies when there is no immediate need to have the patient 
transported to a medical facility.  Be advised, this service is not covered under your subscription.


2019/2020 EMS Subscription Drive: EMS Subscription Brochure (View) Membership Enrollment Card (View)
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