Show All Answers

1. Why do I have to pay for a public service like EMS? Don't I already pay taxes for that?

Actually, very little of our operational budget comes from tax-based funding. In fact, less than 20% of our budget comes from the taxpayers of Butler County. The remainder of our operational budget comes from billing for our services.

2. Why didn't Medicare cover my ambulance bill?

Unfortunately, Medicare does not always cover ambulance charges to the hospital. It is important to remember that Medicare is a benefit, not an insurance plan. Medicare determines whether an ambulance trip is "medically necessary" by an established set of guidelines. Many factors contribute to this decision by Medicare. Some of these factors include:

• Did the patient's condition at the time 9-1-1 was called warrant immediate medical attention? Remember, this decision is made by Medicare, not by the EMS staff attending to the patient.
• Could the patient have been taken to a hospital by any other means of transportation other than an ambulance?
• If the patient was being transferred from one hospital to another hospital by ambulance, could the patient have received the same level of required care from the transferring hospital? Also, in many cases Medicare will not pay for transport from a "greater" facility to a "lesser" facility, which includes being transported from a hospital back to a residence.

3. What does Medicare cover in relation to the costs associated with EMS services?

Medicare will cover medically necessary ambulance transportation to the nearest appropriate medical facility. Emergency ambulance transportation may qualify for Medicare coverage if the transport is a result of a sudden onset of a medical condition or a traumatic injury when delaying immediate medical attention could reasonably result in placing the patient’s health in serious jeopardy, impairment to bodily function, or serious dysfunction to any bodily organ or part. Medicare requires that all ambulance transportation be medically necessary and reasonable.

4. What do I do if Medicare does not pay my ambulance bill?

If Medicare does not cover your ambulance bill, you have the right to file with Medicare for a Medical Review. This process is explained in the Medicare Remittance Notice that the patient receives from Medicare in the mail. When filing for a Medical Review, it is recommended that the patient provide the following documents to Medicare:

• A letter from the patient's family physician explaining why the ambulance transport was medically necessary
• Copies of the patient's ambulance transport medical records. The patient may contact the Butler County EMS Billing Office at (316) 321-9260 to obtain a copy of his/her records
• Copies of the patient's medical records from the hospital that the patient was transported to
• A letter from the patient explaining why 9-1-1 was called for medical assistance

Notice: Filing for Medical Review does not guarantee that Medicare will reverse their original decision, but is an option to all patients covered through Medicare.

5. Why wasn't a claim filed with my secondary insurance company after Medicare denied my claim?

Most patients have insurance coverage secondary to Medicare. However, most of these secondary insurance policies are Medicare Secondary Supplement Policies, such as Blue Cross and Blue Shield Plan 65. These secondary insurance coverage plans will only cover balances after Medicare pays their coverage rates. Therefore, if Medicare does not cover the charges, then neither will most of the secondary insurance plans.

6. The hospital filed with my insurance company, so why didn't Butler County EMS?

If a patient receives a bill for their ambulance transport without insurance being filed, it is most likely because the EMS Billing Office does not have complete insurance information on file for the patient. Please contact the Billing Office at (316) 321-9260 or fill out the insurance information form on the back of your statement and return it to our offices at:
701 N. Haverhill
El Dorado, KS 67042

Once all insurance information is on file with our billing office, we will gladly file a claim with your insurance provider.