EMS Billing FAQ

1. What is Emergency Medical Services (EMS) billing?
EMS billing is a service fee charged by the City of Kettering for ambulance transportation (paramedic or EMT) to a hospital facility.

2. Why does the City of Kettering charge for EMS services?
By billing insurance carriers for ambulance service, the city expects to avoid seeking additional tax revenue – in the form of levies — from residents for the new equipment and stations.

3. Where will the money go that the city receives from reimbursement?
The money will be used for fire department capital improvements such as new ambulances, fire engines, station improvements and/or new fire stations.

4. Who will be billed?
We will bill only the insurance carriers of Kettering residents who are insured or have Medicare coverage. In other words, if you live in Kettering and don’t have health insurance, we will not bill you. We will bill all non residents; however, even if they are not insured.

5. Who receives the ambulance bill?

• For those who work or live in Kettering, the ambulance bill goes directly to third-party payers. Third-party payers include Medicare,
  Medicaid and private health insurers. No bill should ever be sent to persons living or working in Kettering even if third-party payers
  do not pay. If you live or work in Kettering and receive a bill directly, please contact Kettering Fire Department at (937) 296-2489.
• For those who don’t live or work in Kettering, the initial ambulance transport billing goes to a third-party payer, if available. If the
  bill is not paid by Medicare, Medicaid or a private health insurer, we will bill the individual.
• You may receive an Explanation of Benefits (EOB) from your insurance carrier. This is not a bill. Your insurance carrier may not
  reimburse the city for the full fee, but rest assured, if you live or work in Kettering, you are not responsible for this difference.

6. How does it work?
Our crews will simply ask you a few questions. If you are covered by Medicare we may ask you to sign a form allowing us to bill Medicare. Our billing service handles the rest. If you are unable to sign the form when you are transported, our billing service may mail you the form. Please fill out the form, so we can file your claim.

7. How much does it cost?
The city will invoice Medicare or your insurance carrier reasonable and customary rates for this area based on the services you received.

8. Will this increase local insurance rates?
No. These costs have been built into your premiums for many years. More than 80 percent of the nation’s fire departments – that transport patients to the hospital – bill for these services. Ambulance costs are less than 1 percent of health care expenditures. Rate increases are driven by drug costs, technology and research. Billing at the allowable costs will have minimal impact on insurance premiums.

9. Let’s say, I am a Kettering resident and have insurance. I receive a bill for ambulance transportation, what should I do?
You should contact our billing company at 1-800-676-0111. If the problem is not resolved, call the Kettering Fire Department at (937) 296-2489.

10. What if my insurance doesn’t pay or only pays a portion of the fee?
If you are a Kettering resident or work in Kettering, you are not responsible for any co-pays, deductibles or any uncovered fees.

HIPAA (The Health Insurance and Accountability Act )

The City of Kettering (the “City”) is required by law to maintain the privacy of certain confidential health care information, known as Protected Health Information or PHI, and to provide you with a notice of our legal duties and privacy practices with respect to your PHI. The City is also required to abide by the terms of the version of this Notice currently in effect.   For the full City HIPAA policy, please read the document linked below.

Click for EMS Billing faq and HIPAA Policy pdf