EMS Billing Information for
Patient / Individual
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EMS|MC
EMS Management & Consultants |
Mailing Address:
PO Box 863 Lewisville, NC 27023 Phone: 1.800.849.5603 Website: https://emsmc.com/patient-portal/ Hours: Monday - Friday 8 am - 8 pm (EST) |
The City of Willard and Willard Fire & Rescue use a third-party billing agency, EMS|MC, to bill for EMS incidents.
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EMS|MC Patient Customer Service Department
Phone: 1.800.849.5603
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EMS|MC Patient Portal
Website: https://emsmc.com/patient-portal/
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How do I, as an individual or patient, obtain a copy of my EMS PCR (Patient Care Report) from the fire department?
EMS reports are confidential and contain privileged Protected Health Information (PHI), and are protected under the Federal HIPAA (Health Insurance Portability and Accountability Act) laws. The patient who was treated, or his/her power of attorney or legal guardian, can request a copy of the EMS Patient Care Report (PCR).
If you are a patient or individual seeking to obtain a copy of a Patient Care Report (PCR), please complete Form 1010 using the link below. After completion, please email, fax, mail, or drop it off at the station.
If you are an attorney, law office, or record retrieval company seeking to obtain a copy of the PCR or billing statement, the process has changed.
Attorneys, Law Offices, and Record Retrieval Companies: Please click this link to be redirected.
Form 1010 - Patient Request for Access to Protected Health Information (PHI)
Email: [email protected]
Fax: 419.933.7800
Mail: Willard Fire & Rescue, PO Box 367, Willard, OH 44890
Station: Willard Fire & Rescue, 425 Fort Ball Rd, Willard, OH 44890
EMS reports are confidential and contain privileged Protected Health Information (PHI), and are protected under the Federal HIPAA (Health Insurance Portability and Accountability Act) laws. The patient who was treated, or his/her power of attorney or legal guardian, can request a copy of the EMS Patient Care Report (PCR).
If you are a patient or individual seeking to obtain a copy of a Patient Care Report (PCR), please complete Form 1010 using the link below. After completion, please email, fax, mail, or drop it off at the station.
If you are an attorney, law office, or record retrieval company seeking to obtain a copy of the PCR or billing statement, the process has changed.
Attorneys, Law Offices, and Record Retrieval Companies: Please click this link to be redirected.
Form 1010 - Patient Request for Access to Protected Health Information (PHI)
Email: [email protected]
Fax: 419.933.7800
Mail: Willard Fire & Rescue, PO Box 367, Willard, OH 44890
Station: Willard Fire & Rescue, 425 Fort Ball Rd, Willard, OH 44890
Notice of Privacy Practices
To view or download our Notice of Privacy Practices, click the form below:
Form 1008 - Notice of Privacy Practices
To view or download our Notice of Privacy Practices, click the form below:
Form 1008 - Notice of Privacy Practices
Questions
Please contact the Compliance & Privacy Officer if you have questions:
Email: [email protected]
Phone: 419.935.8297 Ext 1343
Please contact the Compliance & Privacy Officer if you have questions:
Email: [email protected]
Phone: 419.935.8297 Ext 1343
No Surprises Act (NSA) and Ohio Balance Billing Protections
No Surprises Act (NSA)
PLEASE NOTE: The No Surprises Act is a new federal law enacted by Congress in December 2020. As noted in this interactive, some states have laws that have protected some state residents from surprise bills. The No Surprises Act will now protect all consumers with private health insurance— including the more than 163 million people with job-based coverage — from out-of-network surprise bills in certain situations. These new protections go into effect for health plan years that begin on or after January 1, 2022. Key rules implementing the new federal law were issued in July and September 2021.
“Balance bills” primarily occur in two circumstances: 1) when an enrollee receives emergency care either at an out-of-network facility or from an out-of-network provider, or 2) when an enrollee receives elective nonemergency care at an in-network facility but is inadvertently treated by an out-of-network health care provider. Since the insurer does not have a contract with the out-of-network facility or provider, it may decide not to pay the entirety of the bill. In that case, the out-of-network facility or provider may then bill the enrollee for the balance of the bill. While 33 states have enacted laws to protect enrollees from balance billing, the scope of these protections varies as shown in the map below. Congress enacted the No Surprises Act in 2020 to protect most people who are not currently protected under this patchwork of state laws. This federal law goes into effect on January 1, 2022.
PLEASE NOTE: The No Surprises Act is a new federal law enacted by Congress in December 2020. As noted in this interactive, some states have laws that have protected some state residents from surprise bills. The No Surprises Act will now protect all consumers with private health insurance— including the more than 163 million people with job-based coverage — from out-of-network surprise bills in certain situations. These new protections go into effect for health plan years that begin on or after January 1, 2022. Key rules implementing the new federal law were issued in July and September 2021.
“Balance bills” primarily occur in two circumstances: 1) when an enrollee receives emergency care either at an out-of-network facility or from an out-of-network provider, or 2) when an enrollee receives elective nonemergency care at an in-network facility but is inadvertently treated by an out-of-network health care provider. Since the insurer does not have a contract with the out-of-network facility or provider, it may decide not to pay the entirety of the bill. In that case, the out-of-network facility or provider may then bill the enrollee for the balance of the bill. While 33 states have enacted laws to protect enrollees from balance billing, the scope of these protections varies as shown in the map below. Congress enacted the No Surprises Act in 2020 to protect most people who are not currently protected under this patchwork of state laws. This federal law goes into effect on January 1, 2022.
Ohio: Comprehensive Balance Billing Protections
Notes:
*While “ambulance” is broadly defined as "any motor vehicle that is used, or is intended to be used, for the purpose of responding to emergency medical situations, transporting emergency enrollees, and administering emergency medical service to enrollees before, during, or after transportation," the Superintendent of Insurance will also have the ability to further define the term by regulation.
**Payment standard is defined as the greatest of 1) the median rate negotiated with in-network providers, facilities, emergency facilities, or ambulances for the service in question in that geographic region under that health benefit plan [this amount is disregarded when there is no per service amount, such as when there is a capitation payment in place.] 2) the usual method paid for OON services, such as the usual, customary, and reasonable rate amount, or 3) the Medicare rate. In all cases, in-network coinsurance, copayments, and deductibles are excluded.
***In lieu of accepting the reimbursement rate, provider, facility, or ambulance service can choose to negotiate reimbursement with the health plan. If good faith negotiation does not come to a resolution within 30 days, the provider, facility, or ambulance service can request binding arbitration if 1) service in question was provided not more than one year prior to the request and 2) total amount of individual or bundled claims exceeds seven hundred fifty dollars.
The Department of Insurance contracts with a single arbitration entity to perform all arbitrations described. Each party submits a final offer to the arbitrator, along with any additional evidence that relates to factors the arbitrator is directed to consider. The arbitrator is directed to select the final offer that best reflects a fair reimbursement rate based upon the factors considered. The non-prevailing party is responsible for 70% of arbitration fees, with the prevailing party responsible for the remaining 30%. The arbitrator will perform arbitrations on a flat fee basis.
Factors for the arbitrator to consider include 1) In-network rates that other health benefit plans have reimbursed the out-of-network provider for the service in question and factors determining that rate (2) In-network rates that the health benefit plan has reimbursed other providers for the service in question in that particular geographic area and factors determining that rate; (3) In-network reimbursement rates previously agreed upon between parties, if the health benefit plan and provider have had a contractual relationship in the previous six years. (4) The results of, or any documents submitted in the course of, a previous arbitration between the parties.
****Protections do not apply to non-emergency services if the enrollee had the ability to request non-emergency services from an in-network provider and the following requirements are met: 1) out-of-network provider informs the enrollee that the provider is not in the enrollee's health benefit plan network 2) out-of-network provider provides the enrollee a good faith estimate of the cost of the services, alongside disclosure that the enrollee is not required to obtain services from that that location or from that provider, and 3) enrollee affirmatively consents.
- State requires insurers to hold enrollees harmless for amounts beyond in-network level of cost sharing
- Above protection applies:
- To HMO and PPO enrollees
- For (1) emergency services provided by out-of-network professionals, facilities, and ground ambulance service providers* and (2) non-emergency services provided by out-of-network professionals at in-network facilities
- Provided by those classes of health care professionals as defined by regulation
- State provides a payment standard**
- State provides a dispute resolution process***
- Protections do not apply to:
- enrollees of self-funded plans
- enrollees who consent to out-of-network non-emergency services****
Notes:
*While “ambulance” is broadly defined as "any motor vehicle that is used, or is intended to be used, for the purpose of responding to emergency medical situations, transporting emergency enrollees, and administering emergency medical service to enrollees before, during, or after transportation," the Superintendent of Insurance will also have the ability to further define the term by regulation.
**Payment standard is defined as the greatest of 1) the median rate negotiated with in-network providers, facilities, emergency facilities, or ambulances for the service in question in that geographic region under that health benefit plan [this amount is disregarded when there is no per service amount, such as when there is a capitation payment in place.] 2) the usual method paid for OON services, such as the usual, customary, and reasonable rate amount, or 3) the Medicare rate. In all cases, in-network coinsurance, copayments, and deductibles are excluded.
***In lieu of accepting the reimbursement rate, provider, facility, or ambulance service can choose to negotiate reimbursement with the health plan. If good faith negotiation does not come to a resolution within 30 days, the provider, facility, or ambulance service can request binding arbitration if 1) service in question was provided not more than one year prior to the request and 2) total amount of individual or bundled claims exceeds seven hundred fifty dollars.
The Department of Insurance contracts with a single arbitration entity to perform all arbitrations described. Each party submits a final offer to the arbitrator, along with any additional evidence that relates to factors the arbitrator is directed to consider. The arbitrator is directed to select the final offer that best reflects a fair reimbursement rate based upon the factors considered. The non-prevailing party is responsible for 70% of arbitration fees, with the prevailing party responsible for the remaining 30%. The arbitrator will perform arbitrations on a flat fee basis.
Factors for the arbitrator to consider include 1) In-network rates that other health benefit plans have reimbursed the out-of-network provider for the service in question and factors determining that rate (2) In-network rates that the health benefit plan has reimbursed other providers for the service in question in that particular geographic area and factors determining that rate; (3) In-network reimbursement rates previously agreed upon between parties, if the health benefit plan and provider have had a contractual relationship in the previous six years. (4) The results of, or any documents submitted in the course of, a previous arbitration between the parties.
****Protections do not apply to non-emergency services if the enrollee had the ability to request non-emergency services from an in-network provider and the following requirements are met: 1) out-of-network provider informs the enrollee that the provider is not in the enrollee's health benefit plan network 2) out-of-network provider provides the enrollee a good faith estimate of the cost of the services, alongside disclosure that the enrollee is not required to obtain services from that that location or from that provider, and 3) enrollee affirmatively consents.