EMS Billing Information
Notice: EMS Billing company for runs BEFORE 04/01/2023
The City of Willard and Willard Fire & Rescue uses a third party billing agency, Change Healthcare, to bill for EMS incidents. If an ambulance transports a patient to the hospital or a patient refuses transport but was treated and received an administration of medications, the patient will receive a bill for the call. A patient that refuses transport and was treated, however, has not been administered medications will not be billed.
To contact Change Healthcare about your EMS bill, please contact their Billing Department by calling 1-866-631-2658. To pay your bill online or find additional information, go to the billing website www.PerYourHealth.com and enter either the account number from your billing statement or your registered user ID to login.
To contact Change Healthcare about your EMS bill, please contact their Billing Department by calling 1-866-631-2658. To pay your bill online or find additional information, go to the billing website www.PerYourHealth.com and enter either the account number from your billing statement or your registered user ID to login.
How do I obtain a copy of my EMS PCR (Patient Care Report) from the fire department?
EMS reports are confidential and contain privileged information and protected under the Federal HIPAA (Health Insurance Portability and Accountability Act) laws. The patient that was treated, or his/her power of attorney or legal guardian, are the only people that can request a copy of the EMS Patient Care Report.
Please complete the form below. After the form is completed, please mail, email, fax, or drop-off the form at the station.
Form 1010 - Patient Request for Access to Protected Health Information (PHI)
Please contact the HIPAA Privacy Officer at the fire station during the hours of 7:00 am and 3:00 pm Monday through Friday at (419) 935-8297 if you have any questions or need to obtain a copy of an EMS Patient Care Report. You may also send an email to the HIPAA Compliance & Privacy Officer at: [email protected]
Please complete the form below. After the form is completed, please mail, email, fax, or drop-off the form at the station.
Form 1010 - Patient Request for Access to Protected Health Information (PHI)
Please contact the HIPAA Privacy Officer at the fire station during the hours of 7:00 am and 3:00 pm Monday through Friday at (419) 935-8297 if you have any questions or need to obtain a copy of an EMS Patient Care Report. You may also send an email to the HIPAA Compliance & Privacy Officer at: [email protected]
How does an attorney's office obtain a copy of an EMS Billing Statement for a client?
Any attorney may request a copy of the EMS Billing Statement by sending an email with the request and signed HIPAA statement by their client to our EMS Billing Company, Change Healthcare.
Email: [email protected]
Email: [email protected]
Notice of Privacy Practices
To view or download our Notice of Privacy Practices, click the form below:
Form 1008 - Notice of Privacy Practices
Form 1008 - Notice of Privacy Practices