Thank you for using the District of Columbia Fire and EMS Department (DCFEMS) to help with your emergency. On behalf of the first responders who treated you, and more than 2,000 firefighters, emergency medical technicians, paramedics and other personnel of DCFEMS, please accept our best wishes for a speedy recovery from your illness or injury. DCFEMS is assisted in providing ambulance transport services by Global Medical Response (GMR, formerly AMR), which provides Basic Life Support (BLS) ambulance transport to hospitals and/or other healthcare facilities. DCFEMS is a Government of the District of Columbia municipal department and the exclusive public emergency medical system (EMS) jurisdictional provider of ambulance transport services within the District of Columbia. DCFEMS is not associated with hospitals, other EMS services, or the United States (Federal) Government.

If you need help with any information on this page, including understanding the information presented in a language other than English, have difficulty reading the information presented, or are unsure what to do, please call the DCFEMS third party billing service office representative at 1-202-673-3368 during normal business hours.

TREATMENT AND TRANSPORT RECORDS

If you received treatment and/or transport by DCFEMS (including GMR), an electronic patient medical record was created documenting your care. This record contains 9-1-1 call information, the location of the emergency incident, details of the emergency incident, your personal identifying information, and medical information pertaining to assessment, treatment and/or transport for your illness or injury. For information about how to obtain a copy of your patient medical record, please visit this page.

When DCFEMS first responders made contact with you during a call, they requested and recorded information about your condition. Such information may have included the following:

• Personal identifying information, including your full (legal) name, full residential address, birthdate, driver’s license and/or governmental identification number, and/or other identity information. First responders may have asked to scan your driver’s license (or your hospital ID bracelet if you were transported) to obtain such information electronically.

• Information about what caused your illness or injury, including what happened on the day of your emergency, why you called 9-1-1, and what may have contributed to you needing an ambulance. First responders may have recorded such information based on what they observed or were told by other people, including obtaining such information from the 9-1-1 call record.

• Detailed medical history information, including medical conditions, prescribed medications, allergies, other substance and/or alcohol use, last food and water intake, and how much you weigh. First responders may have asked and obtained such information from family, friends and/or other people who were present on the day of your emergency.

• Insurance information, including healthcare insurance, automobile insurance, workers compensation information, and/or other beneficiary policy information. First responders may have asked to review and/or scan your insurance cards (or your hospital ID bracelet if you were transported) to obtain such information electronically.

• Detailed medical treatment information, including an assessment of your condition, evaluation of your injury or illness, vital signs, medical procedures and/or treatment information, medical device information, reasons for ambulance transport, and ambulance transport destination.

After DCFEMS first responders finished treating and/or transporting you, they may have asked you to electronically sign a patient medical record created for documenting your care (if you were capable of signing). If you signed the record, your signature was recorded by date/time stamp and added to the patient medical record. If you signed the record, you acknowledged receiving privacy rights notification and gave DCFEMS permission to use all information contained in your record to submit insurance claim(s) for payment of ambulance fees and charges on your behalf. If you were incapable of signing because of your condition, your consent was implied.

• To review an example copy of the signature form used by DCFEMS for privacy rights notification, please click this link.

• To review an example copy of the signature form used by DCFEMS for assignment of benefits and permission to bill for services, please click this link.

INSURANCE CLAIM PROCESSING

Once DCFEMS first responders complete your patient medical record, it is transferred to the third party billing service for management of your patient account. All communication, insurance claims, and patient account billing is provided by this service. DCFEMS only bills for ambulance transport (with limited exceptions). Most billing involves submission of a claim to a health insurance plan, automobile insurance company, workers compensation plan or another party. The third party billing service will review your patient medical record, determine the level of service provided, calculate the number of miles you were transported, and create a patient account identifying your ambulance fees and charges. After this is complete, you will be mailed a statement of account.

• Statement of Account: Generally, within 30 days after you were transported by ambulance, you will receive a statement of account. This is NOT A BILL – PLEASE DO NOT MAKE PAYMENT. The statement of account summarizes your ambulance fees and charges. Included in this statement is an information and signature form. Please follow the directions included on the form and (if indicated) sign and mail the form back to DCFEMS for processing in the return mail envelope provided. Alternatively, please visit this page and submit such information electronically. If you do not receive a statement of account within 60 days, or if you have not been notified by an insurer that DCFEMS has filed a claim for ambulance fees and charges on your behalf, please call the third party billing service at the telephone number shown on the statement of account and/or below.

• Submission of an Insurance Claim: For the large majority of patients, the DCFEMS third party billing service will identify your insurance coverage and automatically submit a claim for ambulance fees and charges on your behalf. If you are a Medicaid plan beneficiary, this will be completed without you receiving billing notice. After DCFEMS submits an insurance claim, your insurer may notify you about responsibility for a remaining unpaid balance. This is NOT A BILL – PLEASE DO NOT MAKE PAYMENT. If you have a remaining unpaid balance you are responsible for paying, DCFEMS will bill you directly.

The DCFEMS third party billing service works extensively to identify insurance coverage for paying your ambulance fees and charges. This includes obtaining insurance information from healthcare insurance clearing houses, hospitals, and other sources. The third party billing service also uses public information to verify (or correct) personal identifying information which is required for insurance claim submission. However, this process is not always successful and may require you (or your patient representative) to assist them.

• Request for Insurance Information: If you receive a request for insurance information from DCFEMS, please follow the directions included on the form and (if indicated) sign and mail the form back to DCFEMS for processing in the return mail envelope provided. Alternatively, please visit this page and submit such information electronically. The third party billing service will make every effort to verify (or correct) your insurance coverage and personal identifying information. This may require your involvement in the process. Please respond to such requests for information. If you need direct assistance, including understanding the information requested using a language other than English, have difficulty reading the information, or are unsure what to do, please call the third party billing service at the telephone number shown below.

After DCFEMS submits an insurance claim for your ambulance fees and charges, your insurer may contact you by mail or phone. Your insurer may also request that you submit additional information to them, and/or verify the information contained in your submitted claim. Please respond to such requests for information. If you need direct assistance, including understanding the information your insurer has requested using a language other than English, have difficulty reading the information, or are unsure what to do, please call the third party billing service at the telephone number shown below. Your insurer may also send you an Explanation of Benefits (EOB) notice concerning claim denials and/or payments. Generally, your insurer will respond to insurance claims submitted by DCFEMS in one of the following ways:

• Reject the Claim: This means your insurance and/or personal identifying information was wrong and could not be verified (or corrected) by the DCFEMS third party billing service. You may receive a claim rejection notice from your insurer. To avoid being billed for ambulance fees and charges, please call the third party billing service at the telephone number shown below.

• Deny the Claim: This means your insurance did not cover ambulance fees and charges or your insurer could not identify a reason of medical necessity for using a DCFEMS ambulance. You may receive a claim denial notice from your insurer. To avoid being billed for ambulance fees and charges, please call the third party billing service at the telephone number shown below.

• Pay the Claim: This means your insurance paid ambulance fees and charges in whole or in part. In some cases, a secondary insurer may also make payment. In other cases, an insurer may apply a high deductible or co-pay to your ambulance fees and charges, leaving you with a large unpaid balance. PLEASE DO NOT MAKE PAYMENT. If you have a remaining unpaid balance you are responsible for paying, DCFEMS will bill you directly.

• Not Respond to the Claim: This means your insurer did not accept your claim, or paid you directly (in whole or in part) for the claimed amount. If your insurer did not accept your claim, DCFEMS will bill you directly. If you received payment from your insurer, you are responsible for making payment to DCFEMS. Please call the third party billing service at the telephone number shown below.

After insurance claim processing is complete, or an insurer did not respond to a submitted claim for ambulance fees and charges, the third party billing service will apply DCFEMS ambulance billing policy to determine if you have payment responsibility for a remaining unpaid balance. If you are responsible for payment, DCFEMS will bill you directly.

EXEMPTIONS FOR BILLING

Certain patients may qualify for complete or partial exemption for payment responsibility of a remaining unpaid balance after insurance claim processing is complete. Such exemptions are automatically applied by the DCFEMS third party billing service and do not require action by a patient or patient representative. Complete or partial exemptions from payment responsibility include the following:

• Any patient who is a Medicaid plan beneficiary on the date of ambulance transport has no financial responsibility for payment and is ineligible for collection of unpaid account balances.

• Any patient who is a DC resident and a Medicare plan beneficiary on the date of ambulance transport has no financial responsibility for payment and is ineligible for collection of unpaid account balances.

• Any patient who is an out-of-state resident and a Medicare plan beneficiary on the date of ambulance transport has limited responsibility for payment and is ineligible for collection of unpaid account balances if full payment is made at adjusted rates.

• Any patient who is a DC resident and a Veterans Healthcare plan beneficiary on the date of ambulance transport has no financial responsibility for payment and is ineligible for collection of unpaid account balances.

• Any patient who is an out-of-state resident and a Veterans Healthcare plan beneficiary on the date of ambulance transport has limited responsibility for payment and is ineligible for collection of unpaid account balances if full payment is made at adjusted rates.

• Any patient who is a private healthcare plan beneficiary on the date of ambulance transport, provided such a plan has entered into a participating provider agreement (PPA) with DCFEMS, has limited financial responsibility for payment and is ineligible for collection of unpaid account balances.

• Any patient who is a DC resident and a small or self-employed private healthcare plan beneficiary on the date of ambulance transport, provided such a plan accepts insurance claims from DCFEMS, has limited financial responsibility for payment and is ineligible for collection of unpaid account balances provided full payment is made at PPA adjusted rates.

Complete or partial exemptions from payment responsibility are fully described by DCFEMS ambulance billing policy and include certain terms and conditions. To review the policy, please visit this page.

REDUCTIONS AND WAIVERS FOR BILLING

Certain patients may qualify for reduction or waiver ambulance fees and charges before or after insurance claim processing is complete. Such reductions or waivers may require the submission of a request form and action by a patient or patient representative to be applied. Reductions or waivers for ambulance fees and charges include the following:

• Any patient who is homeless on the date of ambulance transport has no financial responsibility for payment and is ineligible for collection of unpaid account balances. Requires submission of Hardship Request Form. Please click this link to download and submit by mail. Alternatively, please visit this page to submit the form electronically.

• Any patient who is unemployed on the date of ambulance transport has limited financial responsibility for account balance payment and is ineligible for collection of unpaid account balances if full payment is made at hardship adjusted rates determined by review (when applicable). Requires submission of Hardship Request Form. Please click this link to download and submit by mail. Alternatively, please visit this page to submit the form electronically.

• Any patient who is uninsured on the date of ambulance transport has limited financial responsibility for account balance payment and is ineligible for collection of unpaid account balances if full payment is made at hardship adjusted rates determined by review (when applicable). Requires submission of Hardship Request Form. Please click this link to download and submit by mail. Alternatively, please visit this page to submit the form electronically.

• Any patient who is permanently disabled on the date of ambulance transport has limited financial responsibility for account balance payment and is ineligible for collection of unpaid account balances if full payment is made at hardship adjusted rates determined by review (when applicable). Requires submission of Hardship Request Form. Please click this link to download and submit by mail. Alternatively, please visit this page to submit the form electronically.

• Any patient who is experiencing end-of-life medical conditions on the date of ambulance transport, or died following ambulance transport, has limited financial responsibility for account balance payment and is ineligible for collection of unpaid account balances if full payment is made at hardship adjusted rates determined by review (when applicable). Requires submission of Hardship Request Form. Please click this link to download and submit by mail. Alternatively, please visit this page to submit the form electronically.

• Any patient who was not identified as having insurance on the date of ambulance transport, when such a patient submitted insurance coverage information, and the claim filing deadline has expired, has limited financial responsibility for account balance payment and is ineligible for collection of unpaid account balances if full payment is made at adjusted rates determined by review (when applicable). Requires submission of an Insurance Review Form. Please click this link to download and submit by mail. Alternatively, please visit this page to submit the form electronically.

• Any patient who experienced an insurance claim processing error, when such error resulted in claim rejection or denial, and the claim re-filing deadline has expired, has limited financial responsibility for account balance payment and is ineligible for collection of unpaid account balances if full payment is made at adjusted rates determined by review (when applicable). Requires submission of an Insurance Review Form. Please click this link to download and submit by mail. Alternatively, please visit this page to submit the form electronically.

• Any patient who experienced insurance claim denial, or an insurer did not respond to a claim, and the claim was re-filed without further action by an insurer or another insurer, has limited financial responsibility for account balance payment and is ineligible for collection of unpaid account balances if full payment is made at adjusted rates determined by review (when applicable). Requires submission of an Insurance Review Form. Please click this link to download and submit by mail. Alternatively, please visit this page to submit the form electronically.

• Any patient who experienced a high out-of-pocket unpaid balance (more than $500), when such a balance was the result of an insurer applied deductible and/or co-pay, has limited financial responsibility for account balance payment and is ineligible for collection of unpaid account balances if full payment is made at adjusted rates determined by review (when applicable). Requires submission of an Insurance Review Form. Please click this link to download and submit by mail. Alternatively, please visit this page to submit the form electronically.

• Any patient who experienced involuntary ambulance transport, and an insurer denied or did not respond to the claim, has no financial responsibility for payment and is ineligible for collection of unpaid account balances. Requires submission of an Insurance Review Form. Please click this link to download and submit by mail. Alternatively, please visit this page to submit the form electronically.

• Any person who was not the patient identified by an account number, date of service, or other information provided to the DCFEMS third party billing service, or who was fraudulently identified as the patient, has no financial responsibility for payment and is ineligible for collection of unpaid account balances. Requires submission of a Patient Identity Dispute Form. Please click this link to download and submit by mail. Alternatively, please visit this page to submit the form electronically.

• Any patient receiving ambulance transport who was the victim of crime, when to reduce or waive ambulance fees and charges is in the best interest of the Government of the District of Columbia, as determined by the Chief of DCFEMS (or the Chief’s designee) in the exercise of his or her discretion, has no financial responsibility for payment and is ineligible for collection of unpaid account balances. Please call the DCFEMS third party billing service office representative at 1-202-673-3368 to discuss this request.

Reductions or waivers for ambulance fees and charges are fully described by DCFEMS ambulance billing policy and include certain terms and conditions. To review the policy, please visit this page.

PATIENT BILLING

After insurance claim processing is complete, and if an insurance claim could not be submitted on your behalf, or if an insurer denied your claim, or if an insurer did not respond to your claim, and if DCFEMS ambulance billing policy determined you have payment responsibility for a remaining unpaid balance, you will receive bills from DCFEMS for ambulance fees and charges mailed to your home address (if verified). Please review such bills for information accuracy. If you are insured, but a bill indicates the DCFEMS third party billing service could not identify your insurance information, please follow the instructions included on the form with the bill and (if indicated) sign and mail the form back to DCFEMS for processing in the return mail envelope provided. Alternatively, please visit this page and submit such information electronically. If you have questions about your bills and need direct assistance, including understanding billing information using a language other than English, have difficulty reading the bill, or cannot pay the bill, please call the third party billing service at the telephone number shown on the bill and/or below. Once your patient account enters the patient billing cycle, you can expect to receive several notifications:

• First Bill for Services: A notification of what you are required to pay, with detailed ambulance fees and charges. This bill will indicate where you received DCFEMS ambulance transport services, the date you received such services, what level of transport services were provided to you, the hospital you were transported to, and other information concerning billing. If you have a remaining unpaid balance after insurance claim processing, this will be indicated by the bill. Please note the patient account number indicated on the bill. All communication regarding billing is identified by this number. If you are responsible for payment of DCFEMS ambulance fees and charges, you will receive this notice within 30 days after such a determination.

• Second Bill for Services: A notification of what you are required to pay, with detailed ambulance fees and charges. This bill will be identical to the first, but will remind you to make payment and/or submit other information for payment of DCFEMS ambulance fees and charges. You will receive this notice within 45 days after payment responsibility determination.

• Third and Final Bill for Services: A notification of what you are required to pay, with detailed ambulance fees and charges. This bill will be identical to the second, but will remind you to make payment and/or submit other information for payment of DCFEMS ambulance fees and charges. This bill also includes a collection warning notice. You will receive this notice within 60 days after payment responsibility determination.

• Automated Telephone Calls Requesting Payment: A telephone (or text) notification informing you to contact to contact the DCFEMS third party billing service regarding payment of DCFEMS ambulance fees and charges. You will receive such calls (or texts) between 30 and 90 days after payment responsibility determination.

After the patient billing cycle is complete, the DCFEMS third party billing service will complete a final review of your account. If any mailed bill is returned indicating a bad address or the patient no longer lives at the billing address, your account will be placed on billing hold. If an insurance claim for DCFEMS ambulance fees and charges was submitted and/or resubmitted without subsequent payment by an insurer or other responsible party, your account will be placed on billing hold. If you were transported by ambulance because of an injury resulting from an accident (liability case), your account will be placed on billing hold. If you contacted the billing service regarding payment arrangements, including payment by responsible parties other than insurers, your account will be placed on billing hold. Billing holds last between 180 and 360 days, allowing additional time for payment of DCFEMS ambulance fees and charges. After a billing hold expires, an unpaid patient responsibility balance will be considered delinquent and subject to collection action.

ACCOUNT INQUIRIES AND PAYMENT

To contact the DCFEMS third party billing service, please have a copy of your statement of account or bill available for reference. Please identify your patient account number on the notice. When you speak with the call center, you will be asked to identify the patient by account number, full (legal) name and birthdate. For all patient account inquiries including updating patient information, insurance coverage information, insurance claim status, payment responsibility status, and other account information, please call:

To access a patient account that is not in collection and view or pay invoices, submit insurance information, or ask a question concerning billing, please visit this page. Please use the invoice number and incident number found on a statement of account and/or bill for service to access. You will also need to enter a patient birthdate.   

To make payment for a patient account that is not in collection by credit card (including healthcare savings plan cards), please visit this page. To mail payment for a patient account that is not in collection (please make checks or money orders payable to D.C. Treasurer), submit forms, or mail other documents, please use this mailing address:

 

REFUNDS

After insurance claim processing and the patient billing cycle is complete, a patient account may have a credit (refundable) balance. This may occur because payment was made on the account before insurance was identified, you made payment on the account and then your insurance made payment on the account, your insurance overpaid on the account, you overpaid on the account, or for other for reasons. When a patient account has a credit (refundable) balance, the DCFEMS third party billing service identifies the account for refund at the end of each month, and then processes refund requests during the next month. All refund requests are then submitted to the D.C. Treasurer for payment processing. Refunds accepted for payment processing by the D.C. Treasurer are generally completed within 45 days.

• Insurance Refunds: Insurance refunds are processed using the rules of insurance plans. Payment is made to the insurer by check or electronic funds transfer.

• Patient Payment Refunds: Patient refunds are made to the patient (or other responsible party) by check. Payment is mailed to the patient mailing address, or other address identified for a responsible party.

• Credit Card Refunds: Credit card refunds are processed using the rules of a credit card company and/or financial institution issuing the card. Payment is made to the credit card company by check or electronic funds transfer.

If you are due a refund and have not received notification your refund is being processed, please call the DCFEMS third party billing service office representative at 1-202-673-3368 during normal business hours for assistance.

DELINQUENT ACCOUNTS AND COLLECTION

After insurance claim processing and the patient billing cycle is complete, a patient account may have an unpaid balance. Generally, unpaid accounts are classified delinquent between 180 and 360 days after the date you received ambulance transport services. If a patient account is classified delinquent, the DCFEMS third party billing service will apply DCFEMS ambulance billing policy to determine if you are eligible for collection action on the remaining unpaid balance. To review DCFEMS ambulance billing policy, please visit this page. If your account is eligible for collection, it will be transferred to the D.C. Central Collections Unit (CCU) for processing. Once a collection eligible patient account is transferred to the CCU, DCFEMS can no longer assist with account inquiries or accept payments. For all collection inquiries including notices about past-due delinquent debt from Harris & Harris, disputing a collection action, or making payment arrangements in response to a collections notice, please contact CCU by visiting this page.