City of Fredericksburg, VA
 
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[Ord. No. 07-04, 2-27-2007]
Reasonable fees shall be charged for emergency medical transport services provided by all emergency medical services personnel, whether provided by volunteer or City employees. The schedule of rates for services shall be established by resolution of the City Council of the City of Fredericksburg. The funds received from the payment of this fee shall be paid into the general fund of the City to aid in defraying the payment of this fee shall be paid into the general fund of the City to aid in defraying the cost of providing such service.
[Ord. No. 07-04, 2-27-2007]
The following words, terms and phrases, when used in this article, shall have the meanings ascribed to them in this section, except where the context clearly indicates a different meaning:
ADVANCED LIFE SUPPORT, LEVEL 1 (ALS1)
Services shall be medical treatment or procedures provided to a patient beyond the scope of an EMT-Basic as defined by the Nation EMS Education and Practice Blueprint as amended.
ADVANCED LIFE SUPPORT, LEVEL 2 (ALS2)
Services shall be defined as advanced life support services provided to a patient including one or more of the following medical procedures:
A. 
Manual defibrillation/cardioversion;
B. 
Endotracheal intubation;
C. 
Central venous line;
D. 
Cardiac pacing;
E. 
Chest decompression;
F. 
Surgical airway;
G. 
Intraosseous line; and/or
H. 
Administration of three or more medications.
BASIC LIFE SUPPORT (BLS)
Services shall be medical treatment or procedures to a patient as defined by the National Emergency Medicine Services (EMS) Education and Practice Blueprint for the Emergency Medical Technician Basic (EMT).
GROUND TRANSPORT MILEAGE (GTM)
Mileage shall be assessed in statute miles from the location of the incident to a hospital or other facility where a patient is transported. Transportation fees shall be assessed per statute mile from the location of the incident scene, or from the center point of the emergency demand zone, if applicable, where an incident scene or address is located, to a hospital or other facility where a patient is transported. The City Manager is authorized to establish emergency demand zones for the purpose of administering this article.
[Ord. No. 07-04, 2-27-2007]
A. 
A bill will be generated for ambulance transports by all emergency medical personnel whether volunteer or City employees.
B. 
Patients will fall into one of the following categories for billing purposes:
(1) 
Insured, City resident or non-resident. The appropriate insurance carrier will be billed.
(2) 
Uninsured City residents. The City of Fredericksburg Compassionate Billing Policy provides for waiver of emergency transport fees for eligible uninsured City residents. A statement showing zero balance will be sent to any patient qualifying for such waiver.
(3) 
Uninsured non-resident. A bill will be sent to the patient transported. If the individual has the ability to pay, then payment is expected in full. If the patient can demonstrate financial hard ship in accordance with the compassionate billing policy, they may qualify for waiver of fees.
(4) 
Bill generated/no collection. There are instances when a bill is generated in which the City would be merely transferring funds from one department budget to another to satisfy the bill. For example, when an on-duty City employee is transported for a compensable workers' compensation injury, the employee's department is responsible for payment of those expenses. Generally, when an inmate of the regional jail is transported, the sheriff's department is responsible for the bill. The billing contractor will update its records to reflect such adjustment. For accounting purposes, interdepartmental transfers (IDT's) will not be required when an internal bill is generated. However, designated personnel will notify the City's billing contractor that the bill generated is internal to the City in those circumstances to ensure proper record keeping.
(5) 
If the workers' compensation claim is denied, the employee's health insurance will be billed. The Commonwealth of Virginia will be billed for transports of state inmates in the judicial system.
[Ord. No. 07-04, 2-27-2007]
A. 
No one will ever be denied necessary medical transport service due to either his or her inability to pay or a lack of insurance.
B. 
All consumers of ambulance services will be asked, in writing, to provide information regarding available insurance coverage. All consumers of ambulance services will receive written notification of the value of services received and notice of billing forwarded to their insurer(s).
C. 
Compassionate billing is intended to eliminate or minimize out-of-pocket expenses for ambulance services received by City residents. The City regards taxes paid by our residents as inclusive of co-pays and/or deductibles for ambulance service for all persons living in a taxpaying household. Elderly or disabled residents qualifying for real estate tax relief pursuant to City ordinance shall be deemed qualified for relief from any deductible or co-pay for ambulance services received.
D. 
Any resident lacking health insurance may submit a waiver request form stating a financial hardship. No personal banking information or tax form copies will be required as proof; the good-faith statement made by the resident regarding household income level will suffice. Residents showing household income below $100,000 shall qualify for waiver of fees based on hardship.
E. 
The City's billing company will not pursue payment recovery through a debt collection agency without express authorization of the City administrator or his designee.
F. 
Nonresidents receiving City medical transport will receive a bill, but these nonresidents may also apply for financial hardship waiver.
G. 
If any insured party requires EMS transport within a given calendar year that exceeds his or her policy limits and no additional insurance coverage is available, the fees for service beyond coverage limits will be waived.
H. 
If the insurance company deems the transport is not medically necessary the billing company will verify the information that was submitted to the insurance company and resubmit the claim for reconsideration. If the insurance carrier still deems the transport not medically necessary the City administrator or his designee will review the individual case for possible waiver of the fees.
[Ord. No. 07-04, 2-27-2007]
Billing and collection services will be provided by a billing contractor. No City emergency medical personnel, whether volunteer or City employee will accept or receive payment on behalf of a patient. Any inquiries regarding billing or collection procedure will be referred to the billing contractor, or to designated personnel of Fredericksburg Fire Department.