Financial Assistance

Financial Assistance is only available to those patients who are either uninsured, under-insured or have suffered a catastrophic event limiting their ability to pay for EMS services.  

Assistance is NOT available to those patients that are already in collections or are past 120 days late from the date of original service.  
Assistance is NOT available to those patients where the insurance company has reimbursed the patient and or primary subscriber for the EMS services. 

This Financial Assistance application is for EMS services rendered and does not necessarily reflect costs that may be incurred in future EMS treatments. 

For a full understanding of the Financial Assistance program, please reach out to the respective Ambulance Service where services were originally provided.  

Purpose:

The purpose of this policy is to establish guidelines for Community Care for patients, regardless of race, creed, color, sex, national origin, sexual orientation, handicap or age, who incur significant financial burden as a result they are expected to pay “out of pocket” for EMS services. 

Goals and Principals

Financial Assistance is provided to a patient who is uninsured and / or underinsured with a demonstrated inability to pay.  A patient is eligible for Financial Assistance consideration based upon meeting certain income eligibility criteria as established by the Federal Poverty Income Guidelines.  Requirements will be reasonable and assistance will be provided to patients when applying. 

Community Care may include unpaid coinsurance, deductibles and non-covered, medically necessary services if the patient meets the Financial Assistance eligibility criteria. 

The Program applies only to medically necessary services that are provided and billed by the ambulance service.  The Financial Assistance program does not cover services that are provided by ambulance providers not contracted by Logical Billing Solutions, Inc.

The discount program is designed to cover “medically necessary” non-elective services provided by the responding ambulance/first response service.   The program is intended to identify the uninsured and underinsured individuals who cannot afford to pay in full for their services.  Individuals who have exhausted their health insurance benefits and individuals with significant catastrophic circumstances also qualify.  Financial Assistance will be available through discounted charges, sliding fee discounts and payment arrangements. 

Administration of the Community Care Program 

 Applications will be accepted by the Business Manager, Administrative Assistant or through the billing company utilized by the ambulance service.  Final approval of any discount granted will be approved by the  President (or Board Officer).

Documentation Needed

Income tax returns for the previous year. 

If these are available copies of information returns issued to the applicant (for example W-2’s, 1099’s, Social Security Statement, etc.) may be substituted.

Any and all documents submitted will be kept confidential and secured.