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1. How do I get information about my ambulance bill?

Ambulance Billing and Contact Information Due to the increased requirements on the medical billing industry, the City of Boulder City now contracts with Iris Medical for all Ambulance Billing services. Should you have any questions regarding a ambulance invoice you received. Please do not hesitate to contact: Iris Medical at 1-801-298-4747. You will need the patient’s name and date of transport.

Due to HIPPA privacy rules, only the patient or parent / guardian may obtain information or copies of patient care reports without a signed / notarized authorization form.

2. What is a nonprovider for my insurance?

A Nonprovider does not have a contract with the insurance company to take a contracted (or reduced) amount for ambulance transport service. Because of our small size, we do not have the staff to administer contracts with multiple insurers. Therefore, Boulder City Fire Department (BCFD) is a nonprovider for all commercial insurance companies.

Typically, insurance companies charge a higher deductible or copay when a nonprovider service is used. However, as there is no other ambulance service available in Boulder City, you may request a redetermination or review of your claim indicating no other service is available should your insurance company make an adverse decision on a particular claim.

Nonprovider status does not typically affect any emergency ambulance transport however, every insurer has their own policies governing ambulance transports and it is the patient’s responsibility to know their insurer’s policies.

3. What or who determines where the ambulance will take the patient?

If the patient is conscious and competent to make their own decisions, they can select which
appropriate hospital they wish to be transported to (if in the paramedic’s opinion, they are
stable and by-passing a closer facility would not potentially jeopardize the patient’s condition).
They can also refuse transport if they sign a liability waiver indicating they understand the risks
of not seeking further medical treatment.

If the patient is unconscious, in an altered mental state, in custody of the police or may be a danger to himself or others, the Paramedic on scene will determine the most appropriate facility for medical treatment.

There are also county protocols which the ambulance crew are required to follow which may affect the destination, such as patients who the police have determined to be not competent must be taken to the closest facility per protocol.

4. When is a patient transported by air rather than by ground ambulance?

The Paramedic on scene will determine the level of care needed based on his assessment of the patient. Patients can be transported by Boulder City Fire Department (BCFD) to the Boulder City Airport for transfer to a medical facility or picked up at the scene of an accident by a medical helicopter. BCFD rescue units transport less critically ill patients to the closest appropriate facility.

5. What is a trauma center?

A trauma center is a hospital which meets certain criteria established by the American College of Surgeons.

There are different levels for trauma centers based on the availability of specialists. The biggest difference between a level I and level II trauma center is a research program, surgical residency, and the availability of specialists.

Level I Trauma has a certain number of surgeons and anesthesiologists on staff 24 hours per day / 7 days per week. Level II is similar with less stringent standards and usually work with a Level I for clinical expertise. Level III does not have availability of all specialties and have transfer agreements with Level I and II trauma centers. Currently, UMC is level 1, Sunrise is level II, and St. Rose Siena is level III.

6. What does it cost to have EMS come to my house?

The only charges incurred when EMS comes to your home are for an actual transport to a medical facility. We do not charge to come to your house to check on a potential patient. If you are unsure if the situation warrants transport to a medical facility, our Paramedics are trained to monitor the patient’s situation and provide a skilled assessment and opinion.

7. Can I refuse to be transported by ambulance?

Patients may refuse transport if they do not wish to be taken to the hospital by ambulance, but they will be required to sign a release form indicating that medical personnel have explained the possible dangers or consequences of not seeking further medical treatment. There are also times when both the police and fire personnel are required by law to transport a patient - even if the patient does not wish to be transported - when the patient is not mentally or physically capable of making a sound decision regarding their medical care, when the patient may be a danger to himself or others, or when the patient is in custody by the Police Department.

8. Medicare paid my bill, why do I have to pay more?

Medicare sets the rates they allow agencies to charge for the type of emergency transport provided whether it be Basic Life Support, Advanced Life Support and Advanced Life Support-2. They also set the rates for co-pays and mileage. By law, the Boulder City Fire Department (BCFD) cannot bill Medicare patients for more than the Medicare-approved rate, but we must bill for the copay or coinsurance amount. However, if Medicare declines or denies the claim due to the nature of the transport, e.g., nonemergency transports which did not require transport by ambulance, payment of the full bill is the responsibility of the patient.

9. Who do I contact if a personal item is lost during an emergency ambulance transport?

The Boulder City Fire Department does not hold any personal items after an ambulance trip. Any items left behind in the ambulance are given to the Emergency room hospital staff. Most if not all hospitals have a safe within the hospital that they will place any valuables that is removed and transported with the patient. Contact the Emergency Room and Security office of the hospital you was transported to for additional information.

10. Where can I go to get my blood pressure checked?

The Emergency Medical Technicians (EMTs) will take your blood pressure at the fire station. However, they may be unavailable if they are out of the station on a call or in training.

11. Can I pay my ambulance transport bill online, by phone or credit card?

The City of Boulder City now contracts with Iris Medical for all Ambulance Billing services. Should you have any questions regarding a ambulance invoice you received. Please do not hesitate to contact: Iris Medical at 1-801-298-4747.