EMS Records & Billing

All patient and billing records are kept at the headquarters facility at 1399 Dean Forest Road. You can make payment by check, Money Orders, Mastercard, Visa, Discover or American Express. We only accept cash payments at the Headquarters facility ONLY. We accept most insurance companies with the exception of: Out of State Blue Cross Blue Shield, Blue Cross Blue Shield Federal, Out of State Medicaid, and Third-Party Automobile Claims. If you need to provide us with insurance information, a form can be downloaded, faxed or mailed to you. In order to obtain your medical records you will have to complete a Medical Release form, provide a picture ID and submit a payment of $25.88 per record. If you have a financial hardship you may qualify for our Uncompensated Care Program. You will need to complete a detailed application and return all requested documentation to us and we will determine eligibility.

AUTOMOBILE INSURANCE INFORMATION [pdf]

BLUE CROSS BLUE SHIELD OUT OF STATE REIMBURSEMENT POLICY [pdf]

FINANCIAL APPLICATION FOR UNCOMPENSATED CARE [pdf]

HIPPA POLICY [pdf]

HOSPICE INSURANCE INFORMATION [pdf]

IINSURANCE FORM [pdf]

PROTECTED HEALTH INFORMATION POLICY [pdf]

VETERANS INSURANCE INFORMATION [pdf]

WORKER'S COMP INSURANCE INFORMATION [pdf]