Billing and Insurance Claims

FREQUENTLY ASKED QUESTIONS

WHY DID I RECEIVE A BILL?
Charges are billed for emergency as well as non-emergency response and transport as a base rate plus mileage. If you have received a bill you were reported to us as uninsured or “self-pay”; or we did not received your insurance information; or, there is a policy or health plan copayment, charges were applied to your policy deductible leaving a billed balance, or the claim was denied by your insurance carrier or health plan.

WHAT IF I REFUSED TRANSPORT?
King-American will charge a "response to call" fee regardless of the patient's decision to cancel or to refuse transport to a hospital or emergency facility. We can file a claim with your insurance carrier or health plan. Some insurance carriers will pay for these "dry run" calls. However, others will not. The patient is then responsible for payment. Contact your insurance carrier or health plan for more information regarding your plan benefits. NOTE: Medicare Part B will not pay ambulance benefits if you refused transport.

HOW CAN I FILE A CLAIM WITH MY INSURANCE OR HEALTH PLAN?
Call our Billing Department at 415 931-3000 to provide insurance or health plan information; or return a copy of the front and back of your insurance ID card in the envelope provided with the bill you received. We accept private and commercial insurance, workers compensation insurance, Medicare and Medi-Cal, Veterans Administration benefits, and local community health plans including the San Francisco Health Plan, Healthy San Francisco, and Chinese Community Health Plan.

King-American will file a claim with your insurance or health plan as a courtesy on your behalf. All claims are subject to insurance or health plan approval of payable benefits. Insured patients and guarantors are responsible for payment of their policy copayments and deductibles, and for payment of any charges not covered, excluded, or otherwise denied by their insurance carrier or health plan.

Title 28 of the California Code of Regulations, Section 1367.11 (c) provides for direct reimbursement to providers of medical transportation services:

The enrollee shall file a claim for the medical transportation service with the plan; the plan shall pay the medical transportation provider directly; and the medical transportation provider shall not demand payment from the enrollee until having received payment from the plan, at which time the medical transportation provider may demand payment from the enrollee for any unpaid portion of the provider's fee." (Emphasis added.)

WHO IS RESPONSIBLE FOR THE COORDINATION OF MY INSURANCE OR HEALTH PLAN BENEFITS?
King-American will file a claim with your insurance as a courtesy on your behalf. The patient or insured guarantor is responsible for coordination of their insurance benefits. Coordination of Benefits ("COB") was established as a method by which two or more carriers or plans could coordinate your respective benefits so the total benefit paid does not exceed 100% of the total allowable expenses incurred.

WHAT IF I HAVE SECONDARY INSURANCE?
If you are covered by a secondary insurer (supplemental insurance), contact King-American Ambulance Company's billing office with your secondary insurance or plan information so we can file a supplemental claim on your behalf.

HOW CAN I PAY MY BILL DIRECTLY TO KING-AMERICAN?
Send your check payable to King-American Ambulance Company for the amount due; or pay by credit card by return mail. You can also call our Billing Department at 415 931-3000. We accept VISA, MasterCard, and American Express.

WHAT CAN I DO IF I BELIEVE I RECEIVED A BILL IN ERROR?
Patients and insured guarantors who believe they received a bill in error must submit a letter detailing the reasons why they believe the bill is in error. The letter must be signed. ALL appeals must be submitted in writing and must be delivered via U.S. Mail (telephone calls, fax or e-mail appeals will not be accepted). Appeal letters must be sent to the company address shown on the bill which is 2570 Bush Street, San Francisco, CA 94115-2003. Reviews may take up to 30 days. Once a determination is made, you will be notified in writing. Appeals shall not be subject to further review or consideration.

Patients who are disputing their insurance policy or health plan co-payments, deductibles, excluded or uncovered charges or denied claims for which they are being billed should contact their insurance carrier or health plan provider. Do not file an appeal with King-American Ambulance Company.

CAN I PLEAD FINANCIAL HARDSHIP?
Patients and guarantors asserting personal financial hardship must submit a letter stating the bases of the personal financial hardship claim. The letter must be signed and be delivered via U.S. Mail to 2570 Bush Street, San Francisco, CA 94115-2003 Attention: Office of Appeals. Reviews may take up to 30 days. Telephone calls and fax or e-mail appeals will not be accepted.

Patients and guarantors asserting personal financial hardship are offered the opportunity to make monthly payments directly to King-American Ambulance, interest free, up to a maximum term of 6 months with minimum payments due each month. There is no penalty for prepayment. Failure to adhere to a payment plan once accepted would cause the entire balance to become immediately due and payable. Unsettled claims are automatically assigned to a collection agency.

Patients asserting extreme personal financial hardship will have their appeal assigned to Creditors Specialty Services (CSS). CSS is contracted by King-American Ambulance Company to provide credit and collection services and is responsible for collecting payments on accounts assigned to them. Upon verification of financial hardship, and upon the recommendation of CSS, a reduced settlement amount or an extended deferred payment plan may be considered.

King-American Ambulance is under no obligation to offer reduced rates or discounts except under insurance provider agreements or government health care contracts such as Medicare and Medi-Cal. Patients or guarantors who do not qualify for financial hardship consideration are responsible for full payment of the principal amount assigned to the collection agency plus interest at the agency's legally established rate.

WHAT CAN I DO IF MY ACCOUNT IS ASSIGNED TO A COLLECTION AGENCY?
Once a claim is assigned, all inquiries, requests, and payment arrangements must be made through the agency.

Creditors Specialty Services, Inc.
Post Office Box 764
Acton, CA 93510
PH# (800) 277-8660
FX# (661) 269-5814