8/13/2015 - Ambulance Reimbursement Procedure

CITY OF HACKENSACK
Ambulance Service
Reimbursement Program


Program Summary

Since federal law prohibits Hackensack University Medical Center (“HUMC”) from providing free or insurance only billing for ambulance services provided to residents, the City of Hackensack (“the City”) has established an Ambulance Service Reimbursement Program (“Program”). This Program is available to any Hackensack resident transported by an HUMC ambulance from a location within the City regardless of the individual’s insured status or ability to pay.

Under this new Program, the City will reimburse residents for certain uninsured costs associated with ambulance transportation provided by HUMC in the City by way of the processes outlined below. The City’s Finance Department is ready to assist residents making claims for reimbursement under the Program, and will ensure that any personally identifiable health information, if any is received, is safeguarded pursuant to law.

With Insurance

If you have health insurance, the following process will be followed to receive reimbursement for certain out of pocket expenses associated with ambulance transportation services provided by HUMC in the City.

1. If you have health insurance, HUMC will directly bill your carrier.

2. If you have a co-pay that has not been covered by your carrier, you must pay the bill and then submit it with proof of payment to the City’s Finance Department for reimbursement.

a. The City will advance such payments if the resident demonstrates economic need; otherwise no eligibility determination is required to be made for reimbursement of a payment already made.

3. Upon submission of a claim for reimbursement, within two weeks, the Finance Department will mail the resident a purchase order for their signature, or they may request the same in person.

4. Upon receipt of the signed purchase order by the Finance Department, a check for reimbursement will be issued to the resident after the next meeting of the governing body at which such payment may readily be authorized.

Without Insurance

If you do not have health insurance, the following process will be followed to receive reimbursement for certain out of pocket expenses associated with ambulance transportation provided by HUMC in the City.

1. If you are billed by HUMC in the absence of health insurance, your bill will be discounted by 80%.

2. The remaining balance may either be paid by the resident and reimbursement will with paid by the City utilizing the same process for insured residents, or the resident may directly apply for charity care with HUMC and have the outstanding balance waived.

a. Please note that to receive charity care a resident may be required to meet certain income eligibility criteria.

b. Any resident, however, is eligible for reimbursement from the City without meeting any income eligibility criteria unless a request is made to have such payment advanced by the City.

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All questions concerning the procedure may be directed to James Mangin, CFO, jmangin@hackensack.org, 201-646-3935.