Ambulance Billing

Since 2008, the Delmar Volunteer Ambulance Service (Delmar-Bethlehem EMS) has accepted payment from insurance companies. The agency began accepting insurance payments so that we could enhance the level of ambulance service available to the community, without raising the cost to taxpayers. The number of ambulance calls in the Town of Bethlehem increases each year. To keep up with increasing needs, Delmar-Bethlehem EMS hire paid responders to ensure that we have enough personnel available to put more ambulances on the road during the hours when many of our volunteers are at work.

Rather than relying on the ambulance tax to enhance these programs, the ambulance services, with support from the Town government, are accessing the health insurance benefits that are available to many Town residents. This means faster responses to emergencies in our community.

In addition to enhancing services, the revenue from health insurance payments has allowed for the ambulance tax to be decreased. The ambulance tax in the hamlets of Delmar, Elsmere, and Slingerlands has decreased by 23% since 2008.

If you are a resident of the Town of Bethlehem, the current tax funds that support the ambulance services will be used to cover any out of pocket costs that are not paid by insurance, such as copayments or deductibles. Therefore, the ambulance squads will not ask you to pay costs in excess of the coverage provided by your insurer.

The residents of our community benefit every day from the skill and commitment of our EMS volunteers who dedicate thousands of unpaid hours each year to respond to the emergency needs of their neighbors. From six pm to six am, Delmar-Bethlehem EMS is 100% volunteer staffed. However, with the demands of careers and family, there are not enough volunteer Emergency Medical Technicians (EMTs) and drivers to keep up with the rising daytime call volume. Therefore, our partners at the Albany County Sherriff’s Department provide paid daytime ambulance staffing in the town to meet our community’s needs. The collection of insurance payments allows Delmar-Bethlehem EMS to grow with our community, continue enhancing services, reduce taxes, and keep on sound financial footing.

Frequently Asked Questions about Billing

Why are the ambulance service collecting insurance payments and copayments/deductibles? 

The ambulance service accepts insurance payments and individual copayment and deductibles so that we may enhance the level of ambulance service available to the community, without raising the cost to taxpayers.  The ambulance service is funded by insurance payments, the copayments/deductible funds collected, an ambulance tax, which appears as part of your property tax bill, and donations from members of the community.  DBEMS is a 501(c)(3) charitable organization and accepts tax-deductible donations.

The residents of our community benefit every day from the skill and commitment of our EMS volunteers who dedicate thousands of unpaid hours each year to respond to the emergency needs of their neighbors.  However, with the demands of careers and family and the extensive training required to be an EMT, there are not enough volunteers to keep up with the rising call volume.  The Town is growing and the population is aging, causing the number of ambulance calls in the Town to increase.

Delmar-Bethlehem EMS has hired paid EMTs to ensure that we have enough personnel available to put more ambulances on the road, especially during the hours when many of our volunteers are at work.  While adding paid staff costs money, these employees — along with our dedicated volunteers – deliver the professional services that our community expects.  Rather than raising the ambulance tax, the ambulance service and Town government implemented a solution that minimizes the impact on Town residents—tapping into the health insurance benefits that are available to most people to pay for the paid EMTs.  The collection of insurance payments allows the ambulance service continue enhancing services for the Town of Bethlehem, while keeping the system on sound financial footing.  This means faster responses to emergencies in our community.

How does billing work?  

NO ONE WILL EVER BE DENIED NECESSARY MEDICAL TRANSPORTATION SERVICES DUE TO EITHER HIS OR HER INABILITY TO PAY OR A LACK OF INSURANCE COVERAGE.

The ambulance crew should have asked you to sign a billing authorization form that will give us permission to bill your insurer.  They may have also collected your health insurance information.  If you did not have health insurance policy information available, the billing company contacts you to get it at a later date.  The billing company will send you a questionnaire and/or invoice, or one will be sent directly to your insurance company.  When you receive a bill, please forward it to your insurance company.  There is no charge for emergency ambulance service if the patient is not transported by ambulance.  However, there is an assessment fee collected by the ambulance service on behalf of the Town of Bethlehem when an Albany County Paramedic provides treatment and the patient ultimately does not go to the hospital.

What about out-of-pocket costs, insurance copayments, and deductibles?

If you reside in the Town of Bethlehem and have traditional health insurance you are asked to pay out-of-pocket costs, such as insurance copayments and deductibles, up to $100 per ambulance trip.  Tax funds are used to cover these copayment and deductible costs above $100 per trip.

If your insurer sets limits on copayments, such as is done by Medicare, your copayment will be capped at the lower of the copayment allowed by your insurer or $100.  If your insurer does not allow copayments, such as Worker’s Compensation, Medicaid (unless there is a required spend down), and VA, you will not be asked to make any payment beyond what the insurer pays.

Prior to September 2017, DBEMS accepted whatever your insurance paid as payment in full.  The Town of Bethlehem government and DBEMS agreed to begin collecting up to $100 per call in copayment and deductibles to help pay the rising costs of maintaining a high-quality ambulance service.

What if I have a High Deductible Health Plan?

If you have a High Deductible Health Plan with employer funded Health Reimbursement Arrangement (HRA), the purpose of the HRA funds is to bridge the gap between the higher deductible and the expenditure amount at which insurance coverage begins.  Therefore, in these circumstances, Delmar-Bethlehem EMS will ask you to use your HRA to pay the uncovered portion of your ambulance bill.

What if I am not a resident of the Town of Bethlehem?

If you are not a resident of the Town of Bethlehem, you will be responsible for out-of-pocket costs, insurance copayments, and insurance deductibles.

ALL PATIENTS WILL BE SERVED, EVEN IF YOU DO NOT HAVE INSURANCE.

If you are accepting insurance payments, are you still volunteers?

Delmar-Bethlehem EMS still consists of approximately 75 unpaid volunteers who dedicate more than 15,000 hours per year to training, maintaining our equipment, and responding to emergencies.  To meet the needs of the community, Delmar-Bethlehem EMS pays EMTs to staff three ambulances from six am to six pm.  From six pm to six am, Delmar-Bethlehem EMS is more than 75% volunteer at all times, saving taxpayers approximately $400,000 per year.

How are my taxes impacted?

Delmar-Bethlehem EMS spends approximately $500,000 per year to cover the cost of paid EMTs.  Without billing, the ambulance tax would need to be significantly increased to reach the necessary level of staffing.  The revenue recovered from billing covers the cost of increased staffing, has resulted in an ambulance tax decrease, and financed other service enhancements.