City of Columbus

EMS Report

A copy of a patient care report is only available to the patient, assigned representative, parent/guardian, Medical Power of Attorney, executor or administrator of the patient’s estate, and/or the Next of Kin listed on a Death Certificate. EMS Records are considered to be private and confidential. The information in a patient care report is protected under the Health Insurance Portability and Accountability Act (HIPAA). In order to release this information, we must have a completed medical authorization form.  Proper documentation must be included with your request: 

• If you are the patient, in person photo ID or a notarized medical authorization form
• If you are the assigned representative, the medical authorization formwith yourself listed in the authorization section. This form must be notarized.
• If you are the parent/guardian of the patient who is a minor,medical authorization form along with a copy of the birth certificate or insurance card that lists both the parent/guardian and the child.
• If you are the patient’s Medical Power of Attorney (POA),  medical authorization form and a complete copy of the POA.
• If you are the executor or administrator of the patient’s estate, medical authorization form and a copy of that document.
• If you are the Next of Kin,medical authorization form, a copy of the Death Certificate with the Next of Kin listed (must be same person who is obtaining report), your photo ID. 

You may receive the EMS report through one of the following:

1. Email - Email the notarized request to EMSRecordReq[email protected]  
2. Mail - Mail the notarized medical authorization form to 3639 Parsons Ave., Room 113, Columbus, Ohio 43207
3. FAX - Fax the notarized medical authorization form to (614) 645-6332
4. In person – Bring in or fill out the medical authorization form to  3639 Parsons Ave., Room 113, Columbus, Ohio 43207

Please Review the following documents:

Columbus Division of Fire Notice of Privacy Practices

Authorization for Use and Disclosure of Protected Health Information

To have your report ready, please call our office first at 614-645-7384 opt. 2. There is no charge for this report.

Please call (614) 645-7384 opt. 2 or email [email protected] with any questions.

EMS Records Contact Information

Address: 3639 Parsons Avenue Room 113 Columbus, Ohio 43207

Email: [email protected]

Phone: (614) 645-7384 opt. 2 

Fax: (614) 645-6332

Why does The Columbus Division of Fire charge for EMS services? 
 
The Division of Fire provides one of the best Emergency Medical Services (EMS) in the United States. The costs for providing emergency medical services are expensive by nature. In an effort to help fund this system, a "third-party reimbursement" program was implemented in 2003. Such programs exist in an estimated 85 percent of communities nationwide. 

Reimbursement for the expense of emergency ambulance transport is sought from a patient's Medicare, Medicaid, or commercial health insurance provider. These policies contain provisions with built-in premium charges that reimburse fire departments such as the Columbus Division of Fire for transports to hospitals. Consequently, everyone pays for EMS transports services regardless of usage.
 
The City of Columbus wants to take advantage of these premium charges and "re-direct" private medical insurance premium dollars and Medicare dollars back to the city. Therefore, EMS revenue recovery may be viewed as a "rebate" of private insurance and Medicare premium dollars; not a form of "double taxation" as some would say. Moreover, EMS recovery is also viewed as more equitable as the citizens who actually use this service help to pay for it. 
 
Lastly, this reimbursement is used to support city operations such as providing vital emergency services e.g. the purchase of medical supplies, paramedic training, fuel, etc. It must be noted that while this reimbursement assists in offsetting emergency medical costs these monies in no way cover all the costs incurred for treatment and transport. 
 
Who will be billed?  
 
We will bill only the insurance carriers of patients who are insured or have Medicare coverage and only when they are transported to a hospital emergency room. Furthermore, if you live in the City of Columbus and do not have health insurance coverage, you will not receive a bill for transport. Consequently, no Columbus resident will pay anything "out of pocket" as the result of being transported to a hospital by The Columbus Division of Fire. 
 
In the event that our billing company does not have complete insurance information, you may receive a Request for Information (RIF) letter requesting insurance information. Also, if you are transported to a hospital and your insurance company pays for the transport, you may receive an Explanation of Benefits (EOB) letter from your insurance company. Do not confuse an EOB letter with a bill; once again, no City of Columbus resident will receive a bill for transportation to the emergency room of any hospital. While Medicare law provides the above exemption for "out of pocket" expenses for City of Columbus residents, the same Medicare law mandates that The Columbus Division of Fire charges all nonresidents for hospital transportation regardless of insurance coverage. 
 
Who receives the ambulance bill?  
 
For City of Columbus residents, the ambulance transport bill goes directly to third-party payers. Third party payers include Medicare, Medicaid, and private health insurance companies. 
 
For those who do not live in the City of Columbus, the initial ambulance transport revenue recovery bill goes directly to a third-party payer, if available. If Medicare, Medicaid, or a private health insurer does not pay the bill, the individual is "balance billed"

The patient can also assign a Representative by completing this medical authorization form and having the Representative come to our office with picture ID and this authorization form completed and notarized.

As stated above, you may receive an Explanation of Benefits (EOB) from your insurance carrier… remember, this is not a bill. Your insurance carrier may or may not reimburse The Columbus Division of  Fire for the full fee, but rest assured you are not responsible for this difference if you live in the City of  Columbus. However, any patient transported to a hospital that is not a resident of the City of Columbus will be responsible for all "out of pocket" expenses regardless or whether or not health insurance coverage exists. 
 
The city has made provisions for financial hardship, however, and will work with low-income individuals who do not have insurance as such cases arise. It must be stressed that no on who calls 911 will ever by denied treatment or transport.

 
What will The Columbus Division of Fire charge for an EMS transport?  
 
It depends on your level of care, but the fire department, through its EMS billing vendor, will invoice Medicare or your insurance carrier reasonable and customary rates for this area. 
 
Who do I call if I have questions? 
 
If you receive a Request for Information letter (RFI), as mentioned above, or any other correspondence from the Columbus Division of Fire as a result of being transported to the hospital, please call the toll free number provided on the letter. Representatives of Change Healthcare (the billing vendor for the City of Columbus) will assist you with any question you may have. 
 
If you have a question concerning the care provided by the fire department, please call the fire department directly and we will assist you in any way we can. 
 
Who handles the EMS billing for the City of Columbus? 
 
Effective January 1, 2008, the City of Columbus contracted with Change Healthcare, a national healthcare management and technology company devoted to providing service excellence to healthcare professionals and patients. The EMS billing office can be reached toll-free at 1-866-631-4549. 

RFI letters, insurance information and other inquiries should be mailed to: 
 
Columbus Division of Fire 
C/O Change Healthcare 
3131 Newmark Drive 
Suite 100 
Miamisburg, OH 45342   
 
Payments should be mailed to:  
 
Columbus Division of Fire  

PO Box 78000

Department 781182

Detroit MI 48278   
 
How does Change Healthcare get my health insurance information? 
 
Change Healthcare networks directly with all local hospitals to obtain insurance information. Occasionally, this information cannot be obtained from the hospital, and must be confirmed directly with the patient. If you receive a Request for Information letter (RFI), please respond as soon as possible so that your claim can be handled quickly and professionally.