A bill for EMS services is usually mailed to the home of the patient within one week from the date of service. Payment can be made by check or with a major credit card - 

• VISA, 
• Mastercard, 
• American Express, or 
• Discover

Payment instructions are listed on the bill.

Questions

All questions related to billing should be directed to the EMS billing department 210-227-7252 between the hours of 8 a.m. and 5 p.m. Central Standard Time (CST).

Charity Care Policy for Ambulance Services

Purpose

The purpose of this policy is to recognize that the San Antonio Fire Department may provide ambulance services to patients who may not have the means to pay the ambulance transport fee due to circumstances beyond their control. It is not the intent of this policy to provide charity care to patients who have the ability to pay, or to patients who have private insurance, Medicare, Medicaid or other third-party coverage.

Policy

It is the policy of San Antonio Fire Department to provide ambulance services to our community without regard to a patient’s and/or guarantor’s ability to pay for these services. We maintain a charity care policy for patients who are unable to pay for all or part of their care for various reasons.

Charity care is not available for patients who are able to pay for their care. For those patients who are able to pay for their care, San Antonio Fire Department shall require payment but may offer special arrangements, including payment plans, with approval of the City of San Antonio. Payment plan inquiries shall be directed to the SAFD EMS billing vendor at 621 N. Alamo, San Antonio, TX 78215, the SAFD EMS Division, or subsequent billing vendors as contracted by the SAFD.

• Download: Charity Care Policy ^(PDF)

Guidelines

These guidelines are provided to the contractor(s) currently performing ambulance billing and collections and revenue maximization consulting services for San Antonio Fire Department. The contractor(s) may rely on these guidelines and provide hardship assistance without further approval from the San Antonio Fire Department and/or the City of San Antonio. However, San Antonio Fire Department reserves the right to review any of the accounts that were deemed eligible for charity care in order to ascertain if the contractor is acting in conformity with the guidelines. San Antonio Fire Department further reserves the right to modify this policy at any time with the approval of City Council.

Full charity care reduction (100% write-off of ambulance service charges to charity care) shall be granted to patients earning less than or equal to 400% of the Federal Poverty Level (FPL), as published annually by the Department of Health and Human Services. San Antonio Fire Department and/or its contractor(s) shall rely on financial data provided by the patient and may also utilize data from credit bureaus and other sources to determine if the patient is eligible for charity care. Once it is determined that the patient is eligible for charity care, San Antonio Fire Department or its contractor(s) shall make no further attempts to collect payment from the patient.

Related Documents

• Request for Charity Care Assistance ^(PDF)
• Charity Care Assistance Application ^(PDF)

The EMS billing department can assist with filing insurance claims, including Medicare, Medicaid and private insurers. To request the filing of a claim, complete an Insurance Request Form - English ^(PDF) / Insurance Request Form - español ^(PDF) and mail or fax it to the SAFD Billing Contact. The EMS billing department will then submit the claim to the appropriate carrier. Insurance carriers typically take up to 60 days to process a claim. In cases of partial coverage, the EMS billing department will send an adjusted bill to the patient for any remaining balance.

Medicare/Medicaid Claims

For Medicare or Medicaid claims, coverage for ambulance services follows the government’s guidelines: “…ambulance transportation is a covered service when the patient's condition is such that the use of any other method of transportation would endanger the patient's health. A patient whose condition permits transport in any type of vehicle other than an ambulance would not qualify for coverage. The payment for ambulance transportation depends on the patient's condition at the time of service regardless of the patient's diagnosis or other reason for transport. Medicare only covers ambulance transports. If the ambulance crew does not transport the patient but only renders aid, this is a non-covered service. The patient will be liable for payment of the service.” Review “Medicare Coverage of Ambulance Services” (PDF) for more information.

Private or Commercial Insurers

For private or commercial insurers, the City of San Antonio is not a contracted provider for any HMO’s or PPO’s. It’s up to the insurance carrier to decide if ambulance services will be covered.