Georgetown EMS

EMS Billing

The Georgetown Fire Department utilizes a third-party billing company for all Emergency Medical Services (EMS/Ambulance) related billing. Every effort is made to seek reimbursement from the patient’s insurance carrier. Balances not covered by insurance are then billed to the patient.

Pay Your Bill Online

To mail in a payment, please send a check, made payable to Georgetown Fire Department, to:
Georgetown Fire Department
P.O. Box 180446
Dallas, TX 75218

If you have questions regarding your invoice, need to update your insurance information, or to make a payment over the phone, please contact 877-602-2060.Ā Please note: Payments are typically posted within 2-3 weeks of receipt. If you receive another invoice after paying, please call the number above to investigate and confirm receipt and posting of your payment.

Emergency Medical Service (EMS) fees are approved by City Council to reduce the tax cost of emergency medical services for Georgetown residents and to offset the tax cost of providing EMS to residents and visitors. You may be interested to know that nearly 80% of our emergency responses include a need for medical care. Ambulance bills are covered primarily by insurance entities, such as Medicare, Medicaid or private insurance.

View EMS Billing Fee Schedule


Medical/Billing Records Frequently Asked Questions

How can a records retrieval company, insurance company, law firm or attorney’s office, or any other business that requests records with a signed patient HIPAA authorization obtain patient medical and/or billing records?

Georgetown Fire Department utilizes Chartswap.com, where you can register or sign-in as a Requestor to inquire about obtaining the needed documents. (Account Name: Georgetown Fire Department).

How can I obtain my ambulance medical or billing records?

You will need to complete the Authorization to Use/Disclose Protected Health Information form to release/obtain your records.

Please note that while the majority of the form is fillable, you will need to:

    • type your information where appropriate
    • print the form
    • physically sign and initial the requested parts
    • mail completed form to the:
      Georgetown Fire Department
      Attn: Custodian of Records
      P.O. Box 409
      Georgetown, TX 78627

HIPAA laws will be obeyed & enforced regarding protected health information (PHI). The following is required to obtain your medical record:

    • For obtaining your own PHI: a valid state or federally issued photo ID must be presented by the patient with a completed Authorization (above).
    • For obtaining another person’s PHI: a valid state or federally issued ID must be presented, along with proof of legal authority (health care Power of Attorney) with a completed Authorization (above).
    • For obtaining a minor’s PHI: a valid state or federally issued ID must be presented, along with the minor’s Birth Certificate and a completed Authorization (above).
    • For obtaining a deceased person’s PHI: a valid state or federally issued ID must be presented, Death Certificate, and a Letter Testamentary, Letter of Administration, or other document establishing the requester as the Personal Representative must be presented.

Payment Plans

We understand that it can be difficult to pay a medical bill and are happy to offer up to a 12-month payment plan option.

Please call 877-602-2060 for more information.

Financial Hardship

We are sensitive to those struggling financially and are committed to treating all patients regardless of their situation.

Individuals who can demonstrate financial hardship and would like to be considered for a reduction in the fees associated with ambulance treatment and/or transport may complete the Financial Hardship Application.

Please note that independent information is required to support claims of financial hardship, which can include verification of expenses and income. The following are accepted documents to aid in this consideration:

    • Proof of income
    • Notarized Unemployment Statements; how long unemployed
    • Unemployment check stubs
    • Income Tax Return
    • Employer or Welfare Documents

Other documents that may be accepted for consideration include the Financial Hardship Acceptance/Approval from other institutions (specific to the incident); or a letter from the applicant explaining circumstances, expenses, debts, and/or providing the specific circumstances which require financial assistance.

Upon receipt and review of the submitted documents, applicants will be contacted regarding the resolution. Applicants will continue to receive invoices during the application review process.

View the Georgetown Fire Department’s Financial Hardship Determination Policy Manual for more information.

On behalf of the emergency personnel who treated you and the employees of Georgetown Fire Department, please accept our best wishes for a speedy recover from your illness or injury.

 

 

 

 

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