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Emergency Medical Service (EMS) Cost Recovery is the process of obtaining financial reimbursement for the cost of providing medically necessary ambulance transportation. Medicaid, Medicare and most private and employer-sponsored health insurance policies provide for payment for ambulance transport. For more information on prehospital EMS services, see the National Highway Traffic Safety Administration’s Office of EMS Information (PDF).
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Emergency medical calls account for a large percentage of the total number of emergency services calls in the City. For example, in 2016, there were over 5,000 EMS incidents in the City and 54% of Charlottesville Fire Department responses were for Emergency Medical Service (EMS) incidents. As the need for emergency medical services continues to grow, the City, like many other localities, is seeking ways to fund these services without relying solely on local tax revenue or donations to local volunteer agencies. EMS Cost Recovery permits localities to recover system costs from those individuals who benefit directly from EMS delivery, including non-City residents, with the vast majority of the costs collected from Medicare, Medicaid and insurance companies.
The EMS Cost Recovery program will be utilized to support the volunteers at the Charlottesville-Albemarle Rescue Squad (CARS), will provide a funding stream to support additional Charlottesville firefighters to staff ambulances in the City, and will support the acquisition and deployment of sophisticated EMS equipment.
No one will ever be denied emergency service because of the Emergency Medical Services (EMS) Cost Recovery Program. If a patient calls 911 but is not transported, there is no charge. City residents covered by Medicare, Medicaid, or private insurance will not be billed for any balances due after applicable insurance payments have been collected. City residents without insurance will not be billed at all. Non-city residents, in cases of hardship, may apply to the City for a hardship waiver once all applicable insurance payments have been collected.
Yes. Both CARS and Charlottesville Fire Department staffed ambulances will bill for service as part of the Emergency Medical Services (EMS) Cost Recovery Program.
The City estimates that between 1 and 1.4 million dollars will be recovered annually. These funds will be used to support and strengthen the City’s combination of volunteer-career Emergency Medical Services (EMS) transport system.
Nearly 80% of Virginia residents live in localities that bill for Emergency Medical Services (EMS) transport. Nationally, that percentage approaches 85%. Many other localities in Virginia are currently considering this type of EMS Cost Recovery. More than 40 cities, counties, and towns in Virginia currently bill for emergency ambulance transport to recover expenses and offset system costs. Localities in our region that bill for service include:
