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1. What information does Danbury Emergency Medical Services (Danbury EMS) need to file my claim?

Medicare

• Patients name (spelled correctly as it appears on their card)
• Medicare number

Medicaid

• The 8-digit number on the Gold Card or either the 10-digit recipient ID number.
• Workers Comp Insurance
• Employer name, Employers Mailing Address, Employer city, Employer phone number

Major Medical Insurance / Secondary Insurance

• Insured's name
• Patients relationship to insured (self, spouse or child)
• Insured's Date Of Birth (DOB). (Insurance Company's will no longer pay without the DOB)
• Insured's sex
• Group name and Group number
• Contract (policy) number

Auto Insurance

• Owner of the Vehicle you were in.
• Auto Insurance Name, Address, Phone Number.
• Policy Number and Claim Number

2. I’d like to speak someone about my claim?

Our billing service representatives are available to speak with you at 888-980-9301 Monday through Friday from 8 am to 5 pm Eastern Standard Time.

3. Can I access my account or provide remit information online?

Yes Danbury EMS has a secured website portal:
View the EMS Portal.

4. Why am I receiving an invoice?

Statement and invoices may be sent to the recipients of service by Danbury EMS for many reasons.

An invoice is mailed to all patients who have been transported via a Danbury EMS ambulance. Please read it carefully. If we have all of the information to file your claim, the invoice will state "we have filed this bill with Medicare / Insurance and are awaiting payment". We will send you the balance due statement after Medicare/Insurance has paid or denied our claim. We will also file your secondary insurance if applicable. Or it could be as simple as needing a signature in order to file your claim with the insurance provider, verification of Insurance information, or missing or no Insurance information.

1. Except as provided in subsection (b) of this section and subject to the provisions of sections 19a-177, 38a-498 and 38a-525 of the general statutes, any person who receives emergency medical treatment services or transportation services from a licensed ambulance service or certified ambulance service shall be liable to such ambulance service for the reasonable and necessary costs of providing such services, irrespective of whether such person agreed or consented to such liability.
2. The provisions of this section shall not apply to any person who receives emergency medical treatment services or transportation services from a licensed ambulance service or certified ambulance service for an injury arising out of and in the course of his employment as defined in section 31-275 of the general statutes.

5. Why am I receiving a statement?

Monthly Statements are mailed at the end of each month on all accounts that have a balance.

6. Will you send the claim to my secondary insurance?

Yes, we will file a claim to your secondary / supplemental insurance after we receive the payment from your primary insurance/Medicare.

7. Can I make payment arrangements?

We will gladly set up a monthly payment plan with you.

8. What method of payments do you accept?

Check, Money Order, Visa, MasterCard, Discover, and Debit Cards.

9. How can my attorney get a copy of the billing record?

Intermedix on behalf of the City of Danbury EMS utilizes the services of Healthport for all attorney requests for billing records. Due to the ever evolving changes within the HIPAA laws, privacy of our patient's information is our first priority. Healthport insures that only people that you have authorized can gain access to your records.

The following is a link to their website where you can request billing records information via fax or set up access through their portal and receive ambulance billing information securely.

• Request via Portal
• Request Via Fax: 305-521-0773

Should you encounter any issues, please contact Healthport's Customer Care directly at: 800-367-1500.

Note: Please be advised that there may be a nominal charge for ambulance billing records. You will be provided this charge prior to finalization of your records request.

10. How do I get a copy of my medical record?

You can request copies of your medical records by contacting the Health Information Services (Medical Records) Department: Request Medical Records or call 203-739-7218.

Please note that there may be a fee associated with your request.

Release of Information

You may also complete the Release of Information Authorization form, available in English, Spanish and Portuguese. Please fax the completed form to Health Information Services at 203-739-6689. Please be sure to include your current address and phone contact information in case we need to reach you about your request.

Click on a Release of Information Authorization to view online or print a copy. Release of Information Authorization are available online in PDF format. You may need to download the free PDF reader from Adobe.com.