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Billing and Schedule of Transfers
At Montgomery County EMS, we are happy to provide ambulance transport for all your medical emergencies to our local hospital as well as Emergency and Advanced Life Support or Specialty Care Non-Emergency Transports from our local facility to a facility in another location.
Since some insurance companies require prior authorization and other paperwork to be completed before a transport can occur, this page provides general information about this matter in order to prepare you in advance. This will save time for everyone involved and get you safely on your way to your destination.
Our billing staff in the business office is available to you Monday through Friday from 7:30 a.m. to 4:30 p.m. CST with the exception of Federal holidays. Our billing staff is ready to assist you with any concerns you may have connected to securing non-emergency transport, insurance matters and/or information on your account with the Montgomery County EMS.
Payments can be made in person or by mail any time from 7:30 a.m. to 4 p.m. CST. Our office accepts cash, personal checks and money orders. Credit card payments are also accepted by phone. In the near future, we will have online payment access for your convenience.
We are happy to file insurance on behalf of the patient and currently accept most forms of insurance to include TennCare, Medicare, TriCare and commercial carriers. However, we do not file claims for out-of-state Medicaid programs with the exception of Kentucky and insurance companies based in other countries. We do file claims with automobile insurance carriers; however, the patient is responsible for payment of the invoice if the carrier has not paid the claim within 90 days of the filing date.
Please contact our billing office at (931) 648-5737 if you have any questions regarding the transport services, our knowledgeable staff will cover any of your questions regarding the requirements that must be met. In the event, you have a request for our services which is not covered by Medicare or any other insurance company, you will be asked to complete a form known as the Advanced Beneficiary Notice Form. This form will provide you with the reason the insurance company will not cover the transport and also the amount to be charged. In this way, you will be in a position to make an informed decision about the transport.
Download the Advanced Beneficiary Notice Form
TennCare patients must have prior authorization in place before scheduling your transport. The patient, patient’s family or nursing home facility must obtain this authorization from the TennCare managed care organization in which the patient has coverage. We are unable to obtain authorization for the patient due to TennCare guidelines.
HealthSpring Medicare and HMO patients must have prior authorization before scheduling nonemergency transport. Please contact HealthSpring at (888) 501-3965 or (800) 453-4464 to obtain authorization.
Accounts are held for 90 days from the date of the patient’s transport. We keep the patient informed of the account’s status by mailing out medical release forms, invoices, statements and final notices. If an account has not been paid or a payment agreement has not been reached at the end of the 90 day period, the account will be held in a collection status and turned over to Credit Bureau Systems, Inc. Please keep our office informed of any address changes or if you have not received correspondence from us.
“Accounts may be forwarded to collection earlier than 90 days if our correspondence has been returned by the United States Postal Service.”
Download the Insurance and Medical Release Form
- For billing questions, please call (931) 648-5737.
- We are located at 1608 Haynes Street, Clarksville, TN 37043
- If your account has been transferred to collection status, please contact Credit Bureau Systems at (931) 647-5614 for further assistance.
- Privacy Practices
Thank you for using the services of Montgomery County EMS.