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Ambulance Fee for Service

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1. What is Ambulance Fee for Service and why is Page County implementing this program?

Ambulance Fee for Service is the process of obtaining financial reimbursement for the cost of providing medically necessary ambulance transportation. Medicaid, Medicare and most other private insurance policies (health, automobile, and/or homeowners) already allow for reimbursement for this service. Page County is implementing this program to seek reimbursement of the cost of providing these services which will help offset some of the operational expenses for providing a combination of volunteer and paid fire, rescue, and emergency services system while giving some relief to the County's General Fund and ultimately to the taxpayer.

2. What are the charges for emergency medical transport services?

See the Emergency Medical Transpor Services Charges page for fees. Emergency Medical Transpor Services Charges Page

3. Will I have to pay for services if the ambulance does not transport me?

No, if you or family members are not transported, there will be no bill for services rendered. Ambulance fee for service is based on what is called "loaded service," whereby someone is actually transported.

4. What is the Compassionate Billing Policy?

No one will ever be denied necessary medical transport service due to either their inability to pay or lack of insurance. Compassionate billing is intended to eliminate or minimize out-of-pocket expenses for ambulance services for those that do not have the means to pay. Priority may be given to county residents.

Any person receiving emergency medical transport may submit a waiver request form stating a financial hardship. Appropriate financial documentation will be required.

5. What happens if I do not have insurance or cannot afford to pay for ambulance service?

All patients who do not have any insurance can submit a waiver and fees may be waived pursuant to the Compassionate Billing Policy.

6. What if my insurance company will not cover my ambulance transport bill?

Insured patients, who are residents of Page County, are not responsible for any ambulance transport service fees not paid by their insurance carrier or carriers. All other patients are responsible for ambulance transport service fees not paid by their insurance carrier or carriers unless otherwise waived as provided in the Compassionate Billing Policy. Patients are not responsible for any amount of the ambulance transport service fees adjusted by insurance carriers as a result of state or federal regulations or by agreement with Page County.

7. How does the Ambulance Fee for Service program help the volunteers?

New funding made available through Ambulance Fee for Service will be used to assure adequate resources to volunteers, helping them to continue to provide the best possible service to the County's citizens. The primary goal of all Page County emergency personnel is for the public to receive the best emergency service possible.

8. How does the billing process work for the Ambulance Fee for Service program?

Page County contracts this service out to a private company to handle the billing process. After patient care is provided, insurance information will be obtained routinely, often at the hospital. Page County will waive co-payments and deductibles for County residents. Non-insured residents will receive an initial statement from the billing company, while insured residents will receive an explanation of benefits (EOB) from their insurance company. All patients may apply for the hardship waiver, if needed.

9. Will visitors and non-County residents be charged a co-payment for ambulance service?

Yes, only County residents will have their co-payments and deductibles waived.

10. Will my health insurance premiums increase as a result of Ambulance Fee for Service billing?

Unfortunately, health insurance premiums continue to rise regardless of whether or not a community decides to bill for EMS transports. Such factors as prescription-drug coverage, litigation, technology improvements in the medical field, and depressed insurance company investment returns have resulted in escalating health insurance premium costs. However, ambulance transport costs represent less than 1% of health care expenditures. Many other local governments in Virginia have implemented a revenue recovery program for ambulance transport fees, and they have reported no evidence that EMS billing increases health insurance premiums.

11. What type of information will I have to give when an ambulance arrives?

Individuals using the Emergency Medical Service are asked to provide any insurance information you have at the time of service, whenever possible. Attending to the patient's medical needs will always be the 1st priority.

12. What if I'm not able to provide the necessary insurance information to an ambulance when it arrives?

If your insurance information is not available at the time of service, the billing company will attempt to obtain the information at the hospital. If the information cannot be obtained, you may receive a letter asking you to provide the information. You can contact the billing office to provide the information. When the billing offices receives the information, your insurance will be billed. You will not receive any further correspondence or bills until the insurance company has made a determination on your claim.

13. Who is the 3rd-party billing contractor that the County uses for Ambulance Fee Service?

Page County uses Ambulance Medical Billing (AMB), Paducah, KY, for billing services. They can be contacted at 270-744-9600.

14. If I don't have health insurance, can other types of insurance pay for ambulance service?

Many automobile insurance policies and homeowners' insurance policies provide some form of coverage if the insured was injured and required transport by ambulance. We recommend that citizens review their insurance coverage to verify their limits of coverage under each policy. In speaking with the billing contractor, they routinely bill health insurance first, followed by auto insurance and lastly any other form of insurance.

15. How much revenue will be generated by the Ambulance Fee for Service program?

Staff has estimated that approximately $300,000 to $400,000 will be generated annually.

16. Will people hesitate to call for emergency services if they cannot pay or if they are uninsured?

Some residents have expressed concern regarding individuals who cannot afford to pay for this service and/or do not have any form of insurance. Specifically, they feel individuals will hesitate in calling for EMS services when they have an emergency. Ability to pay will never be considered when providing service.

When residents need emergency assistance, they should call 911 without hesitation.

Also, based upon the localities we have contacted, they have all reported that there has not been a decrease in call volume and in most cases call volume has increased.

17. Who will I call if I have a question regarding billing or insurance coverage of ambulance services?

The billing company has customer service representatives to address your questions. If you wish to speak with someone locally, you can contact the Department of Fire and Emergency Medical Services at 540-743-4142.

18. Will uncollected debts for ambulance service be sent to a collection agency?

Page County's billing company will not pursue payment recovery through a debt collection agency without the expressed authorization of the County Administrator or his designee.

19. Will the County waive out-of-pocket expenses related to revenue recovery if they meet the criteria?

There has been discussion among staff regarding an Office of Inspector General (OIG) opinion that surfaced last year. This opinion relates to the jurisdiction being able to use any taxes (real or personal property) to qualify as the co-pay for County residents. It is the intent of the County to utilize the OIG opinion for County residents, so the out-of-pocket expense for the co-pay will not need to be paid by County residents.

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Animal Shelter

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1. Where can I purchase a County dog license/tag?

You can purchase a county dog license at the Treasurer's Office located in the County Government Center, 103 South Court Street, Suite A, Luray, VA 22835. Please bring a copy of your dog's current rabies vaccination certificate to verify proof that the dog has been vaccinated against rabies. The cost is for a one year tag: $6 for regular and $3 for spayed or neutered; for a two year tag it is $10 for regular and $5 for spayed or neutered; and, for a three year tag it is $14 for regular and $7 for spayed or neutered. Kennel tags are also available.

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Geographical Info Systems (GIS)

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1. How do I get a physical address?

You must first obtain a building permit after satisfying all application requirements. After the measurements are taken, they are downloaded into the system.

You will receive your address within 14 calendar days.

2. Why would a new road name be required?

§127-4.A(2) of the County's E-911 Addressing Code states: "When a private road has three or more habitable structures, it must be assigned a road name."

3. Do I have to have my E911 number on my house?

Yes, all residents must have an E911 number on their house and/or at the beginning of their driveway. Numbers should be at least 4 inches and reflective. You may download and submit a 911 Address Application. 911 Address Application (PDF)

4. Where can I get a listing of all the roads in Page County?

Contact the GIS Department by phone at 540-743-7316, or by email. Email GIS

5. My road sign has been stolen, who can I report this to?

The E911 Office will make a report of all missing or damaged road signs and inform the Page Sheriffs Office to replace the sign.

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Landfill

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1. Does the landfill accept florescent bulbs?

No. EPA regulations do not permit their disposal in a sanitary landfill.
Check with area hardware stores to see if they have a recycling program.

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Zoning

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1. What is the minimum lot size?

The minimum lot size is 1 3/4 acres.

2. If my lot is smaller than 1 3/4 acres can I still build on it?

Yes, but only if the lot was created before June 21, 2005 and you can meet the minimum setback requirements.

3. What is my property zoned?

For this information, you will need to fax (540-743-1419) or email your tax map number to the Zoning Office so that this information can be verified. This information is not provided over the telephone. Email the Zoning Office

4. How do I know if my property is in the floodplain?

You can contact the Zoning Office, at 540-743-1324, for this information and the staff will research your property on the Federal Emergency Management Agency (FEMA) Flood Maps and the Hawksbill Creek Study. You may visit the FEMA Map Center's website. FEMA Flood Map Servce Center Website

5. Am I allowed to live in a camper?

No. (Refer to Section 128-5 of the Code of Page County.) Section 128-5 of the Code of Page County

6. I already have a house on my property, can I put another home on the same lot?

No, but you may put a guest home on the same property. Page County only allows 1 permitted principal residential structure per lot or tract of land. A guest home is defined as a 1- to 2-bedroom structure designed to compliment the permitted principal residential structure. Only 1 guest home shall be allowed on any lot, tract or parcel of land, and cannot be rented or sold separate from the permitted principal residential structure.

7. What is a setback?

A setback is the required distance that a structure must be built from an adjoining property line, road or right-of-way.

8. What are my setback requirements?

Setback requirements depend on the zoning of the property.

9. How often can you subdivide a piece of property?

A piece of property may only be divided once every 5 years.

10. How do you determine what your right-of-way is?

If the property fronts a state-maintained road, you may contact Virgina Department of Transportation (VDOT) to inquire about the width of the right-of-way. If you live on a private road, you may find this information in your deed.

11. In addition to zoning, what other permits may be required?

Other permits required my include building permits and erosion and sediment control permit. Please check with the Building Office at 540-743-6674 to verify this information. Additional questions can be addressed to Tracy Clatterbuck, Zoning Administrator, at 540-743-1324.