This report collects information from licensed EMS ground ambulance providers operating in Texas.
Reporting periods – January 1, 2019, to December 31, 2020
The extended due date for submissions is June 10, 2022.
Background information
Section 3 of Senate Bill 790 requires the Texas Department of Insurance to conduct a study of ground ambulance billing practices. It also allows TDI to collaborate with the Texas Department of State Health Services to conduct the study.
Reporting form
The reporting form is an Adobe PDF document. It must be filled out in a current Adobe Reader application. To prevent problems with reporting, please download the form to your computer’s desktop and open it in Adobe. Opening the form in a web browser can cause problems during submitting.
Ambulance provider reporting form (PDF)
Instructions for reporting (PDF)
FAQ
Is this report applicable to licensed health plans?
No. Only ground ambulance providers licensed by the Texas Department of State Health Services are required to report.
Does this report apply to air ambulances?
No. By statute, this report is applicable to ground ambulances only.
We are a Texas EMS ground ambulance service, but I don’t know the license number.
License numbers can be looked up at https://vo.ras.dshs.state.tx.us/datamart/mainMenu.do.
We are an ambulance provider that operates in several regions of the state and our services differ from region to region. How do we answer question 3 relating to emergency vs. non-emergency classification?
If an ambulance provider operates in more than one region of Texas and provides non-emergency services in at least one region and also provides emergency services in at least one region, the provider should report that it conducts ‘Both emergency and non-emergency’ transports.
For question 5 regarding patient transports, if we transport the same patient more than once, should we count this as several patient transports?
Yes. Question 5 seeks to get a count of the total number of patient transports. If a patient was transported more than once in 2020, please count each time the patient was transported.
If an ambulance provider has a charity or hardship policy that assists patients with their bills, does that affect how we report referrals to a third party for collection in question 12?
If an ambulance provider’s charity or hardship program pays a patient’s bill in full, there is no unpaid balance for the purposes of this question. However, if the program pays a portion of the bill, but there is a remaining balance, the bill is considered unpaid and would be treated just as any other unpaid bill for the purposes of this question. Also, using a charity or hardship program to help pay a patient’s bill is not considered referring it to a third party for collection.
Why would an ambulance provider report that it ‘Sometimes’ refers unpaid bills to a third party for collections in question 12?
If an ambulance provider sends all unpaid bills to a third party for collection, it should report that unpaid bills are ‘Always’ sent to a third party for collection. However, if an ambulance provider does not consistently refer all unpaid bills to a third party for collection, then it should report that it ‘Sometimes’ sends unpaid bills to a third party for collection. This might happen when an ambulance provider “writes off” some bills but not others. For example, an ambulance provider that sends most bills to a third party for collection might have a policy of not referring bills under $100 to a third party for collections. In this case, it should report that it ‘Sometimes’ sends unpaid bills to a third party for collection.
How do we handle denied claims for questions 10 and 11?
Claims that are denied by a payor (such as Medicaid/Medicare in question 10 and private health coverage in question 11) are not considered to be part of the balance billing equation for the purposes of this survey. Claims that are considered “balance billed” are claims where the payor has made a partial payment and, other than the patient’s normal out of pocket costs (deductible, copayment and coinsurance, for example), the patient is billed for the rest of the bill.
As an ambulance provider, we charge one rate to residents of the district and a different rate to non-residents. How do we report rate data for questions 13-19 pertaining to the dollar amounts that we charge for services?
Since both types of patients are being billed by the organization, it is acceptable to average the rates that are charged to residents of the district and non-residents.
How do I send the completed form to TDI?
Once the form is completed, click the ‘submit by email’ button on the bottom of the last page. The form will automatically perform some checks to see that it was filled in completely. If it has any problems, it will alert you to correct the error. If there are no problems, it will open an email and attach the data to the email. You can then send the email to TDI. There is no need to fax the form or print and email the scanned image to TDI. You can also print a copy of the form for your records by clicking the ‘Print form’ button on the bottom of the last page.
If I still have technical questions about entering or submitting data, who can I contact?
If you’ve reviewed the guidance on this page and still have a technical problem with the reporting form, you can send an email with the details of the problem to HealthReports@tdi.texas.gov.