Billing FAQ

Q. How is Lake-Sumter EMS structured?

A. Lake-Sumter EMS is a not-for-profit corporation that is owned by Lake and Sumter counties. The counties have oversight through a Board of Directors with membership representation from both county commissions, as well as representatives on behalf of local hospitals, the League of Cities and citizens at large. Lake-Sumter EMS is funded through a combination of ad valorem taxes and user fees.

Q. Is Lake-Sumter EMS affiliated with any hospitals?

A. No. Lake-Sumter EMS is a not-for-profit corporation jointly owned by Lake and Sumter counties.

Q. How are the Lake-Sumter EMS rates determined?

A. Rates are determined through local market studies, carrier allowables, as well as budgetary processes, and are reviewed and approved by the Lake-Sumter EMS Board of Directors each year. For more information about Lake-Sumter EMS rates, see the billing rates page.

Q. Is the bill for ambulance covered by insurance?

A. In most cases, yes. However, this depends in large part on the type of coverage that the patient has and whether the service is considered “Medically Necessary” by the patient’s insurance carrier. For more information, call the Lake-Sumter EMS Customer Service Department at 352.385.9006.

Q. Who should I contact if I have a question on my bill?

A. Call the Lake-Sumter EMS Customer Service Department at 352.385.9006. For long-distance calls, use the toll free number at 866.735-7515.

Q. I pay for ambulance on my tax bill, why do I also get billed when I use the service?

A. Lake-Sumter EMS is funded through a combination of ad valorem taxes and user fees. To minimize the impact on the entire citizenry of Lake and Sumter counties, it was decided to impact everyone for the availability of the service, and only the users for actual usage of the service. In this way, the taxes necessary to support the ambulance service can be held to a minimum. The millage rate is currently .5289, or 52.89 cents per $1,000 of taxable property value.

Q. I was recently transported by ambulance and Medicare denied my bill for Medical Necessity. Why did they deny and what are my rights?

A. The Medicare program will only pay for ambulance services that it deems “Medically Necessary”. In all cases, other means of transportation must be contraindicated due to the patient’s condition, regardless of whether other means are available. In simpler words, the patient’s condition must be acute and such that transport by other means would be endanger the patient’s life, limb or bodily organs. Roughly 20 percent of the transports that we perform on an annual basis do not meet these criteria.

A patient has the right to appeal Medicare’s decision. In the event that a patient’s bill is rejected, they can file an appeal for reconsideration. Simply obtain all of the information in regards to the service (i.e. ambulance run form, emergency room notes, physician notes, discharge orders, lab results, etc.) and mail them to the Medicare carrier requesting an appeal. For more information, call the Lake-Sumter EMS Customer Service Department at 352.385.9006.