NorthStar EMS
1701 E Beebe-Capps Expressway
Searcy, AR 72143
ph: 501-305-2287
fax: 501-268-7026
alt: 501-268-2353
donald
Membership Terms
NorthStar EMS offers Individual and Family Memberships. Family memberships include head of household, spouse, and unmarried children under age 22 still living at home or under 24 if full time students. Membership purchase affirms that you have read, understand and agree.
This is NOT an insurance policy or supplement.
Membership fees are nonrefundable and nontransferable. Annual enrollment drives are conducted April 1 - May 31. All memberships expire May 31st. Fees are not prorated when joining outside the enrollment period, and such memberships will expire on May 31 of the membership year.
MEDICAL NECESSITY
Ambulance service must be medically necessary, usually as determined by a physician.
NorthStar EMS reserves the right to determine medical necessity for non-emergency service.
Emergency transports are limited to situations in which a member has sustained injury, sudden illness or trauma and the need for the immediatemedical attention of a doctor at a hospital emergency room exists. Non-emergency transportation excludes such immediate, life threatening needs and may require physician authorization and/or a Physician Certification Statement (PCS) form as a condition of transport.
COVERAGE
Ambulance transportation (emergency & non-emergency) is provided to and from HOSPITALS within NorthStar’s service area. Patients are transported to the hospital of their choice; however, the physician or NorthStar EMS may select an appropriate facility based on the patient’s medical condition. Emergencies and the need to provide continuing service area coverage have first priority. All dispatching and staffing decisions are the sole right of NorthStar EMS. Non-emergency services to and from medical facilities other than hospitals (e.g. doctor’s office, clinics, dentist, freestanding dialysis, physical therapy, rehab) require medical necessity and are subject to the member discount privileges below.
“MEMBER’S CHOICE” / OTHER PROVIDERS
Membership benefits are not guaranteed unless ambulance service is provided by NorthStar EMS. To receive membership benefits, you may have to specify that NorthStar EMS be called. In some areas, there are other ambulance providers, which may be automatically dispatched unless you request NorthStar EMS. Members are encouraged to make the dispatcher and others arranging ambulance transportation aware of their membership benefits and to specify NorthStar EMS for transport.
MEMBER PAYMENTS / MEMBER DISCOUNTS !Important!
Membership DOES NOT guarantee no out-of-pocket expense for ambulance service. Where benefits are available, NorthStar EMS will accept the amount paid as payment in full. When there is NO medical, health insurance or other benefits plan which pays for ambulance service, the member will receive a discounted ambulance bill [40% off the total charges] and shall be responsible for payment directly to NorthStar EMS. NorthStar EMS agrees to pursue all payer sources prior to billing the member the discounted rate. The discounted rate may apply transports even if physician authorized.
ASSIGNMENT & THIRD PARTY REIMBURSEMENT
Members assign to NorthStar EMS all rights and benefits under any and all medical or health insurance policies or plans and all other medical benefits programs or plans which provide ambulance coverage. Further, members authorize holders of any information about them to release it to HCFA, its Carriers or agents, and to NorthStar EMS now or in the future. Any payments made directly to the member must be turned over to NorthStar EMS in full, immediately. Failure to provide necessary information concerning available insurance or medical benefits, or failure to forward any amount paid for ambulance service shall result in revocation of membership. NorthStar EMS will file with all available policies or plans its claim for each ambulance service, and further agrees to accept the amount paid as payment in full up to the amount of the charges.
NEW GUIDELINES
Many skilled nursing facilities are subject to Consolidated Billing and Prospective Payment System (CB/PPS) guidelines imposed by HCFA and the Federal government. Membership with NorthStar EMS does not exclude any facility where a member may reside from payment under the CB/PPS guidelines. Membership is not transferable to contracts with facilities without prior authorization by NorthStar EMS.
Notice to persons with only MEDICAID coverage: Joining a membership program is voluntary and is discouraged. You already have all benefits for covered services.
Copyright 2016 NorthStar EMS. All rights reserved.
NorthStar EMS
1701 E Beebe-Capps Expressway
Searcy, AR 72143
ph: 501-305-2287
fax: 501-268-7026
alt: 501-268-2353
donald