Billing and Schedule of Transfers

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Billing Office is located at 1608 Haynes Street, Clarksville, TN 37043

At Montgomery County EMS we are happy to provide for all your emergency and nonemergency transport needs.

This page is to provide general information about our billing and insurance needs for patients transports.

We understand that billing and insurance can be complicated. As a result our billing staff is ready to assist you will any questions or concerns about your transport needs.

Our business office is open Monday through Friday from 7:30 a.m. to 4:30 p.m. CST, except on federal holidays. Payments can be made in person, via phone or by mail any time from 7:30 a.m. to 4 p.m. CST. Our office accepts cash, credit cards, personal checks and money orders. Payment arrangements may also be made by speaking with one of our billing staff.

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.

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

We currently offer wheelchair and stretcher transports for non ambulatory patients. This includes but not limited to physician and dialysis appointments, cancer treatments, discharges, and special care transports.

In order to schedule a transport please note that the following conditions must be met:

All transports regardless of insurance type must have an Ambulance Necessity Form filled out and signed completely. As a convenience we have provided the ANF form below for download.

Download the Medical Necessity Form

Medicare

Please contact our billing office at (931) 648-5737 if you have any questions regarding the transport services they will cover and the requirements that must be met.

TennCare

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.

Health Spring

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.

Questions? Concerns?

Give us a call

For billing questions, please call (931) 648-5737.
To schedule a transport, please call (931) 648-5737 extension 2.
If your account has been transferred to collection status, please contact Credit Bureau Systems at (931) 647-5614 for further assistance.

Thank you for using Montgomery County EMS.