EMS Billing and Patient Records

Billing & Patient Records

Billing Agency Contact
The Random Lake Fire Department contracts with EMS Medical Billing Associates, a specialized EMS billing company. If you have any questions about your bill, insurance payment for service, or would like a copy of your patient care report, please contact the company by phone at 1-866-950-4400 or by email.
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Copy of Patient Records
Each patient that is evaluated or treated by the Random Lake EMS requires a pre-hospital EMS chart to be completed by the crew member(s) rendering care. The chart is completed electronically and is stored securely for future access if needed. It contains information about the call location, date / time and other pertinent data, the patient’s demographics, medical history, details regarding the patient’s condition as well as any treatments or interventions performed by EMS prior to arrival at the hospital.Medical records are maintained for a minimum of 6 years or 3 years past the patient’s 18th birthday if the patient is a minor when treated.Records Request Procedure
In compliance with the HIPAA Privacy Act, the information contained within this chart may only be shared with those providing treatment, for payment purposes (insurance reimbursement, etc.) and for health care operations.

In order to request a copy of a patient’s pre-hospital EMS chart, you must follow one of the these processes:

  • Direct Request – Please contact EMS Medical Billing Associates to obtain request and release forms.
  • Court Order – Through the legal process, a subpoena may be submitted to us requesting a copy of a patient’s chart.
  • Legal Request (Lawyers) – Lawyers or legal agencies may request a copy of a patient’s chart by contacting EMS Medical Billing Associates. These requests must first be approved by the patient or designee.

All requests for patient records will be processed as quickly as possible. If you have any questions about patient records, please contact EMS Director Blaine Werner at (920) 946-0004.

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