Ambulance Transport Billing Policy

In July of 2002, the Mehlville Fire Protection District Board of Directors enacted a billing policy for
ambulance transport services, ensuring our high level of ambulance service will continue.

The District will assess a fee for all emergency ambulance transport service and will file a claim, for such
service, with the insurance carrier(s). All individuals transported by a District ambulance are asked to
provide their insurance information for billing purposes. If adequate insurance information was not
provided at the time of transport, our billing company will send the patient an inquiry form to fill out.
This form may be returned to:

Mehlville Fire Protection District
PO Box 419161
Creve Coeur, MO 63141

Or if preferred it may be sent to:

Mehlville Fire Protection District
ATTN: Ambulance Billing
11020 Mueller Road
Saint Louis, MO 63123

NON-RESIDENTS who utilize the District’s emergency ambulance transport service, will be billed and are
required to pay, in full, all fees associated with such service, including the deductibles and co-payments
which may be associated with the non-resident’s insurance policy.
For District RESIDENTS who utilize the emergency ambulance transport service, the District and/or its
billing company shall collect only that amount of money which is payable under the resident’s insurance
policy. A District resident will not be obligated to pay any remaining balance.
However, the District WILL pursue payment/lien settlements from BOTH RESIDENTS AND NON-
RESIDENTS who have received a settlement on a third-party liability case/law suit, for any amount that
has not been paid by insurance.