Saint Charles MO Homepage

Ambulance Billing

The City of St. Charles Fire Department operates an Advanced Life Support (ALS) emergency medical service for its residents and visitors. The fire department has fire trucks and ambulances staffed 24-hours a day with highly trained, state-licensed firefighter/paramedics to respond to a variety of medical emergencies throughout our community.

In critical emergencies, the closest paramedics are sent which may necessitate that this service is provided by other agencies such as St. Charles County, Pattonville, or Robertson Fire Protection District's ambulances when St. Charles city units are unavailable.

Ambulance Fees

Patients who are treated or transported by the City of St. Charles Fire Department will be billed according to the ambulance fee schedule set by the City Council. The City of St. Charles Fire Department provides ambulance service to its residents and visitors by charging direct user fees that enable them to maintain exceptional service, equipment, and trained paramedic firefighters without charging a separate fire or ambulance tax. The ambulance fee schedule utilized by the City of St. Charles is lower than many surrounding agencies.

Please Note: The City of St. Charles Fire Department is funded from the city's general fund and does not charge a separate fire and ambulance tax.


The City of St. Charles will bill the patient's insurance carrier as a courtesy to its residents and visitors. If the patient was unable to provide insurance information at the time of service, an invoice will be sent to the patient, along with a request for insurance information.

Patients may go online and provide insurance information. The patients or their representatives may also call the billing office at 636-766-4448 or 800-814-5339 and provide the necessary information.

It is the patient's responsibility to follow up and resolve any delay or denial in payment. Our ambulance billing customer service representatives are very knowledgeable and experienced in re-filing claims and may be able to assist in this process. When insurance payments are received, the credit is applied to the account and any remaining balance is the responsibility of the patient. Patients are expected to pay their balance in full or contact our billing office at 336-766-4448 or 800-814-5339 to discuss payment options.

Self Pay / Underinsured / Uninsured Patients

A patient without healthcare insurance coverage is encouraged to contact our office to discuss payment options. A discount may be provided for patients who meet specific criteria and can demonstrate financial hardship. Please contact our billing office via phone at 336-766-4448 or 800-814-5339 or online if you need additional information. Please feel free to read through, download, and fill out our Ambulance Billing Financial Hardship Application (PDF).

Ambulance Transport Records

When the St. Charles Fire Department Paramedics transport a patient, they will complete a Patient Care Report (PCR), also referred to as a "run report". The paramedic will document the patient's condition and care rendered. These reports are governed by federal and state privacy laws. The City of St. Charles must follow federal and state government guidelines for billing and coding (categorizing medical conditions) of ambulance patients. Our billing staff will use the information documented in the Patient Care Report (PCR) to determine the appropriate diagnosis and procedure codes that apply to medical/ambulance service. Notice of our privacy practices (PDF) can be found online.

Medical Necessity

Unfortunately, not all ambulance service is deemed "medically necessary" by Medicare, Medicaid, and other insurance carriers. Many insurance carriers require that a patient's medical condition warrant the use of an ambulance before they will allow payment. In other words, other forms of transportation must be contraindicated. Furthermore, the policies regarding medical necessity are unique to each payer and can be quite complex. The City of St. Charles is not responsible for situations where an insurance carrier determines that an ambulance transport does not meet their medical necessity requirements. In such cases, the patient will be responsible for the charges.

Auto Accidents

If your transport was the result of a motor vehicle accident, our office will send a letter requesting your automobile insurance information. We request that you complete the form in its entirety. Once the completed information is returned to our office, we will file a claim to your insurance carrier. Assuring that claims are paid, as well as any balance due is the responsibility of the patient or their guardian.

Billing Procedures

Our billing procedures are as follows:

  1. 1st Invoice: Shortly after medical or ambulance service, an Invoice will be sent to the patient. If any insurance information was provided to the paramedics, as a courtesy, we will file the claim according to the appropriate rules and standards. If you were unable to provide information or for other reasons, no information was provided at the time of service, please provide the requested insurance information.
  2. 2nd Invoice: If we have not heard back regarding the first invoice, or no payment arrangements have been made, a second invoice is sent reflecting a balance and that the account is past due.

Notice of Intent to Place with Collections

If invoice and letter mailings have proven unsuccessful at contacting the patient with an account that has been unpaid or has balance due, we will send a statement along with notification asking the patient to contact our office immediately concerning the unpaid balance within 10 days. If the patient, or their representative, does not make arrangement for payment or contact our office after this notification, the account will be turned over to our collections processor for further collection attempts.

  1. Saint Charles MO Homepage

Contact Us

  1. City Hall
    200 N Second Street
    Saint Charles, MO 63301

    Phone: 636-949-3200

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