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Business Office

The day to day operations of the Association are coordinated through the Association's Business office, which is managed by Diane Perry, of Hotchkiss.

Diane oversees all the accounting and financial transactions for the Association, transcribes official minutes for board meetings, and handles EMS billing following ambulance transports and manages the Association's Membership rosters. Diane also manages applications for new drivers and EMTs, handles payroll for the Association, completes background investigations and works closely with Executive Director Kathy Steckel to ensure the Association is running smoothly.

Association Mailing Address:

North Fork Ambulance

PO Box 127

Hotchkiss, CO 81419

Association Bylaws and Articles of Incorporation

Health Information Portability Protection Act (HIPPA) Privacy Policy

As an Emergency Medical Services (EMS) Agency responding to emergencies and transporting patients, we collect certain health information about you, our patients in an emergency which is protected by Federal Law under HIPPA. Below is our official Association policy on the release of protected Health Information.

The North Fork Ambulance will create a record of the care and services you receive to provide quality care and to comply with legal requirements. The North Fork Ambulance is required by law to keep medical information about you private, to provide you with this notice of our legal duties and privacy practices with respect to medical information about you and to follow the terms of the privacy practices notice that is currently in effect.

The North Fork Ambulance may use and disclose medical information about you for treatment; to obtain payment for treatment; and to support EMS related health care operations. Subject to certain requirements, the North Fork Ambulance may give out medical information about you without prior authorization for: public health purposes, abuse or neglect reporting, health oversight audits or inspections, research studies, funeral arrangements and organ donation, workers’ compensation purposes, and emergencies.

The North Fork Ambulance may also disclose medical information when required by law, such as in response to a request from law enforcement in specific circumstances, or in response to valid judicial or administrative orders. The North Fork Ambulance may disclose medical information about you to a friend or family member who is involved in your medical care, or to disaster relief authorities so that your family can be notified of your location and condition.

You are entitled to request a complete copy of any medical information we maintain about you. In order to do so, simply contact the Business office of at PO Box 127, Hotchkiss CO 81419 or call 970-872-4303 .

Medical Billing Policy

The North Fork Ambulance Association is a non-profit, emergency transport EMS Agency and as such, reserves the right and ability to collect payment for the services of our trained EMTs for an emergency transport via one of our ambulances to a local health care facility and/or Medical Air Transportation.

As a non-profit organization, we function as a shared medical cooperative in the way that residents and businesses purchase memberships and pay a one-time low annual fee for our services and we will transport members as many times as are necessary via ambulance and we will not bill the member or their insurance for our services. However, if a patient is transported and they are not an active North Fork Ambulance Member, we will submit a bill to that patient and/or their health insurance company following transport for services rendered. Below is the North Fork Ambulance's Billing Policy which is signed electronically by the patient on our Electronic Patient Care Report at the conclusion of every transport .

I request that payment of authorized Medicare, Medicaid, or any other insurance benefits be made on my behalf to North Fork Ambulance Association, Inc. for any services provided to me by North Fork Ambulance now, in the past, or in the future.

I understand that I am financially responsible for the services and supplies provided to me by the North Fork Ambulance, regardless of my insurance coverage, and in some cases, may be responsible for an amount in addition to that which was paid by my insurance. I agree to immediately remit to the North Fork Ambulance any payments that I receive directly from insurance or any source whatsoever for the services provided to me and I assign all rights to such payments to North Fork Ambulance.

I authorize the North Fork Ambulance to appeal payment denials or other adverse decisions on my behalf without further authorization. I authorize and direct any holder of medical information or other relevant documentation about me to release such information to North Fork Ambulance and its billing agents, the Centers for Medicare and Medicaid Services, and/or any other payers or insurers, and their respective agents or contractors, as may be necessary to determine these or other benefits payable for any services provided to me by North Fork Ambulance, now, in the past, or in the future.

For complete details on the North Fork Ambulance Membership Program and how it affects Transport billing, please click here.

 

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