Total Records: 192
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Showing: 10 records
Array ( [id] => 960 [invoice_id] => 3818 [dispatch_id] => 1973 [date_time_of_service] => 2024-01-27 01:01:00 [patient_full_name] => Twigg, Zachary [billable_service_code] => A0428 [origin_name] => Beebe Healthcare's South Coastal Emergency Department [origin_address] => Beebe Healthcare's South Coastal Emergency Department, ED 5, 32750 Roxana Rd, Frankford, DE 19945 [destination_name] => Nemours/A.I. duPont Hospital for Children [destination_address] => Nemours/A.I. duPont Hospital for Children, ER, 1600 Rockland Road, Wilmington, DE 19803-3616 [mileage] => 108.3 [price_invoiced] => $1,254.22 [amount_received] => $- [current_amount_due] => $1,254.22 [billing_notes] => No Date !MCD denial, non-emergent transport [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 959 [invoice_id] => 4805 [dispatch_id] => 5068 [date_time_of_service] => 2024-08-30 19:13:00 [patient_full_name] => Perez Hernandez, Briseyda [billable_service_code] => A0427 [origin_name] => Beebe Healthcare's South Coastal Emergency Department [origin_address] => Beebe Healthcare's South Coastal Emergency Department, ED 14, 32750 Roxana Rd, Frankford, DE 19945 [destination_name] => Beebe Hospital [destination_address] => Beebe Hospital, ED, 424 Savannah Road, Lewes, DE 19958 [mileage] => 23 [price_invoiced] => $766.72 [amount_received] => $- [current_amount_due] => $3,444.00 [billing_notes] => Beebe provided DE Medicaid ID# 0003808737. Nr 3/18/25 No insurance information found , No information in face sheet , no? Medicaid, checked Nsure but no policy found, MA 09/03/2024 !Uninsured [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 958 [invoice_id] => 4805 [dispatch_id] => 4539 [date_time_of_service] => 2024-08-03 19:16:00 [patient_full_name] => Bolden, Daniel [billable_service_code] => A0429 [origin_name] => Beebe Healthcare's South Coastal Emergency Department [origin_address] => Beebe Healthcare's South Coastal Emergency Department, ED 13, 32750 Roxana Rd, Frankford, DE 19945 [destination_name] => Beebe Hospital [destination_address] => Beebe Hospital, 529 B, 424 Savannah Road, Lewes, DE 19958 [mileage] => 23 [price_invoiced] => $686.72 [amount_received] => $- [current_amount_due] => $2,754.00 [billing_notes] => 2025/07/07 elig shows pts first name as 'daniel,' moving back to review queue. -REG 2025/07/07: bcbs needs more info, updated appeals board. -REG 2025/05/29: Mailed appeal to Highmark BCBS. SM 2025/05/27 per Availity claim # 22156099704 denied for Our records indicate the patient does not have coverage for the service dates. Therefore, no payment can be made, not for patients demographics. LDZ 2025/05/25: Recheck eligibility based on DOB note. NR 2025/5/6_MK - As checked on Availity claim#22156099704 denied on 3/29/2025 as Remark Code: S0205 We are unable to identify this patient from the information submitted. Further check in documents patient DOB is 5/13/1961. so we need to send corrected claim with correct DOB. Beebe provided Highmark BCBS # R59593728. NR 3/18/25 Unable to locate any insurance and FS insurance is blank. LDZ 08/06/2024 !Uninsured [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 957 [invoice_id] => 4805 [dispatch_id] => 3016 [date_time_of_service] => 2024-05-08 23:03:00 [patient_full_name] => Espinoza-Elzira, Jesus [billable_service_code] => A0429 [origin_name] => Beebe Healthcare's South Coastal Emergency Department [origin_address] => Beebe Healthcare's South Coastal Emergency Department, 12, 32750 Roxana Rd, Frankford, DE 19945 [destination_name] => Nemours/A.I. duPont Hospital for Children [destination_address] => Nemours/A.I. duPont Hospital for Children, ED, 1600 Rockland Road, Wilmington, DE 19803-3616 [mileage] => 108.3 [price_invoiced] => $1,409.22 [amount_received] => $- [current_amount_due] => $4,460.00 [billing_notes] => MCD is active, please file. member ID # 0002885456 NR. NR 3/18/25 MCD inactive on DOS LDZ 05/13/2024 !Uninsured [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 956 [invoice_id] => 4805 [dispatch_id] => 2598 [date_time_of_service] => 2024-03-28 16:58:00 [patient_full_name] => Vasquez Martinez, Joselyn U [billable_service_code] => A0429 [origin_name] => Beebe Healthcare's South Coastal Emergency Department [origin_address] => Beebe Healthcare's South Coastal Emergency Department, 10, 32750 Roxana Rd, Frankford, DE 19945 [destination_name] => Beebe Hospital [destination_address] => Beebe Hospital, ER, 424 Savannah Road, Lewes, DE 19958 [mileage] => 23 [price_invoiced] => $686.72 [amount_received] => $- [current_amount_due] => $2,754.00 [billing_notes] => NON-CITIZEN EMERGENCY, LABOR, AND DELIVERY, ambulance is covered. Corrected name spelling. NR 3/18/25 Per Nsure no insurance or patient info found LDZ 04/01/2024 !Uninsured [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 955 [invoice_id] => 4805 [dispatch_id] => 5613 [date_time_of_service] => 2024-09-30 19:10:00 [patient_full_name] => Shultz, Anthony [billable_service_code] => A0429 [origin_name] => Beebe Healthcare's South Coastal Emergency Department [origin_address] => Beebe Healthcare's South Coastal Emergency Department, 14, 32750 Roxana Rd, Frankford, DE 19945 [destination_name] => Beebe Hospital [destination_address] => Beebe Hospital, 381A, 424 Savannah Road, Lewes, DE 19958 [mileage] => 23 [price_invoiced] => $686.72 [amount_received] => $- [current_amount_due] => $686.72 [billing_notes] => 2024/10/02_Verified BCBS (Georgia) by Nsure, Face sheet missing, address updated as per bcbs, No secondary or Medicaid, MA 10/02/2024 !Patient Invoiced. No response. [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 954 [invoice_id] => 4805 [dispatch_id] => 5254 [date_time_of_service] => 2024-09-10 23:07:00 [patient_full_name] => Jones, John [billable_service_code] => A0429 [origin_name] => Beebe Healthcare's South Coastal Emergency Department [origin_address] => Beebe Healthcare's South Coastal Emergency Department, ED 7, 32750 Roxana Rd, Frankford, DE 19945 [destination_name] => Beebe Hospital [destination_address] => Beebe Hospital, 372 B, 424 Savannah Road, Lewes, DE 19958 [mileage] => 23 [price_invoiced] => $686.72 [amount_received] => $- [current_amount_due] => $2,754.00 [billing_notes] => 2025/05/23: Emailed follow up to RM on denial.NR 2025/04/29 bcbs deneid again for unable to identify pt. REG Added # to ID, refiling. NR 4/15/25 Sent denial to Rebecca. NR 4/14/25 Beebe provided Highmark BCBS ID# D9V3HZN3037. Nr 3/18/25 As per face sheet we have PIP Personal Injury plan under PT ID # 592624GP is primary but unable to get verify eligibilty, no secondary or Medicaid found inactive under PT ID #0002113913, Address updated as per face sheet, MA 09/16/2024 !Uninsured [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 953 [invoice_id] => 4805 [dispatch_id] => 5199 [date_time_of_service] => 2024-09-06 21:06:00 [patient_full_name] => Velasquez, Juan [billable_service_code] => A0427 [origin_name] => Beebe Healthcare's South Coastal Emergency Department [origin_address] => Beebe Healthcare's South Coastal Emergency Department, 1, 32750 Roxana Rd, Frankford, DE 19945 [destination_name] => Nemours/A.I. duPont Hospital for Children [destination_address] => Nemours/A.I. duPont Hospital for Children, ED, 1600 Rockland Road, Wilmington, DE 19803-3616 [mileage] => 108.3 [price_invoiced] => $1,489.22 [amount_received] => $- [current_amount_due] => $1,489.22 [billing_notes] => 2024/09/10_2 crew signature missing on PCR LDZ 09/10/2024 No insurance information found , Face sheet missing , no? Medicaid, checked Nsure but no policy found, MA 09/09/2024 !Uninsured [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 952 [invoice_id] => 4805 [dispatch_id] => 5041 [date_time_of_service] => 2024-08-29 21:52:00 [patient_full_name] => Bedell, Zachary [billable_service_code] => A0427 [origin_name] => Beebe Healthcare's South Coastal Emergency Department [origin_address] => Beebe Healthcare's South Coastal Emergency Department, 8, 32750 Roxana Rd, Frankford, DE 19945 [destination_name] => Beebe Hospital [destination_address] => Beebe Hospital, ED, 424 Savannah Road, Lewes, DE 19958 [mileage] => 23 [price_invoiced] => $766.72 [amount_received] => $- [current_amount_due] => $766.72 [billing_notes] => 2024/08/30_Tricare ineligible LDZ 08/30/2024 !Uninsured [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 951 [invoice_id] => 4805 [dispatch_id] => 4809 [date_time_of_service] => 2024-08-17 04:56:00 [patient_full_name] => Barnes, Heather [billable_service_code] => A0429 [origin_name] => Beebe Healthcare's South Coastal Emergency Department [origin_address] => Beebe Healthcare's South Coastal Emergency Department, 7, 32750 Roxana Rd, Frankford, DE 19945 [destination_name] => Beebe Hospital [destination_address] => Beebe Hospital, 320B, 424 Savannah Road, Lewes, DE 19958 [mileage] => 23 [price_invoiced] => $686.72 [amount_received] => $- [current_amount_due] => $686.72 [billing_notes] => 2025/03/18_Beebe provided Aetna ID# 1020001560. Nr 3/18/25 !Patient Invoiced 3x [beebe_comments] => [aec_comments] => [epic_comments] => )
Invoice ID Dispatch ID Service Date Patient Name Service Code Origin Name Origin Address Destination Name Destination Address Mileage Price Invoiced Amount Received Amount Due Billing Notes Beebe Comments AEC Comments Epic Comments
3818 1973 Jan 27, 2024 Twigg, Zachary A0428 Beebe Healthcare's South Coastal Emergency Department
Beebe Healthcare's South Coastal Emergency Department, ED 5, 32750 Roxana Rd, Frankford, DE 19945
Nemours/A.I. duPont Hospital for Children
Nemours/A.I. duPont Hospital for Children, ER, 1600 Rockland Road, Wilmington, DE 19803-3616
108.3 $1,254.22 $- $1,254.22
No Date !MCD denial, non-emergent transport
4805 5068 Aug 30, 2024 Perez Hernandez, Briseyda A0427 Beebe Healthcare's South Coastal Emergency Department
Beebe Healthcare's South Coastal Emergency Department, ED 14, 32750 Roxana Rd, Frankford, DE 19945
Beebe Hospital
Beebe Hospital, ED, 424 Savannah Road, Lewes, DE 19958
23 $766.72 $- $3,444.00
Beebe provided DE Medicaid ID# 0003808737. Nr 3/18/25 No insurance information found , No information in face sheet , no? Medicaid, checked Nsure but no policy found, MA 09/03/2024 !Uninsured
4805 4539 Aug 3, 2024 Bolden, Daniel A0429 Beebe Healthcare's South Coastal Emergency Department
Beebe Healthcare's South Coastal Emergency Department, ED 13, 32750 Roxana Rd, Frankford, DE 19945
Beebe Hospital
Beebe Hospital, 529 B, 424 Savannah Road, Lewes, DE 19958
23 $686.72 $- $2,754.00
2025/07/07 elig shows pts first name as 'daniel,' moving back to review queue. -REG 2025/07/07: bcbs needs more info, updated appeals board. -REG 2025/05/29: Mailed appeal to Highmark BCBS. SM 2025/05/27 per Availity claim # 22156099704 denied for Our records indicate the patient does not have coverage for the service dates. Therefore, no payment can be made, not for patients demographics. LDZ 2025/05/25: Recheck eligibility based on DOB note. NR 2025/5/6_MK - As checked on Availity claim#22156099704 denied on 3/29/2025 as Remark Code: S0205 We are unable to identify this patient from the information submitted. Further check in documents patient DOB is 5/13/1961. so we need to send corrected claim with correct DOB. Beebe provided Highmark BCBS # R59593728. NR 3/18/25 Unable to locate any insurance and FS insurance is blank. LDZ 08/06/2024 !Uninsured
4805 3016 May 8, 2024 Espinoza-Elzira, Jesus A0429 Beebe Healthcare's South Coastal Emergency Department
Beebe Healthcare's South Coastal Emergency Department, 12, 32750 Roxana Rd, Frankford, DE 19945
Nemours/A.I. duPont Hospital for Children
Nemours/A.I. duPont Hospital for Children, ED, 1600 Rockland Road, Wilmington, DE 19803-3616
108.3 $1,409.22 $- $4,460.00
MCD is active, please file. member ID # 0002885456 NR. NR 3/18/25 MCD inactive on DOS LDZ 05/13/2024 !Uninsured
4805 2598 Mar 28, 2024 Vasquez Martinez, Joselyn U A0429 Beebe Healthcare's South Coastal Emergency Department
Beebe Healthcare's South Coastal Emergency Department, 10, 32750 Roxana Rd, Frankford, DE 19945
Beebe Hospital
Beebe Hospital, ER, 424 Savannah Road, Lewes, DE 19958
23 $686.72 $- $2,754.00
NON-CITIZEN EMERGENCY, LABOR, AND DELIVERY, ambulance is covered. Corrected name spelling. NR 3/18/25 Per Nsure no insurance or patient info found LDZ 04/01/2024 !Uninsured
4805 5613 Sep 30, 2024 Shultz, Anthony A0429 Beebe Healthcare's South Coastal Emergency Department
Beebe Healthcare's South Coastal Emergency Department, 14, 32750 Roxana Rd, Frankford, DE 19945
Beebe Hospital
Beebe Hospital, 381A, 424 Savannah Road, Lewes, DE 19958
23 $686.72 $- $686.72
2024/10/02_Verified BCBS (Georgia) by Nsure, Face sheet missing, address updated as per bcbs, No secondary or Medicaid, MA 10/02/2024 !Patient Invoiced. No response.
4805 5254 Sep 10, 2024 Jones, John A0429 Beebe Healthcare's South Coastal Emergency Department
Beebe Healthcare's South Coastal Emergency Department, ED 7, 32750 Roxana Rd, Frankford, DE 19945
Beebe Hospital
Beebe Hospital, 372 B, 424 Savannah Road, Lewes, DE 19958
23 $686.72 $- $2,754.00
2025/05/23: Emailed follow up to RM on denial.NR 2025/04/29 bcbs deneid again for unable to identify pt. REG Added # to ID, refiling. NR 4/15/25 Sent denial to Rebecca. NR 4/14/25 Beebe provided Highmark BCBS ID# D9V3HZN3037. Nr 3/18/25 As per face sheet we have PIP Personal Injury plan under PT ID # 592624GP is primary but unable to get verify eligibilty, no secondary or Medicaid found inactive under PT ID #0002113913, Address updated as per face sheet, MA 09/16/2024 !Uninsured
4805 5199 Sep 6, 2024 Velasquez, Juan A0427 Beebe Healthcare's South Coastal Emergency Department
Beebe Healthcare's South Coastal Emergency Department, 1, 32750 Roxana Rd, Frankford, DE 19945
Nemours/A.I. duPont Hospital for Children
Nemours/A.I. duPont Hospital for Children, ED, 1600 Rockland Road, Wilmington, DE 19803-3616
108.3 $1,489.22 $- $1,489.22
2024/09/10_2 crew signature missing on PCR LDZ 09/10/2024 No insurance information found , Face sheet missing , no? Medicaid, checked Nsure but no policy found, MA 09/09/2024 !Uninsured
4805 5041 Aug 29, 2024 Bedell, Zachary A0427 Beebe Healthcare's South Coastal Emergency Department
Beebe Healthcare's South Coastal Emergency Department, 8, 32750 Roxana Rd, Frankford, DE 19945
Beebe Hospital
Beebe Hospital, ED, 424 Savannah Road, Lewes, DE 19958
23 $766.72 $- $766.72
2024/08/30_Tricare ineligible LDZ 08/30/2024 !Uninsured
4805 4809 Aug 17, 2024 Barnes, Heather A0429 Beebe Healthcare's South Coastal Emergency Department
Beebe Healthcare's South Coastal Emergency Department, 7, 32750 Roxana Rd, Frankford, DE 19945
Beebe Hospital
Beebe Hospital, 320B, 424 Savannah Road, Lewes, DE 19958
23 $686.72 $- $686.72
2025/03/18_Beebe provided Aetna ID# 1020001560. Nr 3/18/25 !Patient Invoiced 3x
Showing 1 to 10 of 192 records