| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 6370 | 10515 | May 22, 2025 | Bardi, Janis M | A0428 | Beebe Healthcare's Tunnell Cancer Center |
Beebe Healthcare's Tunnell Cancer Center, 101, 18947 John J Williams Hwy, Rehoboth, DE 19971
|
Beebe Hospital |
Beebe Hospital, 327-A, 424 Savannah Road, Lewes, DE 19958
|
4.1 | $342.57 | $- | $342.57 |
2025/05/23 wait and return transport LDZ
|
|
|
|
| 6370 | 10489 | May 22, 2025 | Bardi, Janis M | A0428 | Beebe Hospital |
Beebe Hospital, 327-A, 424 Savannah Road, Lewes, DE 19958
|
Beebe Healthcare's Tunnell Cancer Center |
Beebe Healthcare's Tunnell Cancer Center, 101, 18947 John J Williams Hwy, Rehoboth, DE 19971
|
4.2 | $343.96 | $- | $343.96 |
2025/05/23 wait and return transport LDZ
|
|
|
|
| 6370 | 10479 | May 21, 2025 | Bardi, Janis M | A0428 | Beebe Healthcare's Tunnell Cancer Center |
Beebe Healthcare's Tunnell Cancer Center, 101, 18947 John J Williams Hwy, Rehoboth, DE 19971
|
Beebe Hospital |
Beebe Hospital, 327 A, 424 Savannah Road, Lewes, DE 19958
|
4.1 | $342.57 | $- | $342.57 |
2025/05/22 cancer treatment and return LDZ
|
|
|
|
| 6370 | 10476 | May 21, 2025 | Alston, Kevin | A0428 | OAK ORCHARD |
OAK ORCHARD, 26744 JOHN J WILLIAMS HIGHWAY, Millsboro, DE 19966
|
Beebe Hospital |
Beebe Hospital, ED 7, 424 Savannah Road, Lewes, DE 19958
|
0 | $285.74 | $- | $285.74 |
2025/05/22 wait and return Beebe Healthcare Open MRI at Oak Orchard Professional Center LDZ
2025/05/22: (BCBS) For BCBS $ 5,000 left for 2025, UPS
|
|
|
|
| 6370 | 10474 | May 21, 2025 | Alston, Kevin | A0428 | Beebe Hospital |
Beebe Hospital, ED 7, 424 Savannah Road, Lewes, DE 19958
|
OAK ORCHARD |
OAK ORCHARD, 26744 JOHN J WILLIAMS HIGHWAY, Millsboro, DE 19966
|
0 | $285.74 | $- | $285.74 |
2025/05/22 wait and return Beebe Healthcare Open MRI at Oak Orchard Professional Center LDZ
2025/05/22: (BCBS) For BCBS $ 5,000 left for 2025, UPS
|
|
|
|
| 6370 | 10451 | May 21, 2025 | Bardi, Janis M | A0428 | Beebe Hospital |
Beebe Hospital, 327 A, 424 Savannah Road, Lewes, DE 19958
|
Beebe Healthcare's Tunnell Cancer Center |
Beebe Healthcare's Tunnell Cancer Center, 101, 18947 John J Williams Hwy, Rehoboth, DE 19971
|
4.2 | $343.96 | $- | $343.96 |
2025/05/22 cancer treatment and return LDZ
|
|
|
|
| 6369 | 10069 | May 2, 2025 | Maull, Willis J | A0428 | Beebe Hospital |
Beebe Hospital, ED 18, 424 Savannah Road, Lewes, DE 19958
|
Excelcare at Lewes |
Excelcare at Lewes, Chk w/ FD, 301 Ocean View Blvd, Lewes, DE 19958
|
1 | $299.60 | $64.60 | $235.00 |
!MCD does not cover non-emergent
|
|
|
|
| 6369 | 9934 | Apr 25, 2025 | Mccarter, Dennis | A0428 | Beebe Hospital |
Beebe Hospital, ED 21, 424 Savannah Road, Lewes, DE 19958
|
Ocean Grove Post Acute |
Ocean Grove Post Acute, CHK W/ CHARGE, 231 Washington St, Millsboro, DE 19966
|
16.4 | $513.05 | $- | $2,507.00 |
2025/05/14: denied, requesting MRs/prim carrier EOB. -REG
2025/04/29: (Amerihealth Caritas Medicaid) No individual OON deductible for 2025, UPS
!MCD denial, unable to bill patient
|
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| 6369 | 9908 | Apr 24, 2025 | Wallenbrock, Sierra | A0428 | Beebe Hospital |
Beebe Hospital, ED 17, 424 Savannah Road, Lewes, DE 19958
|
Peachtree |
Peachtree, 26890 Lewes-Georgetown Highway, Harberson, DE 19951
|
8 | $396.62 | $- | $396.62 |
Attached.
Please attach PCS LDZ 04/25/2025
!MCD denial, unable to bill patient
|
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|
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| 6369 | 9869 | Apr 23, 2025 | Warner, David W | A0428 | Beebe Hospital |
Beebe Hospital, ED 2, 424 Savannah Road, Lewes, DE 19958
|
Peachtree |
Peachtree, 26890 Lewes-Georgetown Highway, Harberson, DE 19951
|
8 | $396.62 | $- | $396.62 |
2025/04/28 on crew signature missing LDZ
(Delaware First Health Medicaid) No individual OON deductible for Delaware First Health Medicaid, UPS 2025/04/28
!MCD denial, unable to bill patient
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