Total Records: 192
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Showing: 10 records
Array ( [id] => 860 [invoice_id] => 6369 [dispatch_id] => 9851 [date_time_of_service] => 2025-04-22 02:15:00 [patient_full_name] => Maharaj, Gyanwattie [billable_service_code] => A0428 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, ED 12, 424 Savannah Road, Lewes, DE 19958 [destination_name] => Excelcare at Lewes [destination_address] => Excelcare at Lewes, Chk w/ FD, 301 Ocean View Blvd, Lewes, DE 19958 [mileage] => 1 [price_invoiced] => $299.60 [amount_received] => $9.60 [current_amount_due] => $290.00 [billing_notes] => 2025/04/30: (UHC Dual Plan) No individual OON deductible for 2025, UPS Submitted. !MCD does not cover non-emergent [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 859 [invoice_id] => 6369 [dispatch_id] => 9816 [date_time_of_service] => 2025-04-20 14:18:00 [patient_full_name] => Moore, James L [billable_service_code] => A0428 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, 537 A, 424 Savannah Road, Lewes, DE 19958 [destination_name] => PAM Health - Rehabilitation Hospital of Georgetown [destination_address] => PAM Health - Rehabilitation Hospital of Georgetown, 22303 Dupont Blvd, Georgetown, DE 19947 [mileage] => 16.1 [price_invoiced] => $508.89 [amount_received] => $- [current_amount_due] => $508.89 [billing_notes] => !MCR part A only, doesn't cover ambulance transports MCR with Part A only [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 858 [invoice_id] => 6369 [dispatch_id] => 9750 [date_time_of_service] => 2025-04-17 14:41:00 [patient_full_name] => Willey, Bonnie J [billable_service_code] => A0428 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, 375 B, 424 Savannah Road, Lewes, DE 19958 [destination_name] => Harbor Healthcare & Rehabilitation Center [destination_address] => Harbor Healthcare & Rehabilitation Center, Chk w/ FD, 301 Ocean View Blvd, Lewis, DE 19958 [mileage] => 1 [price_invoiced] => $299.60 [amount_received] => $49.27 [current_amount_due] => $250.33 [billing_notes] => (Aetna adv and Amerihealth Caritas Medicaid) No individual OON deductible for 2025, UPS 04/18/2025 !MCD does not cover non-emergent [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 857 [invoice_id] => 6369 [dispatch_id] => 9722 [date_time_of_service] => 2025-04-15 22:23:00 [patient_full_name] => Green, Richard A [billable_service_code] => A0428 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, ED HALL B, 424 Savannah Road, Lewes, DE 19958 [destination_name] => Peachtree Health [destination_address] => Peachtree Health, 26900 Lewes Georgetown Hwy, Harbeson, DE 19951 [mileage] => 8 [price_invoiced] => $396.62 [amount_received] => $- [current_amount_due] => $396.62 [billing_notes] => !MCD does not cover non-emergent [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 856 [invoice_id] => 6369 [dispatch_id] => 9671 [date_time_of_service] => 2025-04-13 04:29:00 [patient_full_name] => Maull, Willis J [billable_service_code] => A0428 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, ED 6, 424 Savannah Road, Lewes, DE 19958 [destination_name] => Excelcare at Lewes [destination_address] => Excelcare at Lewes, Chk w/ FD, 301 Ocean View Blvd, Lewes, DE 19958 [mileage] => 1 [price_invoiced] => $299.60 [amount_received] => $64.60 [current_amount_due] => $235.00 [billing_notes] => !MCD does not cover non-emergent [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 855 [invoice_id] => 6369 [dispatch_id] => 9597 [date_time_of_service] => 2025-04-08 22:21:00 [patient_full_name] => Kravis, Robert J [billable_service_code] => A0428 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, WAITING ROOM, 424 Savannah Road, Lewes, DE 19958 [destination_name] => 34122 PINEWOOD CIRCLE [destination_address] => 34122 PINEWOOD CIRCLE, Lewes, DE 19958 [mileage] => 3 [price_invoiced] => $327.32 [amount_received] => $- [current_amount_due] => $327.32 [billing_notes] => ! no PCS received from Beebe, not billable 2025/05/21 no PCS received from Beebe, not billable to insurance. Billing Beebe LDZ 2025/04/23_Facesheet attached. No Faxed PCS submitted by Beebe ED.RMB Needs PCS (MCR and Amerihealth Caritas Medicaid) Part B deductible left $ 0 for 2025 and No individual OON deductible for Amerihealth Caritas Medicaid, UPS 04/23/2025 Emailed Rich for PCS. LDZ 04/23/2025 Submitted. PCS not attached, please attach LDZ 04/09/2025 Submitted. PCS is not attached LDZ 04/09/2025 [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 854 [invoice_id] => 6369 [dispatch_id] => 9586 [date_time_of_service] => 2025-04-08 07:27:00 [patient_full_name] => Maull, Willis J [billable_service_code] => A0428 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, ED 3, 424 Savannah Road, Lewes, DE 19958 [destination_name] => Harbor Healthcare & Rehabilitation Center [destination_address] => Harbor Healthcare & Rehabilitation Center, Chk w/ FD, 301 Ocean View Blvd, Lewis, DE 19958 [mileage] => 1 [price_invoiced] => $299.60 [amount_received] => $64.60 [current_amount_due] => $235.00 [billing_notes] => (Aetna adv and Delaware First Health Medicaid) No individual OON deductible for 2025, MA 04/08/2025 !MCD does not cover non-emergent [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 853 [invoice_id] => 6369 [dispatch_id] => 9358 [date_time_of_service] => 2025-03-27 20:59:00 [patient_full_name] => Davis, Gerald T [billable_service_code] => A0428 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, ED HALL B, 424 Savannah Road, Lewes, DE 19958 [destination_name] => Taton House [destination_address] => Taton House, 18090 Harbeson Road, Milton, DE 19968 [mileage] => 9.8 [price_invoiced] => $421.57 [amount_received] => $- [current_amount_due] => $421.57 [billing_notes] => 2025/03/28_Submitted. No PCR. JH 03/28/25 !MCD denial, unable to bill patient [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 852 [invoice_id] => 6369 [dispatch_id] => 9321 [date_time_of_service] => 2025-03-26 19:33:00 [patient_full_name] => Davis, Gerald T [billable_service_code] => A0428 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, 422 DISCHARGE LOUNGE, 424 Savannah Road, Lewes, DE 19958 [destination_name] => Meadow Wood Behavioral Health [destination_address] => Meadow Wood Behavioral Health, 575 S. Dupont Hwy, New Castle, DE 19720 [mileage] => 77.9 [price_invoiced] => $1,084.08 [amount_received] => $- [current_amount_due] => $1,084.08 [billing_notes] => 2025/03/27_PCS not attached (Highmark Health Options Medicaid) No individual OON deductible for 2025, MA 03/27/2025 !MCD denial, unable to bill patient [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 851 [invoice_id] => 6369 [dispatch_id] => 8975 [date_time_of_service] => 2025-03-11 15:06:00 [patient_full_name] => Farmer, Louise W [billable_service_code] => A0428 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, 511 A, 424 Savannah Road, Lewes, DE 19958 [destination_name] => Harrison House Of Georgetown [destination_address] => Harrison House Of Georgetown, 110 W North St, Georgetown, DE 19947 [mileage] => 15.5 [price_invoiced] => $500.57 [amount_received] => $185.57 [current_amount_due] => $315.00 [billing_notes] => 2025/03/12_One crew and transfer of care signature missing (Humana adv and Medicaid) No individual OON deductible for 2025,?MA 03/12/2025 !MCD does not cover non-emergent [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
6369 9851 Apr 22, 2025 Maharaj, Gyanwattie A0428 Beebe Hospital
Beebe Hospital, ED 12, 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 $9.60 $290.00
2025/04/30: (UHC Dual Plan) No individual OON deductible for 2025, UPS Submitted. !MCD does not cover non-emergent
6369 9816 Apr 20, 2025 Moore, James L A0428 Beebe Hospital
Beebe Hospital, 537 A, 424 Savannah Road, Lewes, DE 19958
PAM Health - Rehabilitation Hospital of Georgetown
PAM Health - Rehabilitation Hospital of Georgetown, 22303 Dupont Blvd, Georgetown, DE 19947
16.1 $508.89 $- $508.89
!MCR part A only, doesn't cover ambulance transports MCR with Part A only
6369 9750 Apr 17, 2025 Willey, Bonnie J A0428 Beebe Hospital
Beebe Hospital, 375 B, 424 Savannah Road, Lewes, DE 19958
Harbor Healthcare & Rehabilitation Center
Harbor Healthcare & Rehabilitation Center, Chk w/ FD, 301 Ocean View Blvd, Lewis, DE 19958
1 $299.60 $49.27 $250.33
(Aetna adv and Amerihealth Caritas Medicaid) No individual OON deductible for 2025, UPS 04/18/2025 !MCD does not cover non-emergent
6369 9722 Apr 15, 2025 Green, Richard A A0428 Beebe Hospital
Beebe Hospital, ED HALL B, 424 Savannah Road, Lewes, DE 19958
Peachtree Health
Peachtree Health, 26900 Lewes Georgetown Hwy, Harbeson, DE 19951
8 $396.62 $- $396.62
!MCD does not cover non-emergent
6369 9671 Apr 13, 2025 Maull, Willis J A0428 Beebe Hospital
Beebe Hospital, ED 6, 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 9597 Apr 8, 2025 Kravis, Robert J A0428 Beebe Hospital
Beebe Hospital, WAITING ROOM, 424 Savannah Road, Lewes, DE 19958
34122 PINEWOOD CIRCLE
34122 PINEWOOD CIRCLE, Lewes, DE 19958
3 $327.32 $- $327.32
! no PCS received from Beebe, not billable 2025/05/21 no PCS received from Beebe, not billable to insurance. Billing Beebe LDZ 2025/04/23_Facesheet attached. No Faxed PCS submitted by Beebe ED.RMB Needs PCS (MCR and Amerihealth Caritas Medicaid) Part B deductible left $ 0 for 2025 and No individual OON deductible for Amerihealth Caritas Medicaid, UPS 04/23/2025 Emailed Rich for PCS. LDZ 04/23/2025 Submitted. PCS not attached, please attach LDZ 04/09/2025 Submitted. PCS is not attached LDZ 04/09/2025
6369 9586 Apr 8, 2025 Maull, Willis J A0428 Beebe Hospital
Beebe Hospital, ED 3, 424 Savannah Road, Lewes, DE 19958
Harbor Healthcare & Rehabilitation Center
Harbor Healthcare & Rehabilitation Center, Chk w/ FD, 301 Ocean View Blvd, Lewis, DE 19958
1 $299.60 $64.60 $235.00
(Aetna adv and Delaware First Health Medicaid) No individual OON deductible for 2025, MA 04/08/2025 !MCD does not cover non-emergent
6369 9358 Mar 27, 2025 Davis, Gerald T A0428 Beebe Hospital
Beebe Hospital, ED HALL B, 424 Savannah Road, Lewes, DE 19958
Taton House
Taton House, 18090 Harbeson Road, Milton, DE 19968
9.8 $421.57 $- $421.57
2025/03/28_Submitted. No PCR. JH 03/28/25 !MCD denial, unable to bill patient
6369 9321 Mar 26, 2025 Davis, Gerald T A0428 Beebe Hospital
Beebe Hospital, 422 DISCHARGE LOUNGE, 424 Savannah Road, Lewes, DE 19958
Meadow Wood Behavioral Health
Meadow Wood Behavioral Health, 575 S. Dupont Hwy, New Castle, DE 19720
77.9 $1,084.08 $- $1,084.08
2025/03/27_PCS not attached (Highmark Health Options Medicaid) No individual OON deductible for 2025, MA 03/27/2025 !MCD denial, unable to bill patient
6369 8975 Mar 11, 2025 Farmer, Louise W A0428 Beebe Hospital
Beebe Hospital, 511 A, 424 Savannah Road, Lewes, DE 19958
Harrison House Of Georgetown
Harrison House Of Georgetown, 110 W North St, Georgetown, DE 19947
15.5 $500.57 $185.57 $315.00
2025/03/12_One crew and transfer of care signature missing (Humana adv and Medicaid) No individual OON deductible for 2025,?MA 03/12/2025 !MCD does not cover non-emergent
Showing 101 to 110 of 192 records