Total Records: 192
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Showing: 10 records
Array ( [id] => 830 [invoice_id] => 5423 [dispatch_id] => 7783 [date_time_of_service] => 2025-01-14 11:05:00 [patient_full_name] => Lewi, Kathryn A [billable_service_code] => A0428 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, ED 12, 424 Savannah Road, Lewes, DE 19958 [destination_name] => 12001 OLD VINE BLVD [destination_address] => APT 208, 12001 OLD VINE BLVD, Lewes, DE 19958 [mileage] => 4 [price_invoiced] => $341.18 [amount_received] => $- [current_amount_due] => $341.18 [billing_notes] => s/w Nicka stated claim rcvd on 1/18/2025 and still in process as they need Authorization number as provider is OON. TLF# 45-60 days. FAX#8777882764 to send Auth No. Claim#250380122800 Callref#943847948 3/6/2025MK (Cigna Healthspring adv) No individual OON deductible for 2025, MA 01/16/2025 !No PA [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 829 [invoice_id] => 5423 [dispatch_id] => 7337 [date_time_of_service] => 2024-12-24 12:11:00 [patient_full_name] => Frank, Eileen [billable_service_code] => A0428 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, ED 37, 424 Savannah Road, Lewes, DE 19958 [destination_name] => BREAKWATER VILLAGE [destination_address] => BREAKWATER VILLAGE, 301 Ocean View Blvd, Lewes, DE 19958 [mileage] => 2 [price_invoiced] => $306.10 [amount_received] => $- [current_amount_due] => $306.10 [billing_notes] => One crew signature missing LDZ 01/02/2025 Corrected. Narrative is incomplete, please review LDZ 12/30/2024 No insurance information found , No information in face sheet , no? Medicaid, checked Nsure but no policy found, MA 12/26/2024 !Uninsured [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 828 [invoice_id] => 5422 [dispatch_id] => 8572 [date_time_of_service] => 2025-02-20 10:35:00 [patient_full_name] => Wietsruk, Jordan [billable_service_code] => A0429 [origin_name] => Beebe Healthcare's South Coastal Emergency Department [origin_address] => Beebe Healthcare's South Coastal Emergency Department, ED 11, 32750 Roxana Rd, Frankford, DE 19945 [destination_name] => Beebe Hospital [destination_address] => Beebe Hospital, 529 B, 424 Savannah Road, Lewes, DE 19958 [mileage] => 23.1 [price_invoiced] => $687.57 [amount_received] => $- [current_amount_due] => $749.17 [billing_notes] => 2025/04/28 Rejected in Waystar stating unable to locate eligibility for patient. LDZ Info from Beebe: Insurance = Cigna ID# 77978156632 No insurance information found, No information in face sheet, no Medicaid, checked Nsure but no policy found, MA 02/21/2025 !Uninsured [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 827 [invoice_id] => 5133 [dispatch_id] => 8570 [date_time_of_service] => 2025-02-19 23:35:00 [patient_full_name] => Meade, Patricia A [billable_service_code] => A0427 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, 368 B, 424 Savannah Road, Lewes, DE 19958 [destination_name] => Jefferson Hospital For Neuroscience [destination_address] => Jefferson Hospital For Neuroscience, 7 N 720 B, 900 Walnut St, Philadelphia, PA 19107 [mileage] => 137 [price_invoiced] => $1,887.33 [amount_received] => $- [current_amount_due] => $1,887.33 [billing_notes] => 2025/05/06: Review with RG, confirm DOS is 2/19/2025 and Beebe is responsible. NR Inpatient with Beebe 02/12 - 02/20 per PGBA LDZ 03/17/2025 mcr denied for inpatient. 3/11/25REG !Inpatient [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 826 [invoice_id] => 5035 [dispatch_id] => 6795 [date_time_of_service] => 2024-11-29 14:58:00 [patient_full_name] => Brenan, Kelly [billable_service_code] => A0427 [origin_name] => Beebe Healthcare's South Coastal Emergency Department [origin_address] => Beebe Healthcare's South Coastal Emergency Department, ED 10, 32750 Roxana Rd, Frankford, DE 19945 [destination_name] => Beebe Hospital [destination_address] => Beebe Hospital, 412 A, 424 Savannah Road, Lewes, DE 19958 [mileage] => 23.1 [price_invoiced] => $815.22 [amount_received] => $- [current_amount_due] => $815.22 [billing_notes] => Beebe provided - DE Medicaid ID# 0000966236 - JM 3/19/25 No insurance information found , Face sheet missing , Medicaid found inactive under PT id #0000966236, checked Nsure but no policy found, MA 12/03/2024 [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 825 [invoice_id] => 5035 [dispatch_id] => 6758 [date_time_of_service] => 2024-11-27 21:09:00 [patient_full_name] => Cavanaugh, Daniel [billable_service_code] => A0428 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, 301 A, 424 Savannah Road, Lewes, DE 19958 [destination_name] => 38537 BLUE HEN DRIVE [destination_address] => 38537 BLUE HEN DRIVE, Selbyville, DE 19975 [mileage] => 31 [price_invoiced] => $635.33 [amount_received] => $67.93 [current_amount_due] => $567.40 [billing_notes] => 2024/12/02_Verified UHC, no secondary or Medicaid, address verified, MA 12/02/2024 [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 824 [invoice_id] => 5035 [dispatch_id] => 6741 [date_time_of_service] => 2024-11-26 22:25:00 [patient_full_name] => Smith, Richard [billable_service_code] => A0429 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, ED 16, 424 Savannah Road, Lewes, DE 19958 [destination_name] => Christiana Hospital [destination_address] => Christiana Hospital, ED, 4755 Ogletown Stanton Road, Newark, DE 19718 [mileage] => 82.3 [price_invoiced] => $1,265.49 [amount_received] => $- [current_amount_due] => $1,265.49 [billing_notes] => 2025/5/22_MK- Called Sussez Correctional s/w Michal stated the claim representative will only assist through E-MAIL. As per rep we can Email on Nmonk@Vitalcorehs.com for claims with Patient Name , DOB , Date of Service and Place of service.Callref# Mishal-5/22/2025 Beebe provided - Vitalcore ID# 222747261 - JM 3/19/25 No insurance information found , no insurance information in face sheet, Medicaid found inactive under PT ID #0000384079, checked Nsure but no policy found, address updated as per face sheet, MA 12/02/2024 [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 823 [invoice_id] => 5035 [dispatch_id] => 6607 [date_time_of_service] => 2024-11-21 15:43:00 [patient_full_name] => Lewis, Christine [billable_service_code] => A0428 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, ED 35, 424 Savannah Road, Lewes, DE 19958 [destination_name] => Genesis Healthcare - Milford Center [destination_address] => Genesis Healthcare - Milford Center, 700 Marvel Road, Milford, DE 19963 [mileage] => 22.5 [price_invoiced] => $558.66 [amount_received] => $502.85 [current_amount_due] => $55.81 [billing_notes] => Beebe provided - Medicare / Amerihealth Caritas ID# 2D24TW0KF94 / 0003353506 - JM 3/19/25 No insurance information found , No information in face sheet , no? Medicaid, checked Nsure but no policy found, MA 11/22/2024 [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 822 [invoice_id] => 5035 [dispatch_id] => 6492 [date_time_of_service] => 2024-11-16 15:20:00 [patient_full_name] => Cavanaugh, Daniel [billable_service_code] => A0428 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, 303, 424 Savannah Road, Lewes, DE 19958 [destination_name] => 38537 BLUE HEN DR [destination_address] => 38537 BLUE HEN DR, Selbyville, DE 19975 [mileage] => 30 [price_invoiced] => $626.31 [amount_received] => $67.93 [current_amount_due] => $558.38 [billing_notes] => 2024/11/19_Verified UHC, no secondary or Medicaid, address updated as per face sheet, MA 11/19/2024 [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 821 [invoice_id] => 5035 [dispatch_id] => 6488 [date_time_of_service] => 2024-11-16 05:47:00 [patient_full_name] => Myers, Olivia [billable_service_code] => A0429 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, ED 9, 424 Savannah Road, Lewes, DE 19958 [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] => 91.9 [price_invoiced] => $1,352.08 [amount_received] => $- [current_amount_due] => $1,352.08 [billing_notes] => 2025/5/6_MK - Call AIS root INS. s/w Jennifer Albert z stated they rcvd claim on 3/21/2025 and still pending as she waiting for Update W9 form form provider. As per rep send the W9 form with Claim number that is G2WWK3DE on Fax# 6143621751. Beebe provided - AIS Root Insurance Company ID# G2WWK3DE - JM 3/19/25 One crew and patient signature missing LDZ 11/25/2024 No insurance information found , Face sheet missing , no? Medicaid, checked Nsure but no policy found, MA 11/25/2024 Submitted. No PCR. JH 11/17/24 [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
5423 7783 Jan 14, 2025 Lewi, Kathryn A A0428 Beebe Hospital
Beebe Hospital, ED 12, 424 Savannah Road, Lewes, DE 19958
12001 OLD VINE BLVD
APT 208, 12001 OLD VINE BLVD, Lewes, DE 19958
4 $341.18 $- $341.18
s/w Nicka stated claim rcvd on 1/18/2025 and still in process as they need Authorization number as provider is OON. TLF# 45-60 days. FAX#8777882764 to send Auth No. Claim#250380122800 Callref#943847948 3/6/2025MK (Cigna Healthspring adv) No individual OON deductible for 2025, MA 01/16/2025 !No PA
5423 7337 Dec 24, 2024 Frank, Eileen A0428 Beebe Hospital
Beebe Hospital, ED 37, 424 Savannah Road, Lewes, DE 19958
BREAKWATER VILLAGE
BREAKWATER VILLAGE, 301 Ocean View Blvd, Lewes, DE 19958
2 $306.10 $- $306.10
One crew signature missing LDZ 01/02/2025 Corrected. Narrative is incomplete, please review LDZ 12/30/2024 No insurance information found , No information in face sheet , no? Medicaid, checked Nsure but no policy found, MA 12/26/2024 !Uninsured
5422 8572 Feb 20, 2025 Wietsruk, Jordan A0429 Beebe Healthcare's South Coastal Emergency Department
Beebe Healthcare's South Coastal Emergency Department, ED 11, 32750 Roxana Rd, Frankford, DE 19945
Beebe Hospital
Beebe Hospital, 529 B, 424 Savannah Road, Lewes, DE 19958
23.1 $687.57 $- $749.17
2025/04/28 Rejected in Waystar stating unable to locate eligibility for patient. LDZ Info from Beebe: Insurance = Cigna ID# 77978156632 No insurance information found, No information in face sheet, no Medicaid, checked Nsure but no policy found, MA 02/21/2025 !Uninsured
5133 8570 Feb 19, 2025 Meade, Patricia A A0427 Beebe Hospital
Beebe Hospital, 368 B, 424 Savannah Road, Lewes, DE 19958
Jefferson Hospital For Neuroscience
Jefferson Hospital For Neuroscience, 7 N 720 B, 900 Walnut St, Philadelphia, PA 19107
137 $1,887.33 $- $1,887.33
2025/05/06: Review with RG, confirm DOS is 2/19/2025 and Beebe is responsible. NR Inpatient with Beebe 02/12 - 02/20 per PGBA LDZ 03/17/2025 mcr denied for inpatient. 3/11/25REG !Inpatient
5035 6795 Nov 29, 2024 Brenan, Kelly A0427 Beebe Healthcare's South Coastal Emergency Department
Beebe Healthcare's South Coastal Emergency Department, ED 10, 32750 Roxana Rd, Frankford, DE 19945
Beebe Hospital
Beebe Hospital, 412 A, 424 Savannah Road, Lewes, DE 19958
23.1 $815.22 $- $815.22
Beebe provided - DE Medicaid ID# 0000966236 - JM 3/19/25 No insurance information found , Face sheet missing , Medicaid found inactive under PT id #0000966236, checked Nsure but no policy found, MA 12/03/2024
5035 6758 Nov 27, 2024 Cavanaugh, Daniel A0428 Beebe Hospital
Beebe Hospital, 301 A, 424 Savannah Road, Lewes, DE 19958
38537 BLUE HEN DRIVE
38537 BLUE HEN DRIVE, Selbyville, DE 19975
31 $635.33 $67.93 $567.40
2024/12/02_Verified UHC, no secondary or Medicaid, address verified, MA 12/02/2024
5035 6741 Nov 26, 2024 Smith, Richard A0429 Beebe Hospital
Beebe Hospital, ED 16, 424 Savannah Road, Lewes, DE 19958
Christiana Hospital
Christiana Hospital, ED, 4755 Ogletown Stanton Road, Newark, DE 19718
82.3 $1,265.49 $- $1,265.49
2025/5/22_MK- Called Sussez Correctional s/w Michal stated the claim representative will only assist through E-MAIL. As per rep we can Email on Nmonk@Vitalcorehs.com for claims with Patient Name , DOB , Date of Service and Place of service.Callref# Mishal-5/22/2025 Beebe provided - Vitalcore ID# 222747261 - JM 3/19/25 No insurance information found , no insurance information in face sheet, Medicaid found inactive under PT ID #0000384079, checked Nsure but no policy found, address updated as per face sheet, MA 12/02/2024
5035 6607 Nov 21, 2024 Lewis, Christine A0428 Beebe Hospital
Beebe Hospital, ED 35, 424 Savannah Road, Lewes, DE 19958
Genesis Healthcare - Milford Center
Genesis Healthcare - Milford Center, 700 Marvel Road, Milford, DE 19963
22.5 $558.66 $502.85 $55.81
Beebe provided - Medicare / Amerihealth Caritas ID# 2D24TW0KF94 / 0003353506 - JM 3/19/25 No insurance information found , No information in face sheet , no? Medicaid, checked Nsure but no policy found, MA 11/22/2024
5035 6492 Nov 16, 2024 Cavanaugh, Daniel A0428 Beebe Hospital
Beebe Hospital, 303, 424 Savannah Road, Lewes, DE 19958
38537 BLUE HEN DR
38537 BLUE HEN DR, Selbyville, DE 19975
30 $626.31 $67.93 $558.38
2024/11/19_Verified UHC, no secondary or Medicaid, address updated as per face sheet, MA 11/19/2024
5035 6488 Nov 16, 2024 Myers, Olivia A0429 Beebe Hospital
Beebe Hospital, ED 9, 424 Savannah Road, Lewes, DE 19958
Nemours/A.I. duPont Hospital for Children
Nemours/A.I. duPont Hospital for Children, ED, 1600 Rockland Road, Wilmington, DE 19803-3616
91.9 $1,352.08 $- $1,352.08
2025/5/6_MK - Call AIS root INS. s/w Jennifer Albert z stated they rcvd claim on 3/21/2025 and still pending as she waiting for Update W9 form form provider. As per rep send the W9 form with Claim number that is G2WWK3DE on Fax# 6143621751. Beebe provided - AIS Root Insurance Company ID# G2WWK3DE - JM 3/19/25 One crew and patient signature missing LDZ 11/25/2024 No insurance information found , Face sheet missing , no? Medicaid, checked Nsure but no policy found, MA 11/25/2024 Submitted. No PCR. JH 11/17/24
Showing 131 to 140 of 192 records