| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 5035 | 6441 | Nov 13, 2024 | Mojica, Benjamin | A0429 | Beebe Healthcare's South Coastal Emergency Department |
Beebe Healthcare's South Coastal Emergency Department, ED 5, 32750 Roxana Rd, Frankford, DE 19945
|
Beebe Hospital |
Beebe Hospital, 321 B, 424 Savannah Road, Lewes, DE 19958
|
23.1 | $731.51 | $- | $731.51 |
Beebe provided - DE Medicaid
ID# 0004135961 - JM 3/19/25
No insurance information found , No information in face sheet , no? Medicaid, checked Nsure but no policy found, MA 11/14/2024
|
|
|
|
| 5035 | 6243 | Nov 3, 2024 | Church, Brandi | 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, ED, 424 Savannah Road, Lewes, DE 19958
|
23.1 | $731.51 | $67.93 | $663.58 |
2025/01/01_BCBS policy starts 01/01/2025
Recheck eligibility. NR 11/21/24
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|
| 5035 | 6207 | Oct 31, 2024 | Green, Amelia | A0429 | Beebe Hospital |
Beebe Hospital, 315, 424 Savannah Road, Lewes, DE 19958
|
John Hopkins |
John Hopkins, MAIN CAMPUS MEDICAL WEINBERG 4AB, 1800 Orleans St, Baltimore, MD 21287
|
142.1 | $1,804.89 | $- | $1,804.89 |
Beebe provided - DE Medicaid
ID# 0001558719 - JM 3/19/25
Per Nsure no insurance found LDZ 11/01/2024
!Uninsured
|
|
|
|
| 5035 | 6172 | Oct 29, 2024 | Naciso, Perez | A0429 | Beebe Hospital |
Beebe Hospital, ED 20, 424 Savannah Road, Lewes, DE 19958
|
Thomas Jefferson University Hospital |
Thomas Jefferson University Hospital, ED, 111 S. 11th St, Philadelphia, PA 19107
|
119.8 | $1,603.74 | $67.93 | $1,535.81 |
2024/10/30_No insurance information found , No information in face sheet , no? Medicaid, checked Nsure but no policy found, MA 10/30/2024
|
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|
| 5035 | 6094 | Oct 26, 2024 | Rojas Hernandez, Zobeida | A0429 | Beebe Healthcare's South Coastal Emergency Department |
Beebe Healthcare's South Coastal Emergency Department, ED 205, 32750 Roxana Rd, Frankford, DE 19945
|
Beebe Hospital |
Beebe Hospital, 226 B, 424 Savannah Road, Lewes, DE 19958
|
23 | $730.60 | $- | $730.60 |
Beebe provided - DE Medicaid
ID# 0001617320 - JM 3/19/25
No insurance information found , Face sheet missing , no? Medicaid, checked Nsure but no policy found, MA 10/29/2024
|
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|
|
| 5035 | 6026 | Oct 23, 2024 | Elliott, Ronald | A0428 | Beebe Hospital |
Beebe Hospital, ED 4, 424 Savannah Road, Lewes, DE 19958
|
The Moorings At Lewes |
The Moorings At Lewes, 17028 Cadbury Circle Lewes, Lewes, DE 19958
|
1.8 | $303.40 | $67.93 | $235.47 |
2024/10/24_Medical necessity missing in narrative LDZ 10/24/2024
Verified Humana adv, no insurance information in face sheet, no secondary or Medicaid found inactive under PT ID #0000416751, address verified, No hospice, MA 10/24/2024
!Patient Invoiced 3x
|
|
|
|
| 5035 | 6000 | Oct 22, 2024 | Elliott, Ronald | A0428 | Beebe Hospital |
Beebe Hospital, HALLWAY B, 424 Savannah Road, Lewes, DE 19958
|
The Moorings At Lewes |
The Moorings At Lewes, 17028 Cadbury Circle Lewes, Lewes, DE 19958
|
1.8 | $303.40 | $67.93 | $235.47 |
2024/10/23_Medical necessity missing in narrative LDZ 10/23/2024
Verified Humana adv, no secondary or Medicaid found inactive under PT ID #0000416751, address updated as per face sheet, No hospice, MA 10/22/2024
!Patient Invoiced 3x
|
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|
|
| 5035 | 5936 | Oct 18, 2024 | Maclary, Susan | A0428 | Beebe Hospital |
Beebe Hospital, HALLWAY B, 424 Savannah Road, Lewes, DE 19958
|
20632 CANAL RD |
20632 CANAL RD, Rehoboth, DE 19971
|
7 | $373.75 | $67.93 | $305.82 |
2025/03/19_Beebe provided - Medicare / AARP
ID# 4WA1EX7RE02 / 31041007211 - JM 3/19/25
She was able to walk with her cane. Pt is self efficient and was left
home alone
Verified MCR, no insurance information in face sheet, no secondary or Medicaid, ,address updated as per face sheet, No hospice MA 10/18/2024
|
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| 5035 | 5935 | Oct 18, 2024 | Anwar, Zulfiqar | A0427 | Beebe Hospital |
Beebe Hospital, ED 1, 424 Savannah Road, Lewes, DE 19958
|
Thomas Jefferson University Hospital |
Thomas Jefferson University Hospital, PAVILLION 1412, 111 S. 11th St, Philadelphia, PA 19107
|
119.8 | $1,687.45 | $- | $1,687.45 |
Beebe provided -DE Medicaid
ID# 0004127082 - JM 3/19/25
No insurance information found , Face sheet missing , no? Medicaid, checked Nsure but no policy found, MA 10/18/2024
!Uninsured
|
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|
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| 5035 | 5911 | Oct 16, 2024 | Sockritter, Scott | A0429 | Beebe Healthcare's South Coastal Emergency Department |
Beebe Healthcare's South Coastal Emergency Department, ED 1, 32750 Roxana Rd, Frankford, DE 19945
|
Beebe Hospital |
Beebe Hospital, PACU 1, 424 Savannah Road, Lewes, DE 19958
|
23 | $730.60 | $- | $730.60 |
Beebe provided - DE Medicaid
ID# 0001565803 - JM 3/19/25
No insurance information found , As per face sheet we have Amerihealth Caritas as primary but unable to verifiy, PT id is also not mentioned, Also Dob is also different from face sheet which I updated correctly, no Medicaid, Also checked Nsure but no policy found, MA 10/17/2024
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