| 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 | 5876 | Oct 15, 2024 | Oneal, William | A0428 | Beebe Hospital |
Beebe Hospital, ED 5, 424 Savannah Road, Lewes, DE 19958
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24295 ZINFANDEL LANE |
APT 101, 24295 ZINFANDEL LANE, Lewes, DE 19958
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4 | $333.16 | $- | $333.16 |
Beebe provided - Tricare East
ID# 188283622 - JM 3/19/25
Medical necessity missing in narrative LDZ 10/16/2024
No insurance information found , Face sheet missing , no? Medicaid, checked Nsure but no policy found, MA 10/16/2024
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| 5035 | 5860 | Oct 14, 2024 | Deleon, Waldemar | A0429 | Beebe Hospital |
Beebe Hospital, ED HALLWAY A, 424 Savannah Road, Lewes, DE 19958
|
Nemours/A.I. duPont Hospital for Children |
Nemours/A.I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19803-3616
|
91.9 | $1,352.08 | $- | $1,352.08 |
Denied PTF. NR 4/8/25
Beebe provided - Amerihealth Caritas
ID# 0002671865 - JM 3/9/25
No insurance information found , Face sheet missing , no? Medicaid, checked Nsure but no policy found, MA 10/15/2024
!Uninsured
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| 5035 | 5823 | Oct 11, 2024 | Lanier, Avalon | A0428 | Beebe Hospital |
Beebe Hospital, ED 3, 424 Savannah Road, Lewes, DE 19958
|
29328 PINEY NECK ROAD |
29328 PINEY NECK ROAD, Dagsboro, DE 19939
|
22 | $554.15 | $67.93 | $486.22 |
2025/03/19_Medical necessity??
Beebe provided - Highmark BCBS / Health Options
ID# XHP12715956 / XHD12717353 -JM 3/19/25
MCD active on DOS 0002258476 ,2/4/2025 JK
Patient is able to walk to and from stretcher unassisted LDZ 10/14/2024
Verified BCBS DE and Highmark Health Options Medicaid, Aid category (51-MEDICAID - SSI DISABLED, GRANT REGULAR, NON-INSTIT), no insurance information in face sheet, address verified, MA 10/14/2024
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| 5035 | 5712 | Oct 5, 2024 | Sullivan, Allen | A0427 | Beebe Healthcare's South Coastal Emergency Department |
Beebe Healthcare's South Coastal Emergency Department, 9, 32750 Roxana Rd, Frankford, DE 19945
|
Beebe Hospital |
Beebe Hospital, 378A, 424 Savannah Road, Lewes, DE 19958
|
23 | $814.31 | $- | $814.31 |
2025/4/28: eob from Detego attached in pmt events. paid $0, services not covered, incurred within mandatory waiting period. -REG
Beebe provided - Detego Health
ID# 683173989 - JM 3/19/25
No insurance information found , No information in face sheet , no? Medicaid, checked Nsure but no policy found, MA 10/07/2024
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| 5035 | 5191 | Sep 6, 2024 | Mendez Juarez, Venancio | 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, PACU, 424 Savannah Road, Lewes, DE 19958
|
23 | $730.60 | $- | $730.60 |
Beebe provided - DE Medicaid
ID# 0003713799 - JM 3/19/25
Emailed Beebe to see if they had any information LDZ 09/09/2024
No insurance information found , Face sheet missing , checked Nsure but no policy found, MA 09/09/2024
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| 5035 | 4412 | Jul 27, 2024 | Teague, Stephen | A0429 | Beebe Healthcare's South Coastal Emergency Department |
Beebe Healthcare's South Coastal Emergency Department, 1, 32750 Roxana Rd, Frankford, DE 19945
|
Beebe Hospital |
Beebe Hospital, 323 A, 424 Savannah Road, Lewes, DE 19958
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23 | $730.60 | $67.93 | $662.67 |
2024/12/19_Claim submitted on 9/16/24 , As checked on availity claim#22643850798 Denied on 9/24/24 as remarks code: X5019, The allowance for this service has been applied to the dollar deductible amount required under the patient's coverage. 12/19/24MK
One crew signature missing on PCR LDZ 07/30/2024
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| 5035 | 4397 | Jul 26, 2024 | Cardascia, Heidi | A0429 | Beebe Healthcare's South Coastal Emergency Department |
Beebe Healthcare's South Coastal Emergency Department, 5, 32750 Roxana Rd, Frankford, DE 19945
|
Beebe Hospital |
Beebe Hospital, 513 A, 424 Savannah Road, Lewes, DE 19958
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23 | $730.60 | $67.93 | $662.67 |
2025/03/29_pt mailed in ins info. 3/29/25REG
Call patient 845-797-9032 RE: WC. NR 3/20/25
Cliam submitted on 9/25/2024, s/w Emma stated they don't have claim no. for this DOS in patient account. As per rep if it is a injury claim than employer need to send first injury report to NYSIF. Callref#18967930 12/23/24MK
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| 5035 | 4339 | Jul 24, 2024 | Smenkowski, William | A0433 | Beebe Hospital |
Beebe Hospital, ICU 242, 424 Savannah Road, Lewes, DE 19958
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University of Maryland Medical Center |
University of Maryland Medical Center, CCRU, 22 S Greene St, Baltimore, MD 21201
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114.5 | $1,876.82 | $67.93 | $1,808.89 |
2025/01/23_BCBS Inquiry Number 25002702932 states patient can appeal, denial upheld. NR 1/23/25
Claim submitted on 9/9/24 , As checked on Availity claim#22062334861 Denied on 9/13/24 as remarks code : E5725 ,The primary care provider did not authorize the services and the condition treated did not meet urgent care guidelines. 12/19/24MK
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| 5035 | 3232 | May 25, 2024 | Grubb, Deborah | A0429 | Beebe Hospital |
Beebe Hospital, 11, 424 Savannah Road, Lewes, DE 19958
|
Christiana Hospital |
Christiana Hospital, 2C 23B, 4755 Ogletown Stanton Road, Newark, DE 19718
|
82.3 | $1,265.49 | $- | $1,265.49 |
Waystar rejected stating member ID not on file. LDZ 03/20/2025
Beebe provided - US Family Health MAP
ID# 801129617 - JM 3/19/25
MCR still shows MSP, invoicing patient for attention to COB. NR 1/2/25
Claim submitted on 9/9/24 , As per availity claim#22062334901 is denied on 9/16/24 for remarks code : H1, Rejected Billable Non-Covered Service and remarks code: S5002 Coverage was cancelled prior to the date of service. 12/18/24MK
BCBS inactive however MCR still showing as primary payer. LDZ 05/28/2024
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| 4807 | 7896 | Jan 20, 2025 | Jones, Michael | A0428 | Beebe Hospital |
Beebe Hospital, ED 34, 424 Savannah Road, Lewes, DE 19958
|
315 COULTER STREET |
315 COULTER STREET, Milton, DE 19968
|
11.1 | $439.59 | $- | $439.59 |
denied, unable to identify pt. 4/8/25REG
Attempt to file this claim. JM 3/19/25
No BCBS found with the ID number LDZ 03/17/2025
Check eligibility for BCBS R59758294. NR 3/17/25 (questionable medical necessity. NR 3/17/25
(Amerihealth Caritas Medicaid) No individual OON deductible for 2025, MA 01/21/2025
!MCD denial, unable to bill patient
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