Total Records: 192
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Showing: 10 records
Array ( [id] => 810 [invoice_id] => 5035 [dispatch_id] => 5876 [date_time_of_service] => 2024-10-15 09:43:00 [patient_full_name] => Oneal, William [billable_service_code] => A0428 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, ED 5, 424 Savannah Road, Lewes, DE 19958 [destination_name] => 24295 ZINFANDEL LANE [destination_address] => APT 101, 24295 ZINFANDEL LANE, Lewes, DE 19958 [mileage] => 4 [price_invoiced] => $333.16 [amount_received] => $- [current_amount_due] => $333.16 [billing_notes] => 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 [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 809 [invoice_id] => 5035 [dispatch_id] => 5860 [date_time_of_service] => 2024-10-14 13:31:00 [patient_full_name] => Deleon, Waldemar [billable_service_code] => A0429 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, ED HALLWAY A, 424 Savannah Road, Lewes, DE 19958 [destination_name] => Nemours/A.I. duPont Hospital for Children [destination_address] => Nemours/A.I. duPont Hospital for Children, 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] => 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 [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 808 [invoice_id] => 5035 [dispatch_id] => 5823 [date_time_of_service] => 2024-10-11 15:50:00 [patient_full_name] => Lanier, Avalon [billable_service_code] => A0428 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, ED 3, 424 Savannah Road, Lewes, DE 19958 [destination_name] => 29328 PINEY NECK ROAD [destination_address] => 29328 PINEY NECK ROAD, Dagsboro, DE 19939 [mileage] => 22 [price_invoiced] => $554.15 [amount_received] => $67.93 [current_amount_due] => $486.22 [billing_notes] => 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 [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 807 [invoice_id] => 5035 [dispatch_id] => 5712 [date_time_of_service] => 2024-10-05 19:08:00 [patient_full_name] => Sullivan, Allen [billable_service_code] => A0427 [origin_name] => Beebe Healthcare's South Coastal Emergency Department [origin_address] => Beebe Healthcare's South Coastal Emergency Department, 9, 32750 Roxana Rd, Frankford, DE 19945 [destination_name] => Beebe Hospital [destination_address] => Beebe Hospital, 378A, 424 Savannah Road, Lewes, DE 19958 [mileage] => 23 [price_invoiced] => $814.31 [amount_received] => $- [current_amount_due] => $814.31 [billing_notes] => 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 [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 806 [invoice_id] => 5035 [dispatch_id] => 5191 [date_time_of_service] => 2024-09-06 13:25:00 [patient_full_name] => Mendez Juarez, Venancio [billable_service_code] => A0429 [origin_name] => Beebe Healthcare's South Coastal Emergency Department [origin_address] => Beebe Healthcare's South Coastal Emergency Department, 14, 32750 Roxana Rd, Frankford, DE 19945 [destination_name] => Beebe Hospital [destination_address] => Beebe Hospital, PACU, 424 Savannah Road, Lewes, DE 19958 [mileage] => 23 [price_invoiced] => $730.60 [amount_received] => $- [current_amount_due] => $730.60 [billing_notes] => 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 [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 805 [invoice_id] => 5035 [dispatch_id] => 4412 [date_time_of_service] => 2024-07-27 16:57:00 [patient_full_name] => Teague, Stephen [billable_service_code] => A0429 [origin_name] => Beebe Healthcare's South Coastal Emergency Department [origin_address] => Beebe Healthcare's South Coastal Emergency Department, 1, 32750 Roxana Rd, Frankford, DE 19945 [destination_name] => Beebe Hospital [destination_address] => Beebe Hospital, 323 A, 424 Savannah Road, Lewes, DE 19958 [mileage] => 23 [price_invoiced] => $730.60 [amount_received] => $67.93 [current_amount_due] => $662.67 [billing_notes] => 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 [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 804 [invoice_id] => 5035 [dispatch_id] => 4397 [date_time_of_service] => 2024-07-26 22:00:00 [patient_full_name] => Cardascia, Heidi [billable_service_code] => A0429 [origin_name] => Beebe Healthcare's South Coastal Emergency Department [origin_address] => Beebe Healthcare's South Coastal Emergency Department, 5, 32750 Roxana Rd, Frankford, DE 19945 [destination_name] => Beebe Hospital [destination_address] => Beebe Hospital, 513 A, 424 Savannah Road, Lewes, DE 19958 [mileage] => 23 [price_invoiced] => $730.60 [amount_received] => $67.93 [current_amount_due] => $662.67 [billing_notes] => 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 [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 803 [invoice_id] => 5035 [dispatch_id] => 4339 [date_time_of_service] => 2024-07-24 08:33:00 [patient_full_name] => Smenkowski, William [billable_service_code] => A0433 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, ICU 242, 424 Savannah Road, Lewes, DE 19958 [destination_name] => University of Maryland Medical Center [destination_address] => University of Maryland Medical Center, CCRU, 22 S Greene St, Baltimore, MD 21201 [mileage] => 114.5 [price_invoiced] => $1,876.82 [amount_received] => $67.93 [current_amount_due] => $1,808.89 [billing_notes] => 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 [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 802 [invoice_id] => 5035 [dispatch_id] => 3232 [date_time_of_service] => 2024-05-25 08:16:00 [patient_full_name] => Grubb, Deborah [billable_service_code] => A0429 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, 11, 424 Savannah Road, Lewes, DE 19958 [destination_name] => Christiana Hospital [destination_address] => Christiana Hospital, 2C 23B, 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] => 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 [beebe_comments] => [aec_comments] => [epic_comments] => ) Array ( [id] => 801 [invoice_id] => 4807 [dispatch_id] => 7896 [date_time_of_service] => 2025-01-20 01:34:00 [patient_full_name] => Jones, Michael [billable_service_code] => A0428 [origin_name] => Beebe Hospital [origin_address] => Beebe Hospital, ED 34, 424 Savannah Road, Lewes, DE 19958 [destination_name] => 315 COULTER STREET [destination_address] => 315 COULTER STREET, Milton, DE 19968 [mileage] => 11.1 [price_invoiced] => $439.59 [amount_received] => $- [current_amount_due] => $439.59 [billing_notes] => 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 [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
5035 5876 Oct 15, 2024 Oneal, William A0428 Beebe Hospital
Beebe Hospital, ED 5, 424 Savannah Road, Lewes, DE 19958
24295 ZINFANDEL LANE
APT 101, 24295 ZINFANDEL LANE, Lewes, DE 19958
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
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
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
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
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
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
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
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
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
5035 4339 Jul 24, 2024 Smenkowski, William A0433 Beebe Hospital
Beebe Hospital, ICU 242, 424 Savannah Road, Lewes, DE 19958
University of Maryland Medical Center
University of Maryland Medical Center, CCRU, 22 S Greene St, Baltimore, MD 21201
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
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
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
Showing 151 to 160 of 192 records