| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4806 | 4696 | Aug 10, 2024 | Ramirez Cash, Vinicio | A0427 | Beebe Hospital |
Beebe Hospital, 516, 424 Savannah Road, Lewes, DE 19958
|
Jefferson Hospital |
Jefferson Hospital, 9222, 1200 Old York Rd, Abington, PA 19001
|
137 | $1,842.59 | $- | $5,724.00 |
Beebe provided: DE Medicaid
(ID# 0004030812. Nr 3/19/25
One crew signature missing LDZ 08/19/2024
Per Nsure no insurance found LDZ 08/19/2024
Completed.
No PCR. JH 08/11/24
!Uninsured
|
|
|
|
| 4806 | 5433 | Sep 19, 2024 | Coffey, Maia | A0429 | Beebe Hospital |
Beebe Hospital, ED 1, 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 | $- | $4,132.00 |
4/24/25: Emailed RM, put back to facility invoice. NR
Beebe provided: Highmark Health Options
(ID# XHD13201703. (See name spelling on documentation). NR 3/19/25
No insurance information found , Face sheet missing , no? Medicaid, checked Nsure but no policy found, MA 09/20/2024
!Uninsured
|
|
|
|
| 4806 | 4969 | Aug 26, 2024 | Archino, David | A0428 | Beebe Hospital |
Beebe Hospital, 373 B, 424 Savannah Road, Lewes, DE 19958
|
Cadia Healthcare Renaissance |
Cadia Healthcare Renaissance, CHK W/ RN, 26002 John J Williams Hwy, Millsboro, DE 19966
|
11.6 | $435.99 | $- | $435.99 |
2025/03/19_Corrected original patient discount and corrected invoice for Beebe. NR 3/19/25
ambulates with assistance from his cane
Verified MCR and AARP and Tricare as Tertiary, address updated as per face sheet, No hospice, MA 08/27/2024
!Not Medically Necessary
|
|
|
|
| 4806 | 3982 | Jul 6, 2024 | Rivera, Jaeveliz | A0429 | Beebe Hospital |
Beebe Hospital, ED 04, 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 | $61.07 | $4,070.93 |
2025/05/25: Advised Beebe. NR
2025/5/7_MK - Call Health Partner s/w Colleen stated no patient found with name (Jaeveliz Rivera) with DOB 2/27/2020. As per rep Member ID# 910517661 not belongs to Health Partner. Need to contact patient for correct insurance information. Callref#50550099
Patient name spelling needs correction, Beebe provided: Health Partners
(ID# 910517661. NR 3/19/25
Unable to locate insurance for minor. LDZ 07/10/2024
!Uninsured
|
|
|
|
| 4806 | 3874 | Jul 1, 2024 | Johnson, Dominique | A0427 | Beebe Hospital |
Beebe Hospital, TRAUMA 2, 424 Savannah Road, Lewes, DE 19958
|
Christiana Hospital |
Christiana Hospital, 2B10, 4755 Ogletown Stanton Road, Newark, DE 19718
|
82.3 | $1,349.20 | $61.07 | $4,568.93 |
2025/05/25: Advised Beebe. NR
2025/5/16_MK - Call Geico s/w Liz stated she is not able to find the patient with Member ID#61710005241 , Name and DOB . Need to contact patient for correct info. Callref# Liz-5/16/2025
Beebe provided: Geico AUTO
(ID# 61710005241. NR 3/19/25
Per Nsure no insurance found LDZ 07/03/2024
!Uninsured
|
|
|
|
| 4806 | 3599 | Jun 18, 2024 | Furlan, Daniel | A0428 | Beebe Hospital |
Beebe Hospital, 360A, 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 | $61.07 | $242.33 |
No Date
!Patient Invoiced 3x
|
|
|
|
| 4806 | 2520 | Mar 20, 2024 | Duffy, Katrina | A0429 | Beebe Hospital |
Beebe Hospital, 36, 424 Savannah Road, Lewes, DE 19958
|
Bayhealth - Sussex Campus |
Bayhealth - Sussex Campus, ED, 100 Wellness Way, Milford, DE 19963
|
18.7 | $691.82 | $61.07 | $630.75 |
No Date
!Patient Invoiced 3x
|
|
|
|
| 4806 | 1871 | Jan 17, 2024 | Flepie, Pablo | A0428 | Beebe Hospital |
Beebe Hospital, ED, 424 Savannah Road, Lewes, DE 19958
|
Christiana Hospital |
Christiana Hospital, ED, 4755 Ogletown Stanton Road, Newark, DE 19718
|
82.3 | $1,098.06 | $61.07 | $1,036.99 |
2024/01/18_No insurance listed or found LDZ 01/18/2024
!Uninsured
|
|
|
|
| 4706 | 7460 | Dec 30, 2024 | Nocks, Daquan | A0130 | Beebe Hospital |
Beebe Hospital, ED 12, 424 Savannah Road, Lewes, DE 19958
|
Taton House |
Taton House, 18090 Harbeson Road, Milton, DE 19968
|
9.8 | $411.64 | $44.91 | $96.54 |
2025/05/06: Adjusted to WCV per RB. NR
2024/01/03_Non billable destination- billing Beebe per NR LDZ 01/03/2024
Verified UHC dual plan, checked but unable to verify UHC medicaid MCO, Highmark Health Options Medicaid found active under pt id #XHD129757529001, Aid category(67-MEDICAID - SSI DISABLED, NON-GRANT ELDERLY/DISABLE), no insurance information in face sheet, So need to wait for cross over, address updated as per face sheet, No hospice , MA 12/31/2024
!Non-covered destination, Not medically necessary
|
|
|
|
| 4706 | 7387 | Dec 26, 2024 | Williams, Linda M | A0130 | Beebe Hospital |
Beebe Hospital, ED 21, 424 Savannah Road, Lewes, DE 19958
|
24313 ZINFANDEL LANE |
24313 ZINFANDEL LANE, Lewes, DE 19958
|
4 | $333.16 | $44.91 | $66.09 |
2025/05/06: Adjustedd to WCV per RB. NR
2024/12/27_Patient walked to and from stretcher- lives alone
Verified MCR and Cigna, address verified, No hospice, MA 12/27/2024
!Not medically necessary
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