| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4706 | 7325 | Dec 23, 2024 | Henry, Carolyn | A0130 | Beebe Hospital |
Beebe Hospital, 529 B, 424 Savannah Road, Lewes, DE 19958
|
Sea Spray Group Home |
Sea Spray Group Home, 17910 Ebb Tide Drive, Lewes, DE 19958
|
4.2 | $335.87 | $44.91 | $67.14 |
2025/05/06: Adjustedd to WCV per RB. NR
2024/12/26_PCS states patient is in a wheelchair
Verified MCR and Amerihealth Caritas Medicaid, Aid category(15-MEDICAID - SSI AGED, GRANT MR WAIVER), address verified as per face sheet but as per MCR address is '1054 S Governors Ave Dover 19904', No hospice, MA 12/26/2024
!Not medically necessary
|
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|
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| 4706 | 7323 | Dec 23, 2024 | Clark, Deborah K | A0130 | Beebe Hospital |
Beebe Hospital, 533, 424 Savannah Road, Lewes, DE 19958
|
Harrison House Of Georgetown |
Harrison House Of Georgetown, 110 W North St, Georgetown, DE 19947
|
15.5 | $488.76 | $44.91 | $126.47 |
2025/05/06: Adjustedd to WCV per RB. NR
2024/12/24_PCS states patient can use a wheelchair van
Verified MCR and Amerihealth Caritas Medicaid, Aid category(28-MEDICAID - SSI AGED, NON-GRANT INSTITUTIONALIZED (), address updated as per face sheet but as per MCR address is '26408 Fells St Georgetown 19947', No hospice, MA 12/24/2024
!Not medically necessary
|
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|
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| 4706 | 7316 | Dec 23, 2024 | Johnson, Lorraine E | A0428 | Beebe Hospital |
Beebe Hospital, 502, 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 | $44.91 | $391.08 |
2024/12/24_PCS states patient can be transported by wheelchair van
Verified MCR and Highmark Health Options Medicaid, Aid category (28-MEDICAID - SSI AGED, NON-GRANT INSTITUTIONALIZED (), address verified as per face sheet but as per MCR address is '1140 Savannah Road Lewes 19958', No hospice, MA 12/24/2024
!Not medically necessary
|
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| 4706 | 7302 | Dec 22, 2024 | Baynes, Dawn P | A0428 | Beebe Hospital |
Beebe Hospital, ED 24, 424 Savannah Road, Lewes, DE 19958
|
34150 JUNIPER DRIVE |
34150 JUNIPER DRIVE, Lewes, DE 19958
|
4 | $333.16 | $44.91 | $288.25 |
2024/12/30_Patient filed appeal with insurance, Highmark letter reads we did not insurance information. Billing contract. Nr 12/30/24
Patient walked with no assistance from the hospital bed to the stretcher, lives alone
Verified MCR and Highmark Health Medicaid, Aid category (57-MEDICAID - SSI DISABLED, GRANT ELDERLY/DISABLED WA), no insurance information in face sheet, address updated as per face sheet, No hospice, MA 12/26/2024
!Not medically necessary
|
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|
|
| 4706 | 7253 | Dec 20, 2024 | Henry, Constance A | A0428 | Beebe Hospital |
Beebe Hospital, 308 A, 424 Savannah Road, Lewes, DE 19958
|
36383 RABBIT RUN |
36383 RABBIT RUN, Millsboro, DE 19966
|
17 | $509.05 | $44.91 | $464.14 |
2024/12/23_PCS states patient could use WC van- wheelchair bound
Verified Aetna adv and Highmark Health options Medicaid, Aid category(27-MEDICAID - SSI AGED, NON-GRANT ELDERLY/DISABLED WA), address updated as per face sheet, No hospice, MA 12/23/2024
!Not medically necessary
|
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| 4706 | 7211 | Dec 18, 2024 | Reynolds, Carmen | A0130 | Beebe Hospital |
Beebe Hospital, 538, 424 Savannah Road, Lewes, DE 19958
|
Harbor Healthcare & Rehabilitation Center |
Harbor Healthcare & Rehabilitation Center, Chk w/ FD, 301 Ocean View Blvd, Lewis, DE 19958
|
1 | $292.57 | $44.91 | $50.34 |
2025/05/06: Adjustedd to WCV per RB. NR
2024/12/23_PCS states wheelchair van is more appropriate LDZ 12/23/2024
Verified Aetna adv and Medicaid, Aid category(Q1-QMB - QUALIFIED MEDICARE BENEFICIARY, NON-INSTITUT), address verified, No hospice, MA 12/23/2024
!Not medically necessary
|
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|
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| 4706 | 7155 | Dec 17, 2024 | Stephenson, Joan | A0130 | Beebe Hospital |
Beebe Hospital, 367 A, 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 | $44.91 | $105.99 |
2025/05/06: Adjustedd to WCV per RB. NR
2024/12/17_PCS states patient be transported in a wheelchair
Verified MCR, no secondary or Medicaid, ,address verified, No hospice MA 12/17/2024
!Not medically necessary
|
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| 4706 | 7097 | Dec 13, 2024 | Spoerer, John | A0428 | Beebe Hospital |
Beebe Hospital, 505, 424 Savannah Road, Lewes, DE 19958
|
Brandywine Living At Seaside Pointe |
Brandywine Living At Seaside Pointe, Check w/ Front Desk, 36101 Seaside Blvd, Rehoboth Beach, DE 19971
|
4.7 | $342.64 | $44.91 | $297.73 |
2024/12/16_Billing to Beebe 2024 claim - not medically necessary
Patient walked to and from stretcher unassisted
Verified MCR and BCBS, address verified, No hospice, MA 12/16/2024
!Not medically necessary
|
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| 4706 | 7062 | Dec 12, 2024 | Macbride, Mary | A0428 | Beebe Hospital |
Beebe Hospital, ED 5, 424 Savannah Road, Lewes, DE 19958
|
35461 KNOLL WAY |
35461 KNOLL WAY, Millsboro, DE 19966
|
15.7 | $491.47 | $44.91 | $446.56 |
2025/02/24_Spoke with patient who states that she is not paying this bill, she had no way home and didnt request for the ambulance to take her home. She said that Beebe should be the one taking care of the bill since they arranged it. LDZ 02/24/2025
Pt was transported home and ambulated up the stair into the house with minimal assistance where she lives alone
Verified MCR, No insurance information found in face sheet, no secondary or Medicaid, ,address updated as per face sheet, No hospice MA 12/12/2024
!Not medically necessary
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| 4706 | 6978 | Dec 8, 2024 | Spoerer, John | A0428 | Beebe Hospital |
Beebe Hospital, ED 8, 424 Savannah Road, Lewes, DE 19958
|
Brandywine Living At Seaside Pointe |
Brandywine Living At Seaside Pointe, Check w/ Front Desk, 36101 Seaside Blvd, Rehoboth Beach, DE 19971
|
4.7 | $342.64 | $44.91 | $297.73 |
2024/12/09_Billing to Beebe 2024 claim - not medically necessary
Patient walked with little assistance from the bed to the stretcher
Verified MCR and BCBS, address updated as per face sheet, No hospice, MA 12/09/2024
!Not medically necessary
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