| 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 | 6948 | Dec 6, 2024 | Sensenig, Betty A | A0130 | Beebe Hospital |
Beebe Hospital, 408, 424 Savannah Road, Lewes, DE 19958
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1 NOTTINGHAM DRIVE |
1 NOTTINGHAM DRIVE, Lewes, DE 19958
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4 | $333.16 | $44.91 | $66.09 |
2025/05/06: Adjustedd to WCV per RB. NR
2024/12/09_Patient is wheelchair bound and can safely transport in one
Verified MCR 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 12/09/2024
!Not medically necessary
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| 4705 | 5153 | Sep 4, 2024 | Kraft, Elizabeth | A0428 | Beebe Hospital |
Beebe Hospital, 523 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 | $48.25 | $387.74 |
2024/10/10_Per Natalie, billing facility. Reviewed notes from hospital and stated upper left extremality slight weakness. LDZ 10/10/2024
Patient walked to and from stretcher unassisted
Verified MCR and AARP, address updated as per face sheet, No hospice, MA 09/04/2024
!Not medically necessary
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| 4703 | 4692 | Aug 9, 2024 | Larrabee, Jade | A0429 | Beebe Healthcare's South Coastal Emergency Department |
Beebe Healthcare's South Coastal Emergency Department, 6, 32750 Roxana Rd, Frankford, DE 19945
|
Beebe Hospital |
Beebe Hospital, 365, 424 Savannah Road, Lewes, DE 19958
|
23 | $730.60 | $- | $2,754.00 |
2025/5/20_MK- As checked on Availity claim finalized on 4/9/2025 under claim#22857387568 paid $270.25 to Member through check#99999995 issued on 4/8/2025 to patient. Need to send TBC letter.
Unable to verify insurance, will file with what was given to us. LDZ 04/04/2025
Information from Beebe:
Insurance = BCBS of Delaware
ID# ZBF20106391
Per Nsure no insurance found LDZ 08/12/2024
!Uninsured
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| 4703 | 4605 | Aug 7, 2024 | Litalien, Nathan | A0429 | Beebe Healthcare's South Coastal Emergency Department |
Beebe Healthcare's South Coastal Emergency Department, 11, 32750 Roxana Rd, Frankford, DE 19945
|
Beebe Hospital |
Beebe Hospital, 365A, 424 Savannah Road, Lewes, DE 19958
|
23 | $730.60 | $- | $2,754.00 |
2025/04/30: denied for timely. -REG
Information from Beebe:
Insurance = Amerihealth Caritas NEXT
ID# 67007366900
Amerihealth termed 12/31/2023
!Uninsured
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| 4698 | 4404 | Jul 27, 2024 | Charlton, Melissa | 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, 103, 424 Savannah Road, Lewes, DE 19958
|
23 | $730.60 | $- | $730.60 |
Information from Beebe:
Insurance = BCBS of Delaware
ID# XHP11472926
Per Nsure no insurance found LDZ 07/30/2024
!Uninsured
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| 4698 | 4354 | Jul 25, 2024 | Stout, Annmarie | A0427 | Beebe Healthcare's South Coastal Emergency Department |
Beebe Healthcare's South Coastal Emergency Department, 13, 32750 Roxana Rd, Frankford, DE 19945
|
Beebe Hospital |
Beebe Hospital, 223A, 424 Savannah Road, Lewes, DE 19958
|
23 | $814.31 | $- | $814.31 |
2025/5/20_MK- As checked on Waystar claim accepted for processing on 4/5/2025. Further checked on Availity claim not found. so need to file again.
Unable to verify coverage, will file with info given to us. LDZ 04/04/2025
Information from Beebe:
Insurance = BCBS of Delaware
ID# QDR10240470
Per Nsure no insurance found LDZ 07/29/2024
Submitted.
No PCR. JH 07/25/24
!Uninsured
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| 4698 | 4210 | Jul 16, 2024 | Cupples, Jackson | A0429 | Beebe Hospital |
Beebe Hospital, 6, 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 | $68.82 | $1,283.26 |
2024/10/17_Mother called in, she is going to call insurance, I am attempting to file. NR 10/17/24
UHC called in provided MCD information. Policy is NJ MCD. OOS MCD. Explained to UHC rep. NR 8/21/24
No MCD found, unable to locate insurance for minor LDZ 07/18/2024
!OOS MCD
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| 4698 | 4007 | Jul 8, 2024 | Stillman, John | A0429 | Beebe Hospital |
Beebe Hospital, ED 07, 424 Savannah Road, Lewes, DE 19958
|
Thomas Jefferson University Hospital |
Thomas Jefferson University Hospital, 3 CENTER BUILDING ROOM 3228, 111 S. 11th St, Philadelphia, PA 19107
|
119.8 | $1,603.74 | $68.82 | $1,534.92 |
No Date
!Patient invoiced 3x:
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| 4697 | 3848 | Jun 29, 2024 | Bowden, Joseph | A0427 | Beebe Hospital |
Beebe Hospital, ED 5, 424 Savannah Road, Lewes, DE 19958
|
Christiana Hospital |
Christiana Hospital, ED, 4755 Ogletown Stanton Road, Newark, DE 19718
|
82.3 | $1,349.20 | $- | $4,630.00 |
2025/05/25: Advised Beebe of denial. NR
2025/5/20_MK- As checked on Availity claim denied on 4/9/2025 as remarks code S5004 : We are unable to identify this patient from the identification number reported above. Please verify the name and number indicated on the identification card. If the patient is covered by us, please resubmit the claim. Claim#22076512698. As per member ID prefix ID belongs to Horizon BCBS of New Jersey, Need to review or need to contact patient for correct information.
Unable to verify BCBS coverage, will file as given to us. LDZ 04/04/2025
Information from Beebe:
Insurance = BCBS of Delaware
ID# HUF3HZN2758
Per Nsure no insurance found LDZ 07/31/2024
Submitted.
PCR is still a draft. JH 06/30/24
!Uninsured
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| 4697 | 3325 | Jun 2, 2024 | Ohara, Timothy | 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, 504-A, 424 Savannah Road, Lewes, DE 19958
|
23 | $730.60 | $- | $2,754.00 |
2025/07/06: coverage terminated sent to Michelle. NR
2025/05/28_MK - As checked on Availity claim#22157424001 denied on 4/11/2025 as Remarks code E5365 This claim was submitted under the BlueCard Program with an incorrect prefix. No more info available on availity. Further checked member ID prefix belongs to Carefirst BCBS of Maryland. Claim query send on availtiy. Need to review
2025/04/08_(MCR) Part B deductible left $ 0 for 2025, MA 04/08/2025
Recheck eligibility. NR 4/7/25
MCR verified, shows BCBS as primary and BCBS termed on 05/01/2023. LDZ 06/04/2024
!Patient invoiced 3x
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