| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4805 | 3688 | Jun 22, 2024 | Dorczuk Yazzie, Susan A | 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, 370B, 424 Savannah Road, Lewes, DE 19958
|
23 | $686.72 | $- | $686.72 |
Waystar rejected as unable to locate member, looked on Cigna portal and no patient found LDZ 03/20/2025
Cigna # 891166631. Beebe has name spelled: Susan Ann Dorczuk Yazzie. Nr 3/18/25
Unable to verify insurance on FS. LDZ 06/26/2024
!Uninsured
|
|
|
|
| 4805 | 3378 | Jun 6, 2024 | Brossus, Leslye | A0428 | Beebe Healthcare's South Coastal Emergency Department |
Beebe Healthcare's South Coastal Emergency Department, 10, 32750 Roxana Rd, Frankford, DE 19945
|
Beebe Hospital |
Beebe Hospital, PACU, 424 Savannah Road, Lewes, DE 19958
|
23 | $686.72 | $- | $2,754.00 |
2025/06/02: KP confirmed no active coverage on DOS. NR
2025/05/05: If infact emergent, please review response modes in PCR, insurance is showing an auth was issued and this should be non-emergent. NR
2025/05/04: Another EOB received, contacted KP. NR
2025/04/28: New MR request # 202508002406000
Kaiser # 00002595114. NR 3/18/25
One crew signature missing on PCR LDZ 06/13/2024
Unable to verify Kaiser coverage LDZ 06/13/2024
!Uninsured
|
|
|
|
| 5034 | 5900 | Oct 16, 2024 | Harrison, Melissa | A0429 | Beebe Healthcare's South Coastal Emergency Department |
Beebe Healthcare's South Coastal Emergency Department, ED 13, 32750 Roxana Rd, Frankford, DE 19945
|
Beebe Hospital |
Beebe Hospital, 504 A, 424 Savannah Road, Lewes, DE 19958
|
23 | $686.72 | $- | $686.72 |
2025/03/19_Beebe provided - Highmark BCBS
ID# THI10001123 - JM 3/19/25
No insurance information found , Face sheet missing , no? Medicaid, checked Nsure but no policy found, MA 10/17/2024
!Uninsured
|
|
|
|
| 5034 | 5645 | Oct 2, 2024 | Gordill Lopez, Lilian | A0429 | Beebe Healthcare's South Coastal Emergency Department |
Beebe Healthcare's South Coastal Emergency Department, ED 9, 32750 Roxana Rd, Frankford, DE 19945
|
Nemours/A.I. duPont Hospital for Children |
Nemours/A.I. duPont Hospital for Children, ED, 1600 Rockland Road, Wilmington, DE 19803-3616
|
108.3 | $1,409.22 | $- | $1,409.22 |
Waystar rejected stating unable to locate member LDZ 03/21/2025
Beebe provided - Highmark Health Options
(D# XHD12715642 - JM 3/19/25
No insurance information found , face sheet missing , no? Medicaid, checked Nsure but no policy found, MA 10/04/2024
!Uninsured
|
|
|
|
| 5034 | 5601 | Sep 30, 2024 | Coats, Shelly | A0427 | Beebe Healthcare's South Coastal Emergency Department |
Beebe Healthcare's South Coastal Emergency Department, ED 7, 32750 Roxana Rd, Frankford, DE 19945
|
Beebe Hospital |
Beebe Hospital, ED, 424 Savannah Road, Lewes, DE 19958
|
23 | $766.72 | $- | $766.72 |
2024/09/30_Verified UHC, No secondary or medicaid, address updated as per face sheet, MA 09/30/2024
!Patient Invoiced 3x
|
|
|
|
| 5034 | 5306 | Sep 13, 2024 | Hernandez Cata, Alexis | A0429 | Beebe Healthcare's South Coastal Emergency Department |
Beebe Healthcare's South Coastal Emergency Department, 10, 32750 Roxana Rd, Frankford, DE 19945
|
Beebe Hospital |
Beebe Hospital, 327 A, 424 Savannah Road, Lewes, DE 19958
|
23 | $686.72 | $- | $686.72 |
2024/09/13_Verified BCBS DE, addres updated as per face sheet, No secondary or Medicaid, MA 09/13/2024
!Patient Invoiced 3x
|
|
|
|
| 5034 | 3485 | Jun 13, 2024 | Ohaire, Patrick | A0429 | Beebe Healthcare's South Coastal Emergency Department |
Beebe Healthcare's South Coastal Emergency Department, 8, 32750 Roxana Rd, Frankford, DE 19945
|
Beebe Hospital |
Beebe Hospital, 504 A, 424 Savannah Road, Lewes, DE 19958
|
23 | $686.72 | $- | $686.72 |
!Patient Invoiced 3x
|
|
|
|
| 5034 | 3376 | Jun 6, 2024 | Mccall, Jacob | 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, 317 B, 424 Savannah Road, Lewes, DE 19958
|
23 | $686.72 | $- | $686.72 |
2024/06/07_Per Nsure no insurance found LDZ 06/07/2024
!Uninsured
|
|
|
|
| 5422 | 8572 | Feb 20, 2025 | Wietsruk, Jordan | A0429 | Beebe Healthcare's South Coastal Emergency Department |
Beebe Healthcare's South Coastal Emergency Department, ED 11, 32750 Roxana Rd, Frankford, DE 19945
|
Beebe Hospital |
Beebe Hospital, 529 B, 424 Savannah Road, Lewes, DE 19958
|
23.1 | $687.57 | $- | $749.17 |
2025/04/28 Rejected in Waystar stating unable to locate eligibility for patient. LDZ
Info from Beebe: Insurance = Cigna
ID# 77978156632
No insurance information found, No information in face sheet, no Medicaid, checked Nsure but no policy found, MA 02/21/2025
!Uninsured
|
|
|
|
| 6003 | 6257 | Nov 4, 2024 | Johnson, Calvin | A0427 | Beebe Healthcare's South Coastal Emergency Department |
Beebe Healthcare's South Coastal Emergency Department, ED 10, 32750 Roxana Rd, Frankford, DE 19945
|
Beebe Hospital |
Beebe Hospital, ED, 424 Savannah Road, Lewes, DE 19958
|
23.1 | $767.57 | $- | $767.57 |
Verified BCBS, no secondary or Medicaid, address updated as face sheet, MA 11/05/2024
!Patient Invoiced 3x
|
|
|
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