[HISTORY: Adopted by the Town of Salem as indicated in article histories. Amendments noted where applicable.]
[Adopted by the 1963 Town Meeting; amended by the Town Council 12-18-2023]
The Town Council shall establish reasonable fees for the use of the Town ambulance services.
[Adopted by the Board of Selectmen 3-27-1995; amended by the Town Council 12-18-2023]
This policy is adopted pursuant to the authority granted to the Town Council by the Town Meeting on March 14, 1992. This policy applies to all transported users or responsible parties charged at a consistent rate as currently in effect per the Ambulance Fee Schedule as adopted by the Board of Selectmen pursuant to § 185-4A.
This policy is applicable to all users or responsible parties, regardless of the existence of third party insurance coverage, except as provided below:
A. 
Town employees injured while in the performance of their regularly assigned duties.
B. 
Mutual aid community Fire Department employees injured in the line of duty.
C. 
Mutual aid agreements.
A. 
The Town Council shall establish a fee schedule to be charged for the use of the Fire Department ambulance service. This fee schedule is incorporated into this policy by reference.
B. 
All patients that are transported by the Salem Fire Department ambulance shall be billed for the service.
C. 
Whenever possible, the Town's ambulance billing service and/or Fire Department staff shall obtain insurance information from the patient and shall submit a bill directly to the insurance company.
D. 
The Town shall accept assignment of all balances due from the insurance companies.
E. 
A patient shall be exempt from payment for ambulance service if he/she certifies to the Town's billing service that his/her family income is equal to or less than the current federal poverty levels. If the income for the household size is less than 1.5 times the federal poverty income levels, he/she will be responsible for 50% of the fees for service. If the income for the household is less than two times the federal poverty levels, he/she will be responsible for 75% of the fees for service.
F. 
After receiving payment from third-party insurers, the Town's billing service shall bill the patient for the patient copayment portion of the ambulance fee.
G. 
Initial thirty-, sixty- and ninety-day bills will be issued on outstanding balances. This will be followed by a fourth and final dunning notice at 105 days. At 120 days, the account will be evaluated for transfer to a collection agency.
H. 
Payment plans may be established to pay off the balance in an acceptable, as determined by the Town Manager, or designee, amount of time at any point.
I. 
Requests for write-offs shall be submitted to the Finance Department and forwarded to the Town Council for approval. Each request will include reasons for the write-off request.
Each multiple transport patient, defined as more than one patient in a single ambulance, requiring definitive care beyond observation and monitoring of vital signs shall be billed at the single transport rate. In cases where additional resources are not required, the flat fee and mileage charges shall be divided equally by the parties being transported.