Billing and Medical Records

Our care doesn't stop when the ambulance leaves you!

If your ambulance transport meets the coverage requirements imposed by your insurance carrier, Liberty Ambulance Service will submit your claim for you. If not, we will assess your situation to determine who is the appropriate party responsible for payment of your transport. If you are responsible for payment, one of our Billing Representatives will be happy to work with you to make the process as easy as possible. Please contact our billing department with any questions or concerns, and make sure to have your insurance cards on hand when you call if you believe any information we have may be incorrect.

**Out of town transports are usually considered not necessary by insurance. Please call Jim Timmer at 904-805-0293 x227 to discuss the specifics of your long distance transport needs.

To pay your bill by VISA or MasterCard you may call us at 904.805.0293.

 

Need copies of your medical records?

 One of our Billing Representatives will be more than happy to guide you through this process! Call 904-805-0293 to discuss your needs.

 

Forms:

Assignment of Benefits Signature Form

Certificate of Medical Necessity form for Healthcare Providers 

Hardship Request Form

Medical Records Release Request

Non-Emergency Transportation Request Form (Facilities Only)

Liberty Ambulance Service

Billing Office
Tel 904.805.0293
Fax 904.724.0226

Hours
Mon-Fri, 8:00 AM - 4:00 PM

Mailing Address
1626 Atlantic University Circle
Jacksonville, FL 32207

FEEL FREE TO CALL US WITH ANY QUESTIONS!