Frequently Asked Questions About Emergency Medical Service Billing
How is the NJ EMS System designed?

How We Determine What to Charge and Why is it so much?

1. Why are the charges so expensive?

Answer: The charges MONOC bills for MICU services are in-line with other MICU systems in New Jersey. About 85% of the charges go towards maintaining readiness. That means when you need Paramedics they will be available, have the best equipment and be the best trained. Also, the cost of vehicles, medical supplies including drugs, staff and on-line doctor compensation, insurance and a 24/7 dispatch center make providing MICU services a very expensive endeavor. MONOC does not receive tax subsidies or any other public financial support for our services. Consequently, the end-users of our services ultimately bear the cost of maintaining the system.

2. What are MICU Paramedics?

Answer: MICU Paramedics are highly trained medical professionals. In addition to being Emergency Medical Technicians for a minimum of two years they undergo 1200 hours of training. They are certified by the Department of Health and are required to complete annual competency evaluations and continuing education. Their advanced skills and equipment make the difference between life and death. They bring the emergency room to the patient. They can administer life-saving drugs, insert breathing tubes and start IV lines. Volunteer or commercial or municipal ambulance services cannot legally render the care they provide.

3. I always thought ambulance service was free in my community. Why did I receive a bill for “MICU” services?

Answer: In New Jersey, emergency pre-hospital care is divided into two categories: Basic and Advanced Life Support. Volunteer first aid squads or municipal services often provide Basic Life Support. Advanced Life Support is provided by MICU (Mobile Intensive Care Unit) Paramedics. They are sent to serious or potentially serious calls, such as chest pain. They are an extension of the hospital and as such there is a charge for this service.

4. The Paramedics came and checked me, but they left after they said it was OK for the First Aid Squad to take me to the hospital. Why did I receive a bill for MICU?

Answer: When an emergency call is received, the dispatcher makes the decision to send Paramedics based on the information given by the caller. Paramedics are often sent only to be cancelled on the way. Sometimes, however it is not always clear if MICU care is needed. In such cases the Paramedics will evaluate the patient; this is “being safe rather than sorry”. That chest pain may be indigestion, but it could be a heart attack. When MICU performs this evaluation a bill for the service will be sent. This is equivalent to a doctor billing for a check-up or the emergency room sending a bill for its evaluation services.

5. Does health insurance cover these charges?

Answer: For the most part: Yes. Different insurance providers have different rules. MONOC bills insurance companies directly. If there were a co-pay, deductibles or a limit that your provider applies, you would be responsible to pay the balance. Check with your insurance company.

6. What if someone does not have insurance and can’t afford to pay?

Answer: MONOC is obligated, just like a hospital ER, to provide care regardless of an ability to pay. If a person has no insurance but can afford to pay the bill, a payment schedule can be arranged. In cases where patients are genuinely unable to pay, the situation is regarded as charity. These are reviewed on a case-by-case basis.

7. What is MONOC?

Answer: MONOC, The Monmouth Ocean Hospital Service Corporation, is a non-profit company comprised of fifteen acute care hospitals throughout New Jersey. Together this shared services consortium acts as a healthcare co-operative for these acute care hospitals and the over 2.8 million residents that they serve living in more than 1,800 square miles along New Jersey's northern, central and southern shore.

How We Determine What to Charge and Why is it so much?