Yes, Medicare, Medicaid, and private insurance are billed as applicable.  Applicability is determined by medical necessity and the reason for the service.  Only your insurance provider can tell you what services may be covered/billable.

If insurance information is not provided at the time of service, you will receive a statement of charges by mail.
Please complete the designated section on the back of the statement and be sure to sign it. To properly submit your insurance claim, we require complete and accurate information, including:

• Policy number

• Subscriber identification number

• Group number (if applicable)

• Name of the insured

• Full mailing address of the insurance company

In addition, Orange Cross Ambulance may request demographic and insurance details from any facility involved in your care or transport, if applicable. We may also work with third-party partners to verify your insurance information as needed.

Orange Cross Ambulance files insurance claims as a courtesy to our patients. However, we are considered non-participating providers with most insurance companies. As a result, some insurers may send payment directly to the policyholder rather than to us.

If this occurs, it is the patient’s responsibility to ensure the full balance is paid to Orange Cross, using any insurance reimbursement received.

Orange Cross Ambulance, Inc.

1919 Ashland Ave,

Sheboygan, WI 53081

Yes, payment plans are available.

We understand that healthcare costs can be a burden, and we offer flexible weekly or monthly payment options through our billing department. To keep your account in good standing, payments must be made consistently.

If you’re unable to make a scheduled payment, you must contact us in advance. Missed payments without notice may result in your account being sent to collections, subject to wage garnishment, or processed through the state debt setoff program.

Mastercard, Visa, Discover, Care Credit, Money Orders, or checks.

It’s a common misconception, but Orange Cross Ambulance is a private, nonprofit 501(c)(3) organization and does not receive any subsidies or funding from Sheboygan County or local tax dollars.

We operate independently and rely solely on service revenue—primarily through insurance reimbursement and patient billing—to cover the costs of 24/7 emergency readiness, skilled personnel, equipment, and medical supplies.

Billing for services rendered is essential to sustain operations and ensure ongoing emergency medical coverage for the community.

We understand this can be frustrating, but here’s why it happens:

When a 911 call is placed for a medical emergency, emergency medical personnel are dispatched—regardless of who made the call. Once the ambulance responds, resources are used to assess your situation, ensure your safety, and provide any necessary on-scene care. These services incur significant costs, even if you decline transport to the hospital.

Ambulance providers commonly charge for “treatment without transport” or for the emergency response itself, as personnel, equipment, and readiness are all part of what’s being delivered. The individual who called 911 (such as a bystander or law enforcement) is not responsible for the bill—the patient is billed for services provided during the response.

If you believe the charge was made in error or you did not receive any medical care on scene, please contact our billing department for review or clarification.

A. Medicare only covers ambulance when a beneficiary is transported. If you were not transported, Medicare will not cover this bill. We are not obligated to submit a claim to Medicare because Medicare does not cover non-transport charges. Therefore, we do not submit this bill to Medicare as a matter of policy.

Orange Cross, like many EMS providers, is not in network with any insurance carrier. Therefore OCA does not accept adjustments from commercial insurance. We like all healthcare providers are required by law to accept Medicare/Medicaid adjustments.

Ambulance services often remain out-of-network due to a combination of structural and financial challenges that make network participation unsustainable. Key factors include:

• Unilateral Contract Terms: Insurance companies frequently require EMS agencies to accept contracts that bind them to the insurer’s “plan manual”—a document that insurers can modify at any time. These changes can affect reimbursement rates, workflows, and approval criteria without any provider input, creating an unpredictable and unstable financial environment.

• Reimbursement Disputes: Ambulance providers and insurers often fail to agree on what constitutes fair compensation. Offered rates typically fall short of covering the high costs of maintaining 24/7 emergency readiness, skilled personnel, and specialized equipment.

• Fragmented System: EMS is delivered by a mix of municipalities, fire departments, hospitals, and private companies. This lack of standardization makes broad network participation difficult to achieve.

• Regulatory Constraints: In some regions, state or municipal rules set fixed rates or prohibit certain types of contracting, limiting providers’ ability to join networks.

• Limited Negotiating Power: Many EMS organizations are small and operate on thin margins, leaving them with little leverage when negotiating with large insurance companies.

• Non-Transport Denials: Insurers often refuse to reimburse EMS providers for care delivered on scene when no hospital transport occurs, despite the use of time, personnel, and resources.

EMS agencies are dispatched regardless of network status.

While we understand that medical bills can be stressful, Orange Cross Ambulance is legally prohibited from arbitrarily reducing or waiving patient charges—especially for those covered by federal healthcare programs like Medicare or Medicaid.

This is because doing so could violate the federal Anti-Kickback Statute (AKS), which prohibits offering anything of value—including discounts or fee waivers—that could be seen as an inducement for referrals or to encourage the use of a particular provider. Even well-intentioned reductions could be interpreted as an attempt to gain favor with patients or facilities, which is strictly regulated.

We can only consider discounts or waivers when all of the following apply:

• There is a documented financial hardship;

• The waiver is consistently and fairly applied (not selectively or based on referral potential);

• The decision is properly documented and aligned with regulatory guidelines.

Violating these federal rules can result in serious consequences, including criminal penalties and disqualification from federal healthcare programs. Our goal is to remain compliant while supporting patients to the fullest extent allowed by law. If you're experiencing financial difficulty, please contact our billing department to discuss possible options.