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Fire Rescue - Emergency Medical Services (EMS)

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1. Who is responding to my emergency?

If you reside or receive services within unincorporated Monroe County or the City of Layton, you will be served by Monroe County Fire Rescue (MCFR) state-certified Firefighter / Emergency Medical Technicians (EMTs) and Firefighter / Paramedics. MCFR provides emergency fire response, advanced-level emergency medical services and ground and air-based emergency medical transport.

2. Do I have to pay if I call 911?

Monroe County Fire Rescue (MCFR) is funded by property taxes. There is no charge for calling and utilizing the 911 emergency service, however MCFR does charge a user fee if you are transported either by air or ground to a hospital.

3. I pay taxes, why am I being billed for this?

Monroe County Fire Rescue (MCFR) is funded by property taxes. However if you are transported either by air or ground to a hospital, you and your insurance provider are charged a user fee to offset a portion of the costs to provide this service, which helps reduce the overall cost to residents.

4. Where do these rates come from?

These rates were approved by the Monroe County Board of County Commissioners.

5. What are your EMS transport rates?

Rates are applied depending on the level of care required to treat and transport a patient to the hospital. Basic Life Support (BLS) is the lowest level of care administered; typically for a stable patient that does not require sophisticated paramedic level care. Advanced Life Support (ALS) involves a higher level of medical care. Depending on the patient's condition, this may require IV medications, cardiac monitoring, airway management, etc.

Ground Ambulance User Fee Rate

• Advanced Life Support I - $600
• Advanced Life Support II - $800
• Basic Life Support - $600
• Mileage (from incident site to receiving facility) - $12

Air Ambulance (Trauma Star) User Fee Rate

• Mileage (from incident site to receiving facility) - $100
• Trauma Star Transport Fee - $12,000

6. Why don't you accept my insurance?

Monroe County Fire Rescue (MCFR) will accept a payment from an insurance company and then bill the balance to the patient. We are required to accept the Medicare, Medicaid and Tricare rates. We follow all laws and statutes related to billing, and statutory adjustments are made to the accounts. The patient is then billed for the co-insurance, co-payments and/or patient responsibility per their individual policy.

7. The hospital has all of my information; why doesn't Monroe County Fire Rescue?

We are not associated with any of the hospitals to which we transport patients. Our paramedics begin to gather information about our patients before they arrive at the hospital; sometimes, the hospital does not have patient information on file. Also, due to the nature of emergency calls, our paramedics may have to leave the hospital to respond to another emergency and not have the opportunity to receive patient information from hospital staff.

8. Why was I sent to collections?

Our billing department sends three statements to the patient at the address of record requesting either insurance information or payment. If the patient does not respond within 90 days the account will be sent to the collection agency for further pursuit of payment. If we do not have a good address for the patient, and the billing department is not able to find a good address, the patient will be sent to collections after 90 days.

9. What if I don't have insurance and I can't pay this bill?

Monroe County does not have any local ordinances or statutes to provide for self-pay discounts. Our patients can email our Billing Department or call 305-289-6010 to utilize the option of a payment plan. It is important that payment arrangements are made within 90 days of receiving a bill. Delinquent accounts, which are those accounts with no activity for 90 days, are sent to a collections agency.

10. What is the Trauma Star Resident Fee Waiver Program?

As a resident or property owner of Monroe County, you have the option of requesting Trauma Star for air ambulance transportation and you may qualify for a waiver of the out-of-pocket costs related to air-transport fees as per Resolution Number 152-2009 (PDF). Download the application form for the resident fee waiver (PDF) or call 305-289-6010. If you qualify for the resident fee waiver, Monroe County will continue to seek reimbursement from any private insurance companies, but any remaining unpaid fees would be waived and there would be no out of pocket expenses.

11. Why do I have to sign the Responsibility Signature Form?

Monroe County Fire Rescue follows Medicare guidelines and Medicare requires that anyone transported to a hospital by an ambulance service, sign an authorization and responsibility form. Since we don’t always know who is a Medicare patient and who isn't, we ask all of our patients who are awake and alert to sign the form for our records.

12. My child (a minor) was taken to the hospital by ambulance. Why is the ambulance bill in my child's name?

At the time that our paramedics provided emergency care to your child, it’s possible that information about you, the parent or guardian, wasn't available or received. Simply call the in house billing department at 305-289-6010, and explain the situation and that you would like your name added to the account as the parent or guardian.

13. Why was my child (a minor) sent to collections?

Our in house billing department sends three statements to the patient at the address of record requesting either insurance information or payment. If the parent or guardian does not respond within 90 days the account will be sent to the collection agency for further pursuit of payment. If we do not have a good address for the patient and we do not have the name of the parent or guardian the patient will be sent to collections after 90 days. If the collection agency is notified that the patient is a minor they will not send the patient's information to the credit bureau.

14. A family member, who received your ambulance service in the past, recently passed away. He/she is still receiving ambulance bills. What should I do?

Contact the in house billing department at 305-289-6010 to let them know of your loss. You will be asked to send them a death certificate as proof of your loved one's passing. We will be happy to re-address the bill to the person in charge of wrapping up the affairs of the estate.

15. Do I have a choice of which hospital I want to be transported to?

State law requires us to transport patients who call 911 to the closest appropriate hospital. Trauma Alert patients: All patients meeting Trauma Alert criteria are transported to Ryder Trauma Center in Miami.

16. Do I have to go the hospital when I call 911?

No, you are not forced to go the hospital because you called 911. It is often strongly recommended that you go to the hospital, but if you are awake, alert and oriented you have the right to choose whether or not you will be transported via ambulance. If you choose to refuse transport to the hospital, you will be asked to sign a Patient Refusal Form by the paramedics to document your decision to refuse medical care.

17. What can I do to help the paramedics who come to my home?

You can assist the paramedics that respond to your emergency by having a complete list of your medical problems, medications and allergies to medications readily available. Keep this information in your automobile as well; you never know where you will be when an emergency happens! If you have pets, it is a good idea to place them in a secure area or room so that they are not startled by the arrival of our paramedics.

In addition, if you or a loved one has a Florida Do Not Resuscitate Order (DNRO), please ensure that it is available upon the paramedics' arrival. You can present a copy of the DNRO, but a copy must be printed on yellow paper in order for it to be considered valid.

18. What will happen when I arrive at the hospital in the rescue unit?

Upon arrival at the hospital, your care will be transferred over to the nursing staff at the hospital facility. Depending on the volume of patients at the hospital, it is possible that you may be sent to the waiting room if you are stable enough - even though you arrived by ambulance. Please remember that the hospitals treat patients utilizing a triage system. This means that the most severely sick or injured patients are seen first.

19. Why was I flown by Trauma Star to a hospital outside of the Keys?

If you have a severe auto accident or suffer any severe trauma, Trauma Star will fly you from your location directly to a Trauma Center in approximately 45 minutes from anywhere in the Keys, including the Dry Tortugas. If you are having a heart attack or brain attack (stroke) and call 911, Trauma Star will fly you from your location directly to a comprehensive cardiac or stroke treatment center on the mainland.

In addition to the primary mission of providing critical trauma-related air-transports, Trauma Star also assists local hospitals by providing hospital-to-hospital transfers. If you are at an area hospital and require a critical care inter-facility hospital transport, you or your representative can request the services of Trauma Star through the hospital staff (provided you meet the State of Florida inter-facility transfer guidelines).

20. What do I do if I have lost some of my belongings when I am transported to the hospital?

Monroe County Fire Rescue does not have a "Lost and Found." Patient belongings are left in the emergency department room with the patient at the time of transfer. Make sure that you only take items that are absolutely necessary with you to the hospital. Remember that the hospitals see large volumes of people each day and it is very easy for items to be lost or accidentally disposed of. Never take your valuables to the hospital with you.

21. How can I share a good experience or a complaint regarding the Monroe County Fire Rescue paramedics that responded to my emergency?

You may contact Monroe County Fire Rescue's Office at 305-289-6004 for either complaints or compliments.

22. How do I get a copy of a medical report?

Medical reports generated by Monroe County Fire Rescue (MCFR) are protected by federal HIPAA privacy laws. If you require a copy of a Medical Transport Report, Incident Report or Billing Statement, please contact our records office at 305-289-6010. Please be ready to provide your name and the location and date of the incident. For a copy of your transportation report you must complete a Medical Records Request and Release Affidavit (PDF). 

This can be done in person at Monroe County Fire Rescue Headquarters in Marathon, but must be accompanied by a Driver’s License or other identification. You can also download the form (PDF) and mail it or fax it to us with a notarized proof of identification to:

490 63rd Street Ocean
Marathon, Florida 33050
Fax: 305-289-6013

A signed affidavit showing that you are the personal representative of the patient or a power of attorney is needed if you are not the patient.