Patient Services
Your Community’s Trusted Partner in EMS & Medical Transport Billing
Medicount Management, Inc. is honored to serve as the billing partner for your local municipality’s Emergency Medical Services. We manage billing for both ambulance and non-ambulance EMS medical services on behalf of patients and their families, ensuring claims are accurately submitted to commercial and government insurance providers for prompt processing.
If you have any questions, our team is here to assist you. To securely provide your health insurance information, please click the Registration/Insurance Information Form below.
- Online Forms
Registration/Insurance Info Form (Just fill in and click Submit)
HIPAA Authorization Form or download form to fax or mail
Financial Hardship Application Form or download form to fax or mail
Solicitud de Dificultades Financieras or descargar formulario
Questions for our Billers?
Contact Us
Email: ptrelations@medicount.com
Phone:888.410.6986 - Links to State Funded Insurance for Low Income Patients
Medicount maintains physical, electronic and procedural safeguards to guard your non–public, personal information. Our operational and data processing systems are contained in a secure environment that is access–controlled. To secure sensitive communications between your computer and our web servers, we have implemented digital certificates and enabled strong, RSA1024-bit, encryption. We use secure sockets layer, SSL, security protocol to protect all exchanges of information via our web pages that are considered private or confidential.
Make a Payment
To make a payment, click the “Make Payment” button below. After clicking “Make Payment” you will be taken to our card processing page where your information will be collected.
