Billing

Gilpin Ambulance billing office is open 8:00 AM to 4:00 PM Monday through Friday (holidays excepted) at the Black Hawk Firehouse, 196 Clear Creek St, in Black Hawk, CO. 
Phone: 303-582-5499
Fax:   303-582-3390
Email: Billing@gilpinambulance.com

After your transport by the ambulance, our Billing Specialist will assist you in processing the necessary paperwork to ensure prompt payment from your healthcare insurance company. We are also committed to helping those without insurance.

Insurance Authorization:

In order for us to bill your insurance company, we must have your authorization in the form of a signature. We make every attempt to get this signature at the time of service, however that is not always possible. If we do not have your signature we will mail you the form or you can download and print the Signature Authorization Form here. Complete all information on the form and mail it (Po Box 638 Black Hawk, Colorado 80422) or fax it (303-582-3390) immediately.

Medicare:

We will electronically submit all ambulance service claims for Medicare Part B patients.  Once Gilpin Ambulance, Inc. has received payment from Medicare we will bill the patients secondary insurance or the patient for the patient's responsibility set by Medicare.

Private Insurance:

Gilpin Ambulance Authority. is not a contracted provider with any insurance companies, other than Medicare. We will, however, submit a standardized claim for you to your insurance company. How much of your claim is paid by your insurance company will depend on your policy (ie: deductibles, the insurance company’s standardized amount they will pay for a specific service, etc.) Please watch for your Explanation of Benefits (EOB) from your insurance company, which will explain what amount they have paid toward the ambulance charges. Any amount remaining after the insurance has paid their portion will be reflected on the next monthly bill. Any amount not paid by your insurance company is your responsibility.

CICP and Financial Assistance:

We have instituted a program that will work with your CICP rating.  CICP does not have a program which reimburses ambulance services, however we will reduce your bill based on CICP rating. Please send us a copy of your CICP card showing your rating to Po Box 638, Black Hawk, CO 80422, FAX 303-582-3390

If you are not a member of CICP and would like Financial Assistance please fill out the Financial Assistance Application and mail or fax it to us with the required documentation. Po Box 638, Black Hawk, CO 80422, FAX 303-582-3390

Gilpin Ambulance will accept 6, 12 or 18 consecutive monthly payments until the balance is paid in full. 

Gilpin Ambulance’s willingness to reduce its fee is contingent upon the patient making the agreed upon payments in a timely manner, and that failure to do so negates the reduced fee and leaves the patient liable for the full amount of the charges.

Our pricing and billing methods are based on Medicare's Ambulance Fee Schedule and guidelines set by Medicare and the Department of Health and Human Services.  If you have questions or problems with your bill please call our office or your insurance company for assistance.

Payment options:

We currently accept the following payments:

• Checks
• Money Orders
• Certified Checks
• Visa, MasterCard or Discover

We follow the laws set forth by HIPPA patient privacy and rights.  Click here for your privacy and rights.