Billing Information

Welcome

Dear Patient,
Thank you for visiting our Emergency Medical Services website.  the statement you have received is for an ambulance transport provided to you or a family member by the Harrison Community Ambulance EMS System.  You may find the following information helpful.

Insurance Information

If we do not have insurance information, a request was included with your statement.

If we have insurance information, the insurance company has been billed and the statement reflects any remaining balance that may be due.

If there is any other insurance that can be billed, please provide us with that information.  You may download and fill out the insurance information form here.

EMS Insurance Form

Authorization to Obtain/Disclose Protected Health Information

If you need to obtain a copy of your medical records you will need to download and fill out the form here.

Medical Authorization Release Form 

Mail or fax a copy of it to the billing service department.

Payment Options
Check/Money Order

Harrison Community Ambulance
PO Box 188
Harrison, ID 83833

Other Payment Arrangements
Please contact our Billing Service Department at 208-689-9103 if you wish to make other payment arrangements.

How to Contact Us

HCAA
PO Box 188
Harrison, ID 83833

208-689-9103        Fax:   208-689-3710        office@hcaaems.org