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Ambulance Billing
About Ambulance Billing
The City of Rio Rancho recognizes that ambulance services are often needed at some of life’s most difficult times.  As such, we strive to minimize the burden imposed on those receiving medical attention as well as on their families.

This page outlines why we charge for ambulance services and details ways you can work with the City to ensure that the billing process is as painless as possible.  By working together, we can make sure our medical response system continues to meet citizens’ needs and expectations.

 

Note:  Federal privacy requirements enacted under the Health Information Portability and Accountability Act (HIPAA) restrict the release of personal health information.  In order for the city of Rio Rancho to release protected health information, proof of authorization must be presented to the Ambulance Billing Division.  Those requesting information will need to fill out an Authorization for Release of Information form and present valid ID before the city will release any information.  You can download the release form by choosing one of the following formats:

            Authorization for Release of Information (PDF)
            Authorization for Release of Information (Excel)
            City of Rio Rancho Fire and Rescue Department Privacy Policy (PDF) 

What Happens After I Receive Ambulance Services?
After receiving ambulance services from the city of Rio Rancho, you will receive a bill for the total amount owed.  (Applicable rates are included below.)  The bill will contain a form where you can document insurance information and return the same to the city.  Once we receive your insurance information, we will promptly present the total amount owed to your insurance provider and attempt to collect payment.  We will forward any remaining balance not paid by an insurance company to you.  The balance of the full bill is ultimately your responsibility.

You may download and compete an Insurance Information Form by choosing one of the following formats:

          Insurance Information Form (PDF)
          Insurance Information Form (Word)

TIP:  The city of Rio Rancho cannot accept insurance information unless it is accompanied by the signature of the insured (or authorized designee).  

What forms of payment do you accept?
The City accepts personal checks, money orders, cashier’s checks, cash, credit card, and debit card payments.  Checks and money orders should be sent to the following address:

City of Rio Rancho – Ambulance Billing

3200 Civic Center Circle NE

Rio Rancho, NM  87144

For online payments please click on the following link to visit
Bill Pay Express

$1.75 fee will apply
The city accepts the following credit and debit cards:


Master Card  Visa  American Express  Discover

Why do I have to Pay?
The city does not levy any assessments on tax payers to cover the cost of ambulance services.  As such, the services provided are supported by user fees.  These fees are set by tariff as approved by the State of New Mexico’s Public Regulation Commission and the city’s Governing Body.  The current rates are included below.

What if I do not Receive a Bill?
The city will charge all customers for services rendered.  Our EMT’s make every effort to collect as much information as possible at the time services are rendered; however, it is not always possible to collect enough information for the Billing Division to locate a customer.  If you have not received a bill within thirty (30) days of receiving services, please contact a representative at: (505) 891-5010

Do I have to Accept EMS Services?
No.  You have the right to refuse any treatment.  In such case, however, you will be required to sign a release form acknowledging that you have refused the city’s services.  You will thereafter not be billed as no services will have been provided.

Do I have to pay the Entire Balance at Once?
If you are uninsured, your insurance denies your claim, or a balance remains after your insurance has paid, you will be responsible for the balance in full.  Payment plans are available, with minimum increments of $50.00.  Please print, complete, and return a payment plan application.  You may download and compete an Payment Plan Application by choosing one of the following formats:

          Payment Plan Agreement (Excel)
          Payment Plan Agreement (PDF)

What if I Cannot Afford my Bill?
Several options are available including establishing a payment plan as described above.  In addition, programs such as the Sandoval County Health Care Assistance Program provide assistance for low-income residents.  If you were the victim of a crime, the New Mexico Crime Victims Reparation Commission may be able to offer assistance.

What if I wish to Dispute my Bill?

All disputes must be submitted in writing.  The City will research the history of the case and examine the nature of the dispute and then respond with a written determination.  Such written determination shall be final.  If you would like to file a dispute, please use the following form:

          Ambulance Customer Dispute Form (PDF)
          Ambulance Customer Dispute Form (Excel)

Current Ambulance Billing Rates
In accordance with the state-wide ambulance tariff, approved by the New Mexico Public Regulation Commission and adopted by the city or Rio Rancho’s Governing Body, the following rates apply to all ambulance services provided by the city:

Advanced Life Support 2 = $715.00
Advanced Life Support 1 = $494.00
Basic Life Support = $417.00

Note: under the tariff, the city charges a fee of $10.40 for each mile of transport beyond the first mile.
Response only/

Patient Evaluation = $111.00

What if the Customer is Deceased?
If an ambulance customer has passed away and left no insurance or estate through which to pay for ambulance charges, you may fill out an Affidavit Concerning Death and Inability to Pay Ambulance Charges, and the city will dismiss any remaining balance.  Please download the form in one of the following formats:
          Deceased Affidavit (PDF)
          Deceased Affidavit (Word)

Contact Us
For questions concerning an ambulance bill, you may contact the Billing Division during our normal office hours – Monday through Friday, 8 am to 5 pm – to speak with a representative.  If a representative is not available, please leave a detailed message and your call will be returned within two business days.  Please contact as follows:

Phone: (505) 891-5010

Fax: (505) 891-5762