Frequently Asked Questions

If this is your first time using our service, you may have questions about billing. Please call our billing office at (315) 782-0157 or email for assistance with your bill.

Billing FAQ:

Why does it cost so much for an ambulance response?
Our highly trained staff (career and Volunteer), vehicles and equipment are dedicated to answering emergency ‘911’ calls our community 24-hours a day, 7-days a week. But all of this equipment and staffing does cost money. These costs are paid for through a combination of user fees that are billed to those who actually use the service, and an ambulance tax subsidy from the Town of Watertown.

All communities have Paramedics in our area, don’t they?
No. Of all the ambulance agencies in Jefferson County, TWAS is one of the few non-commercial EMS agencies that have ambulances staffed at the Advanced Life Support level of care, 24/7/365. We do this to assure that our patient’s receive the highest level of care that we can provide.

Can TWAS transport patients from one hospital to another hospital?
If our EMS crews transport a resident of our authorized ambulance district to an area hospital, TWAS can transport that patient to another hospital if needed. Be aware that TWAS’ supervisory staff has to first consider the immediate needs of our emergency response district and if adequate emergency and backup staffing is available before approving the transport. TWAS will also request a ‘Physician Certification Statement’ statement from the doctor that is in charge of the care for the patient at the time of the transport. This ‘PCS’ form assures the insurance companies that the transport is medically necessary is in the best interest of the patient.

I have a HMO/Medicare/Medicaid – can you bill them directly?
Absolutely! That’s the preferred method! We do submit claims directly to all insurance companies. There are many steps to this process, which if not handled immediately or properly will result in a delay of receiving payment for your claim.

I was in a car accident – how is that billed?
If you were transported as a result of a motor vehicle crash, your medical expenses are covered under the ‘No-Fault’ portion of your vehicle’s insurance. The billing agent for TWAS will send you a questionnaire to obtain your car insurance carrier information. It is very important that you complete and sign this form as soon as you are able to, as New York State Law requires that the claim be submitted to the insurance carrier within 45-days of the accident.

I was injured on the job and I received a bill, why is that?

Please ask your employer to contact our billing vendor immediately regarding this. We need to have their Workers’ Compensation carrier information.

I received a bill for a “Paramedic Intercept”. What is this, and will my insurance cover this?
TWAS also provides “intercept” services to other volunteer services. Not all volunteer ambulance services have Advanced Life Support (ALS) equipment and personnel available, and–depending on the type of call–EMS agencies are required by both State and local protocols to have an ALS provider respond to certain type of calls and evaluate the patient to see if there is a need for ALS treatment.
If you received a bill from TWAS for this service, we were requested by the transporting ambulance service or by Jefferson County’s ‘911’ center.
Most private insurances do cover this “intercept” fee. However, Medicare, as well as the Medicare replacement plans, will not cover these “Intercept” charges. In some cases, TWAS can have written Agreements with our neighbors filed with Medicare to help cover these types of bills, but not all of our neighboring agencies qualify for these Agreements. If you do have a question about an “intercept” charge, your first phone call should be to our billing vendor to see how to proceed.

I received a check from my insurance company, what do I do?
Most insurance companies send the check directly to us. However, some of the insurance companies send the reimbursement check directly to the patient. If you should receive a check, please sign the back of the check and forward it to either TWAS, Inc., or to our billing vendor. If you keep the check, TWAS will continue to bill you for the service provided, and you may end up in Collections if you do not make arrangements to pay the amount that was sent to you.



(315) 782-0157 OR STOP AT THE STATION, 18535 US ROUTE 11,