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Contact the Billing Service Office:

• If you have any questions about your ambulance bill,
• You wish to make a payment, 
• You have information to provide regarding your bill or insurance coverage, 
• You wish to receive a copy of the ambulance run (Records Request)
  

Please have Patient's full name, date of service, address, date of birth, and SS# ready to receive assistance.

Date of Service after October 1, 2015:
Andres Medical Billing                                                                                                 
Toll Free: 1-800-244-2345                                                                                           
Fax: 1-800-329-5274(Records Request)      
3223 North Wilke Road                                                                                                
Arlington Heights, IL  60004  

Online:  www.andresmedical.com                                                                                                                 
Before October 1, 2015:

LifeQuest Services

Toll Free: 1-888-777-4911

N2930 State Road 22  

Wautoma, WI  54982-5267 

Online:  www.myambulancebill.com 

FORMS: Click link to download

- Certification of Appropriate Transfer (Form must be filled out entirely.) 

- Records Request Form and Information

- Notice of Privacy 

- POLST - Do Not Resuscitate Form (For institutions/Nursing Homes)

- State of Wisconsin Do Not Resuscitate (Public)