Schedule an Interfacility Transfer

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Newton Fire/EMS often provides the transfer of non-emergency and emergency patients between health care facilities when ambulance transport is indicated by virtue of patient condition.

NFEMS Captain Authorization

For non-emergent transfers and for transfers going to or from a location greater than 35 miles from Newton, the ranking shift officer on duty must authorize the transfer. Please attempt to contact the Fire/EMS Captain at Station 2 (316-284-6060). He will inform you of the documentation required for transport and schedule a time for transfer based on medic unit availability.

Fiscal Responsibility

The patient being transported or the authorized representative of the patient must sign a Newton Fire/EMS Signature Form authorizing submission of a claim for payment to Medicare, Medicaid or other payer. By signing, the patient or authorized representative also accepts responsibility for payment of services not covered by their insurance. The signature form must be signed and presented to the EMS crew prior to the patient being accepted for transport. The Fire/EMS Captain on duty may request that you download a Newton Fire/EMS Advanced Beneficiary Notice (regular insurance) or Advanced Beneficiary Notice (Medicare) and fax a signed copy to the Fire/EMS Station that will provide transport for the patient.  

The base charge for a BLS transfer is $450 and for ALS transfer is $600. Mileage is $15/mile.

Medical Necessity

Medical Necessity must be determined by the referring physician. A Newton Fire/EMS Physician Certification Statement, signed by the referring physician, must be provided to the EMS crew when they accept the patient for transport.

For more information about scheduling an interfacility transfer, please call Station 2 at 316-284-6060.