Frequently Asked Questions

Who is Northeast Quadrant Advanced Life Support?

The Northeast Quadrant Advanced Life Support, Inc. is a community based, not-for-profit and charitable organization whose purpose is to provide high quliaty advanced life support emergency medical care in a prehospital setting. NEQALS is certified by the New York State Department of Health as a Paramedic intercept agency. This means that NEQALS provides service using first response vehicles, also known as "fly cars", that respond to emergency medical calls along with ambulances from other fire department and ambulance agencies. NEQALS is not affiliated with the ambulance that may have transported you to the hospital. NEQALS is typically dispatched for serious medical emergencies like chest pain, trouble breathing, diabetic emergencies, or other potentially life threatening medical problems or traumatic injuries, as pre-determined by local 911 policies and procedures.

An NEQALS fly car was therefore dispatched to provide advanced life support care to you based on information that you, or others calling on your behalf, provided the 911 center.

What is Advanced Life Support?

Advanced Life Support (ALS) is where a Paramedic will assess and begin treatment for serious medical problems prior to transporting with you to the hospital. The Paramedic can administer medications, perform an EKG or other heart related procedures, provide airway management, or other advanced medical procedures that typically are provided for in a hospital emergency department. This is different from the fire department or Basic Life Suppor (BLS) ambulances that may respond to you in that those ambulances are certified to provide a basic life support level of emergency medical care using emergency medical technicians (EMT). Being able to provide these advanced life support treatments before reaching the hospital has saved many lives and increased the number of positive outcomes for the patients that receive this advanced care.

What other services does NEQALS provide?

As the number of volunteers interested in becoming EMTs continues to decrease, community-based emergency medical services across the state have struggled to maintain an ability to respond. Many of these community-based EMS agencies have begun to augment their volunteer ranks with paid EMTs. To help those agencies ensure that they can get ambulances staffed for timely response, NEQALS has partnered with several local agencies to help supplement their staffs by providing NEQALS EMTs and Paramedics to staff their ambulances. Currently NEQALS EMTs supplement the volunteers at the Williamson Volunteer Ambulance Service and Richmond Fire District.

NEQALS also performs community outreach activities such as complimentary blood pressure screenings at local events and through programs like teaching community-based CPR, AED, Stop the Bleed and other lifesaving training.

Why am I receiving this bill for emergency medical services?

As one can imagine, the cost of providing pre hospital emergency medical services, like any other medical service, is significant. Costs for supplies, medications, staff, equipment, and insurance all contribute to our overall expenses and the rates we charge our patients. As NEQALS is not a taxing entity like the local fire departments that provide ambulance service, NEQALS' revenue come primarly through fees billed directly to the users of that service or to their medical insurance provider. In billing our patients for fees not covered by insurance, we are required to follow state insurance law and federal regulations in how we bill, which in turn also affects the rates we charge for our service.

I have Medicare or a Medicare Advantage Plan, shouldn’t they pay for this?

Because of Federal law and regulations, NEQALS and other Paramedic intercept agencies in New York State, are not permitted to bill Medicare directly for services that we have provided. Medicare Advantage Plan insurers, like MVP and Excellus, will also deny payment for the same reason even though they are not required to do so. The unfortunate effect of this is that under New York insurance law, NEQALS must then bill the patient for the full amount. We have reached out to our Congressional representatives to allow us to bill Medicare directly, but until the law is changed we are forced to follow this procedure. We would ask for your support in this regard by contacting your Congressional representatives by calling their local offices:

· Senator Chuck Schumer - (585) 263-5866
· Senator Kirsten Gillibrand - (585) 263-6250
· Congressman Joeseph Morelle - (585) 232-4850

There are Medicare rules that allow inter-agency agreements that would allow the transporting ambulance to pay us directly, at a reduced rate, after they bill Medicare, but only in instances where that transporting ambulance bills for the service. In New York State, the fire department ambulances that may have transported you, like the ambulance from West Webster Fire Department, are prohibited by state law from billing, so again, we are forced to bill the patients we treat. We have also reached out to our state representatives in an effort to alleviate this impediment.

What if I am unable to pay this bill?

Charity care is available to patients who are financially unable to pay all or part of their bill because of a hardship situation. Charity care is not available to patients who are able to pay for their care. For those patients who are able to pay for their care, arrangements can be made as to the timing of payment, such as by payment plans. Payment plans are available regardless of income and situational status. It is not the intent of this policy to provide charity care to patients who are either underinsured or have high deductibles or copayments.

If you wish to apply and be considered for charity care for either yourself or on behalf of someone else, please contact NEQALS in writing at:

Attention: Billing
P.O. Box 905
Webster, NY 14580

Please provide the patient’s name, date of service, medical insurance information, employment status, and the reason the patient wishes to be considered for charity care. You may be contacted for further information including annual income. All information received by Northeast Quadrant Advanced Life Support will remain confidential and will not be shared with anyone else. Any patient providing misleading information may be reassessed the total bill.

North East Quadrant Advanced Life Support would like to thank those who have helped support our mission over the years.


For more information and to help us reach our funding goal, please visit our DONATION page.

For non-emergency assistance please write to us through our website’s secured contact page or call (585) 787-9060.