ABOUT 911 BILLING
 OUR SERVICES
 INDUSTRY NEWS
 CUSTOMER TESTIMONIALS
 INFORMATION REQUEST
 CONTACT US
 911 EMPLOYEE PAGE
 
 Make an Online Payment

 

911 Billing
Services & Consultant, Inc.
1320 Island Ford Road
Madisonville, Kentucky 42431
Phone: 270-824-8123
Toll Free: 1-888-344-9614

 

 

HIPAA Notice of Privacy and Model HIPAA Consent Form

Lifetime Signature Authorization Form

Insurance Information Request Form

Physician Certification Signature for Medicare and Medicaid Form

Charity Application Form

ABN Form for PatientAmbulance Service