Medical and Billing Records Request


If you have questions regarding your ambulance bill, please contact our third-party billing company, Emergicon, at 877-602-2060 or on their website.

Medical and Billing Records Requests

Attorney Requests:

  • Attorney requests must be submitted through Chart Swap with the County of Wise / Wise County EMS service as the Provider.

Non-attorney requests:

  • Non-attorney requests may submitted in any of the following ways:
    • Download, complete, and submit a Patient Records Request Form (please note that following this link will take you to a third party website)
      • Fax the request (secure and direct) to 800-608-9457
      • Email Emergicon with general information and you will receive a secure email to use for the PHI details. DO NOT EMAIL RECORDS REQUEST FORMS TO THIS EMAIL.
      • Mail the request to PO Box 180446, Dallas, TX 75218.
    • For assistance call 972-602-2060 ext. 1611