Billing Information

 

Medical Transport is pleased to help health care providers and individual customers understand the sometimes confusing reimbursement programs that can help pay for our services. The best time to clear up any confusion over reimbursement is when calling to arrange ambulance transportation.

 

Ambulance charges fall under Medicare Part B guidelines, not Part A, unless the patient is transported between hospitals. Patients who are enrolled in Medicaid must have QMB Extended coverage or call their HMO for prior authorization before transport. Many commercial insurances will pay for emergency transports if covered by policy and the patient’s deductible has been met. Routine transports covered by commercial insurance will vary by individual policy. Government insurance programs, Anthem and Mailhandlers, do not pay co-pays for dialysis transports and most non-emergency transportation.

 

Ambulance charges are usually covered for the following services if:

 

-          patient must be bed-confined at the time of the ambulance trip

-          emergency transportation required (i.e., accident, injury, acute illness)

-          patient must be restrained

-          patient is unconscious or in shock

-          patient requires oxygen or other emergency treatment en route

-          patient must be immobilized because of a fracture or risk of fracture (stretcher bound)

-          patient is experiencing severe hemorrhaging

-          patient can be moved only by stretcher

 

If the patient is unstable and requires emergency transport, we recommend you call 911.

 

Ambulance charges for the following are not paid by Medicare or supplemental polices, will be covered if the patient has Medicaid QMB Extended.

 

Transportation to:

 

-          The doctors office

-          Be treated by a preferred physician or hospital

-          Be closer to home or family

Transportation back home is treated separately. If you call and ambulance transportation back home, the same qualification standards apply. In some cases, the trip to the hospital is covered, but the return trip is not. Return trips are covered by Medicaid QMB Extended.