Should You Call an An Ambulance?

Ambulances are Covered When Medically Necessary

Most people hope they never have to take an ambulance to a hospital. So, before you actually need one, you may want to ask your insurance company how much they pay for an ambulance trip to ahospital.

There should be a written insurance plan that says what percentage of the trip they pay for, and whether you will be asked to pay the ambulance company first and then file a reimbursement claim with your insurance company. You can ask your insurance company to show you the written section of their plan on ambulance transportation and the appeal process if you need to challenge a charge.

At any stage of your billing, be sure to keep good records. It is best to write letters and keep copies. If you only have phone conversations, be sure you keep good notes of when calls were made, the name of the person you talked to and the specifics of what you discussed. If you don�t have documentation, you probably won�t have enough information for an appeal if you want to dispute payment of your claim. Appeals have strict time limits, if you miss the deadline, you can�t file one.

MEDICARE

If you are on Medicare keep in mind it only covers an ambulance ride if it was medically necessary to transport the patient. (Medicare and ambulance rides)

Medicare Part B (Medical Insurance) covers ground ambulance transportation when you need to be transported to a hospital, critical access hospital, or skilled nursing facility for medically necessary services, and transportation in any other vehicle could endanger your health. Medicare may pay for emergency ambulance transportation in an airplane or helicopter to a hospital if you need immediate and rapid ambulance transportation that ground transportation can't provide.

Ambulance costs don't stop when you get out of the ambulance at the hospital. Any hospital that is classified as a trauma center can charge you a "trauma activation fee". The trauma activation fee is a facility revenue code (068x) that enables verified, designated trauma centers to bill for the additional costs incurred by being a trauma center. It only applies, however, to cases where the trauma center received pre-hospital notification of a patient who met field triage criteria.

The moral of this story? Don't go to the hospital in an ambulance if you can help it!

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