Alliance Ambulance, Inc.

Medicare Information Part 2

This is just a simple version of what Medicare will and will not cover concerning ambulance transport.

1. Patient's Residence ( home or non-skilled facility) to Hospital.

Will be evaluated based upon diagnosis.

2. Patient's Residence ( home or non-skilled facility) to Outpatient Hospital.

Will be evaluated on a claim by claim basis.

3. Patient's Residence ( home or non-skilled facility) to Skilled Nursing Facility (SNF).

Will be evaluated based on diagnosis.

4. Patient's Residence ( home or non-skilled facility) to Non-skilled Nursing Home.

This service is not covered by Medicare.

5. Patient's Residence ( home or non-skilled facility) to Free Standing Facility.

This service is not covered by Medicare.

6. Free Standing Facility to Hospital.

This will be evaluated based on Diagnosis.

7. Free Standing Facility (i.e., dialysis centers, radiation thereapy centers, physician's office) to Outpatient Hospital (for routine care only, i.e. dressing changes, catheter changes, x-rays).

Will be evaluated on a claim by claim basis.

8. Free Standing Facility (i.e., dialysis centers, radiation thereapy centers, physician's office) to Patient's Residence (home or non-skilled facility).

This service is not covered by Medicare.

9. Free Standing Facility (i.e., dialysis centers, radiation thereapy centers, physician's office) to Skilled Nursing Facility (SNF).

Will be evaluated on a claim by claim basis.

10. Hospital to Skilled Nursing Facility (SNF).

Will be evaluated on a claim by claim basis.

11. Outpatient Hospital to Skilled Nursing Facility (SNF).

Will be evaluated on a claim by claim basis.

12. Hospital to Patient's Residence (home or non-skilled facility).

Will be evaluated based on diagnosis.

13. Outpatient Hospital to Patient's Residence (home or non-skilled facility).

Will be evaluated on a claim by claim basis.

14. Hospital to Hospital and not Returned to Original Hospital.

Will be evaluated based on diagnosis and facilities. Facilities or services at the second hospital cannot be available at the first hospital.

15. Outpatient/Observation Unit to Hospital and not Returned to Original Hospital.

Will be evaluated based on diagnosis and facilities. Facilities or services at the second hospital cannot be available at the first hospital.

16. Hospital to Free Standing Facility and not Returned to Original Hospital.

Will be evaluated on a claim by claim basis.

17. Outpatient/Observation Unit to Free Standing Facility.

Will be evaluated on a claim by claim basis.

18. Hospital to Hospital with Return Trip to Original Hospital

This service is not covered by Medicare Part B and should be billed by the hospital.

19. Outpatient/Observation Unit to Hospital with Return Trip to Original Hospital.

Will be evaluated based on diagnosis and facilities. Facilities or services at the second hospital cannot be available at the first hospital.

20. Hospital to Free Standing Facility with Return to Original Hospital.

This service is not covered by Medicare Part B and should be billed by the hospital.

21. Skilled Nursing Facility (SNF) to Patient's Residence (non-skilled facility or home).

Will be evaluated based on diagnosis.

22. Skilled Nursing Facility (SNF) to Hospital.

Will be evaluated based on diagnosis.

23. Skilled Nursing Facility (SNF) to Outpatient Hospital.

Will be evaluated on a claim by claim basis.

24. Skilled Nursing Facility (SNF) to Skilled Nursing Facility.

Will be evaluated on a claim by claim basis.

25. Skilled Nursing Facility (SNF) to Free Standing Facility.

Will be evaluated on a claim by claim basis.

26. Texas Ambulance to or from a Foreign (i.e., Canada or Mexico) or Out of State Hospital or Chest, TB or Mental Hospital.

Will be evaluated on a claim by claim basis.

27. No Transport or Air Ambulance.

Will be evaluated on a claim by claim basis.

 

 

 

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