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Questions for Counsel (Billing (Membership Services (Subscription)…
Questions for Counsel
Billing
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Stretcher
Is there a venue to bill for non-medical stretcher transports (from AMR contract: Ambulatory Non-Ambulance)
Charges
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If a non-SNF, non-hospital customer calls for a transport, how are charges arranged?
Does PCS, ABN or Medicare apply
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If medicare is not involved, are there guidelines for charges?
Do we need to keep a "paper copy" of our billing processing or can everything be done electronically
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Call Intake
Can we bill for Emergency Response Rule when calls go through our dispatch center as it is not a 911 system, and what does "equivalent service" mean
Does Emergency Response Rule apply to us with the notation of "Application: The determination to respond emergently with an ALS ambulance must be in accord with the local 911 or equivalent service dispatch protocol. If the call came in directly to the ambulance provider/supplier, then the provider’s/supplier’s dispatch protocol must meet, at a minimum, the standards of the dispatch protocol of the local 911 or equivalent service. In areas that do not have a local 911 or equivalent service, then the protocol must meet, at a minimum, the standards of a dispatch protocol in another similar jurisdiction within the State or, if there is no similar jurisdiction within the State, then the standards of any other dispatch protocol within the State. Where the dispatch was inconsistent with this standard of protocol, including where no protocol was used, the beneficiary’s condition (for example, symptoms) at the scene determines the appropriate level of payment."
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R130BP.pdf
Question regarding if return trips are automatically covered (that is, if a patient is transported to an ED, is the return to a SNF automatically covered, even if not medically necessary):
"An ambulance transport is covered to the nearest appropriate facility to obtain necessary diagnostic and/or therapeutic services (such as a CT scan or cobalt therapy) as well as the return transport. In addition to all other coverage requirements, this transport situation is covered only to the extent of the payment that would be made for bringing the service to the patient."
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c10.pdf
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