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What if I do not have medical insurance? Medicare: When is ambulance transportation covered? When is ambulance transportation deemed necessary? How do I choose the right service? Is Century Ambulance "HIPPA" compliant? Who do I contact for specific billing issues?
To download a Patient Request for Access to Medical Records form, click here. To download the AMBULANCE BILLING AUTHORIZATION AND PRIVACY ACKNOWLEDGMENT FORM, click here.
What if I do not have medical insurance? Century Ambulance understands that not all patients we provide treatment for have medical insurance. In these particular cases, the patient is responsible for payment due and will be billed directly or may require prepayment. Payments are due within thirty (30) days of invoice date and may be paid by Visa, Master Card, Discover, American Express or personal check. To make a payment by phone, please contact our billing department at (904) 356-0835 or (888) 416-3411. top
Medicare: When is ambulance transportation covered? This guide is intended for hospital and skilled nursing facility staff and for anyone who may arrange for ambulance transportation for a Medicare beneficiary. In 1997, the Balanced Budget Act set new federal reimbursement rates and rules under which ambulance services are now reimbursed. Across the United States there are approximately 39 million people enrolled in Medicare organizations. Many of these beneficiaries are now finding that not all ambulance services are covered under their current Medicare plan. Medicare guidelines allow for coverage of the following transports so long as it is deemed necessary: ALS and BLS emergency, ALS and BLS non-emergency and specialty care transports. Medicare will not cover wheelchair or non-medical stretcher transports. top
When is ambulance transportation deemed necessary? Medicare will only pay for services that are medically necessary and reasonable for the condition of the patient. In other words, the patient's medical records must support the claim that the transport was within reason and essential to the patient's current condition and that transportation by any other means would be contraindicated. Medicare also requires that transport be from a qualified origin to a qualified destination. Section 1861 (s) (7) of the Balanced Budget Act states: “Ambulance services are not covered or paid by Medicare if other modes of transportation (e.g., automobile, taxi, wheelchair van, etc.) could have been used by the beneficiary without endangering his or her health. If the decision to use an ambulance service is based on the convenience of the beneficiary, the beneficiary’s family, or some other element of personal preference, Medicare coverage is not available.” Any request for ambulance service must meet medical necessity guidelines in order for Medicare to pay. If ambulance transport is not medically necessary, payment can and will be denied. The patient is then responsible for any amount due the ambulance company. top
How do I choose the right service? The Balanced Budget Act defines in section 1861 (v) (1) (k) (ii) an emergency as “…the sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably be expected to result in placing the beneficiary’s health in serious jeopardy; serious impairment to bodily functions; or serious dysfunction of any bodily organ or part.” Emergency situations (including, but not limited to, chest pain and shortness of breath) are medically necessary and meet Medicare guidelines for ambulance services and transportation. Non-emergency ambulance transportation is appropriate for patients who have a medical condition that requires medical observation/monitoring from an attendant or for those who are bed confined, however, the patients medical records must support the condition. A patient that is bed confined means that all the following conditions exist: the patient is unable to get up from bed without assistance, the patient is unable to ambulate and the patient is unable to sit in a chair or wheelchair. If transport is not medically necessary and the patient is not bed confined, the most appropriate transportation is non-medical stretcher or wheelchair. (Reminder: Medicare does not cover these services and payment will be required by the facility, patient or other means.) Examples that meet medical necessity guidelines:
If you have further questions regarding Medicare or the Certificate of Medical Necessity, please feel free to contact the Director of Billing at Century Ambulance Service Inc. top
Is Century Ambulance "HIPPA" compliant? Century Ambulance Service Inc. is a licensed health care provider and therefore must abide by all regulations and policies set forth by the Center for Medicare and Medicaid Services. The Health Insurance Portability and Accountability Act of 1996 (referred to as “HIPAA”) requires us by law to maintain the privacy of certain confidential health care information, known as Protected Health Information or PHI, and to provide our patients with a notice of our legal duties and privacy practices with respect to PHI. This guide is intended to inform hospital and skilled nursing facility staff of our privacy practices and how we at Century Ambulance Service Inc. are permitted to use and disclose PHI in accordance with HIPAA. Uses and Disclosures of PHI: Ambulances Providers may use and disclose a patient’s PHI for three basic purposes without the consent or authorization of the patient: (1) treatment, (2) payment and (3) health care operations. For treatment: This includes verbal and written information that we obtain in order to properly administer treatment to the patient. This may also include information we give to other health care personnel to whom we transfer care. Such information may be transferred via radio/telephone or in the form of a copy of the written record we create in the course of providing care. For payment: Activities we must undertake in order to get reimbursed for the services we provide including filing claims, coordinating benefits, making eligibility inquiries, collections and more. For health care operations: Information needed for quality assurance and improvement activities, obtaining legal or medical review or auditing, processing grievances and complaints, business planning and creating reports that do not individually identify a patient. When orders are given to allow us to provide care to a patient of your facility, it is both legally and professionally acceptable to provide PHI to our staff for the purpose of rendering proper care and treatment to the patient or submitting claims for payment. Policies on Confidentiality of Patient Information: Given the nature of our business, it is imperative that we maintain the confidence of patient information that we receive in the course of our daily work. Century Ambulance Service Inc. prohibits the release of any patient information to anyone outside the organization unless required for purposes of treatment, payment or for health care related operations. Pursuant to HIPAA guidelines, we are required to establish and implement policies and procedures for the HIPAA compliance program and all members of our workforce are to be trained on the matter. We provide services to patients that are both private and confidential and understand that each employee plays a crucial part in respecting privacy rights. In the event patient confidentiality procedures are breached, our employees are to notify the Privacy Officer of Century Ambulance Service Inc. immediately. Should you have any additional questions about HIPAA or our policies and procedures, please contact our Privacy Officer at (904) 356-0835 or (888) 416-3411. top
Who do I contact for specific billing issues? Please feel free to contact our billing department at (904)356-0835 Monday-Friday 9:00AM-4:00PM.
The following inquiries should be directed to Steve:
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