AMBULANCE SERVICE: MEDICAL NECESSITY & PAPERWORK REQUIREMENTS

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Pre-scheduled, non-urgent stretcher transports must have documentation as to why the patient needs to be transported by stretcher (cot) and cannot sit in a wheelchair. Upon arrival, our staff will need information regarding patient condition. Remember, you are transferring care to us. Additionally, you are required to have an ambulance "stretcher necessity" form filled out thoroughly and completely, signed with professional initials (MD, DO, RN or LSW), noting provider number of the patient's attending practitioner. Finally, a patient demographics sheet ("Facesheet") is to be provided for the gathering of other pertinent information.

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WHEELCHAIR VAN SERVICE (AMBULETTE): MEDICAL NECESSITY & PAPERWORK REQUIREMENTS

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Primary billing is through the Ohio Department of Human Services (Medicaid). Most private insurance companies and Medicare do not cover wheelchair van services. Our documentation must describe what caused the patient to be wheelchair confined, and why the patient is being transported (i.e., what the doctor's appointment is for, what procedure is being performed, etc.). Upon our arrival at your facility please have our wheelchair van forms filled out and signed. The form may be signed by an MD, DO, RN, APN or LSW, and the signature must contain those professional initials. This form must also note the name and provider number of the attending practitioner who is ordering the transport. Please also include a patient demographics sheet ("Facesheet").

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FREQUENTLY ASKED QUESTIONS

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Does Medicare pay for wheelchair van services?

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No, wheelchair van services are non-covered services according to Medicare/ CMS guidelines, and supplemental policies will only pay when Medicare pays.

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Does Medicare pay for transportation to my doctor's office?

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No, trips to doctors' offices are a non-covered services according to Medicare.

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Does Medicare pay for me to be transported from one hospital to another hospital?

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Medicare will only pay for transportation from one hospital to another if a needed service is not available at the first hospital. They will not pay for a transport because of the preference of the patient, family or doctor.

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What should I do if Medicare denies a claim?

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You have the right to appeal any claim that Medicare denies. Sometimes you or your doctor may be able to supply more information that we had available initially, and Medicare may pay your claim. Follow the directions on your Medicare Explanation of Benefits.

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What do I do if my commercial policy denies a claim?

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Call your insurance company and ask them why the claim was denied. Many policies only cover trips into an Emergency Department. You may be able to appeal the claim and submit additional information we did not have available initially. 

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What if I am unable to pay my entire bill at once?

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Please call our office at 216-823-2100 to make monthly reoccurring payment arrangements.

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Which address should I send my payment to?

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Our lock box address is P. O. Box 636, Gates Mills, OH 44040-0636. Our physical address is 4495 Cranwood Pkwy, Cleveland, OH 44128. We will receive payment at either address.

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PRIVACY PRACTICES

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Click here to view our Notice of Privacy Practices document via PDF

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