Transportation and Billing Information
Non-Covered Mileage
Medicare, Medicaid, and other state or federal contracted insurance plans will only pay for ambulance transport to the closest appropriate hospital. If you choose to be transported beyond the closest appropriate hospital, then you will be responsible for the mileage costs beyond the closest appropriate hospital. Our current mileage rate is $15.00 per mile.
The EMT/Paramedic will assess your condition and can offer suggestions on the closest appropriate hospitals for you, but they cannot guarantee your insurance will cover the cost to bypass the closest hospital. In some cases, based on your condition, the EMT/Paramedic has clinical guidelines to follow that will determine the closest appropriate facility. In these cases, insurance will most likely cover all the mileage, but we can never guarantee what insurance will cover.
Hospital Choice Limitations
Ambulance resources are limited, therefore, we normally will only transport patients to the closest appropriate hospital within 30 miles. However, if your condition meets certain clinical criteria, such as Trauma, Stroke, or Heart Attack, we will transport you to the closest Specialty Resource Hospital. We will not transport past Iowa City to go to Cedar Rapids, or vice versa, for the convenience of the patient or family. Our goal is to get patients to the closest appropriate hospital for their condition and get the ambulance available for the next call as soon as possible.
Return Transports From a Hospital
Medicare will only cover non-emergency ambulance transport from a hospital to a care center when it is medically necessary. Ambulance Transportation is medically necessary only if other means of transport are contraindicated or would be potentially harmful to you.
To meet this requirement, you must be either “bed confined” or suffer from a condition such that transport by means other than ambulance is contraindicated by your condition. To meet the definition of “bed-confined,” you must meet all of the following three criteria:
- Unable to get up from bed without assistance.
- Unable to ambulate (walk).
- Unable to sit in a chair (including a wheelchair).
Medicare will not pay for non-emergency services just for convenience or because other transportation means are not available. We will only provide non-emergency transports that are Medically Necessary.
Lift Assistance
When the Ambulance provides you with Lift Assistance because you have fallen and need help getting up, you have two choices.
- You can refuse transport to a hospital and sign a release form.
- You can accept transport to a hospital.
Medicare and most insurance companies only pay for Ambulance service when the patient is transported to the hospital.
If you refuse transport to a hospital, then you may receive a bill because insurance does not cover the service.
It is our policy to bill for lift assistance if someone requests it more than once in a 90-day period.
Our charge for lift assistance is $125.00.
If you require lift assistance on a regular basis, then it is important that a physician evaluates you. Your physician can evaluate your condition and provide a treatment plan to prevent future falls. They can coordinate care for you, such as physical therapy or home health, to help you stay in your own home.
Ambulance Policy Questions
If you have any questions regarding Ambulance policies, please contact the EMS Director at 319-741-6105 extension 10.
Ambulance Billing Questions
If you have Ambulance billing questions, please contact our billing office at 1-877-882-9911 extension 7551.
