Insurance FAQs2023-10-26T15:05:07-05:00

Insurance FAQs

Questions about your medical records or billing information? Please view our FAQs below.

What does “medically necessary” mean for ambulance transport?2023-04-23T01:29:36-05:00

Medicare states ambulance transports are considered medically necessary when the patient’s medical condition is such that the use of any other method of transportation (e.g., taxi, private car, wheelchair coach) would be medically contraindicated (e.g., would endanger the patient’s medical condition).

What’s the difference between Basic & Advanced Life Support?2023-04-23T01:29:37-05:00

Basic Life Support (BLS) ambulances provide transport to patients who do not require extra support or cardiac monitoring. A BLS ambulance is staffed by two emergency medical technicians (EMTs) who have training in basic emergency medical care such as basic airway management, use of an automated external defibrillator and basic drug administration. Examples of BLS transports include:

  • Hospital discharges
  • Psychiatric discharges
  • Basic Life Support emergencies such as lower extremity fractures
  • Interfacility transfers
  • Transport to dialysis
  • Doctor’s offices

Advanced Life Support (ALS) ambulances transport patients who need a higher level of care during transport above those services provided by a BLS ambulance. The unit is staffed by at least one paramedic who has more than 1,000 hours of education and training and are qualified to render advanced life support to patients such as advanced airway management, drug administration and cardiac monitoring under the direction of a hospital. Patients who typically require ALS transport include:

  • Medical/surgical patients with a continuous IV
  • Patients on a cardiac monitor
  • Patients with potential airway compromise
  • Any patient deemed to have a potential complication during transport when reported by the sending facility
  • Life threatening medical emergencies (For example: respiratory distress, stroke, seizure, or chest pains) 
How does Acadian Ambulance establish rates?2023-04-23T01:29:37-05:00

Acadian Ambulance’s rates are competitive for your community and meet all applicable local, state and federal limitations. Ambulance provider fees typically include a base charge for the transport, a mileage fee and charges for other procedures, supplies or medications administered.

What does insurance cover?2023-04-23T01:29:37-05:00

Ambulance and other medical transportation coverage varies from one insurance policy to the next. It is important to review your insurance policy to understand the limitations and requirements of your coverage. It may be necessary to obtain a prior authorization from your insurance carrier when scheduling some non-emergency transportation services. If your policy does not provide 100 percent coverage for transportation, you may be required to pay a deductible or co-payment as outlined in your insurance policy. Payment of all deductibles and co-payments are due immediately upon receipt of the bill.

What does Medicare cover for a non-emergency ambulance transportation?2023-04-23T01:29:38-05:00

In general, Medicare will not pay for non-emergency ambulance service unless the patient is unable to get out of bed without assistance and unable to walk, unable to sit in a chair or wheelchair, and/or that transportation by any other means would pose a hazard to the patient’s health. Medicare will not pay for ambulance transportation to a preferred hospital or facility that is not the nearest appropriate facility or for the convenience of the patient, the family or physician. Medicare does not pay for wheelchair, stretcher or gurney transportation.

What does Medicare cover for an emergency ambulance transportation?2023-04-23T01:29:38-05:00

In general, Medicare will cover medically necessary ambulance transportation to the nearest appropriate medical facility. Emergency ambulance transportation may qualify for Medicare coverage if the transport is a result of a sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity such that the absence of immediate medical attention could reasonably be expected to result in placing the patient’s health in serious jeopardy, impairment to bodily function or serious dysfunction to any bodily organ or part. Medicare requires that ambulance transportation be medically necessary and reasonable. To be medically necessary, Medicare requires that the use of any other method of transportation would be hazardous to the patient’s health.

Does my insurance cover non-emergency services?2023-04-23T01:29:39-05:00

Acadian Ambulance provides comprehensive non-emergency transportation services to patients who need to be safely transported from one location to another. Insurance plans may consider coverage of medically necessary non-emergency transports. Your insurance carrier will determine whether ambulance transportation meets their coverage criteria. It is important to check with your insurance provider to determine the specific requirements for payment related to non-emergency transportation.

Why does Acadian Ambulance require signature authorization before treatment and transport?2023-04-23T01:29:39-05:00

All patients are required to provide their signatures to acknowledge consent for treatment and transportation. A signature on file provides Acadian Ambulance with authorization to submit a bill on your behalf, assign benefits to Acadian Ambulance allowing medical insurance carriers to pay Acadian Ambulance directly, and is used as an acknowledgment showing you did receive a copy of Acadian Ambulance’s Privacy Policy. Acadian Ambulance cannot submit a claim to a medical insurance carrier without a signed authorization from the patient or guardian. Failure to provide a signed authorization may require Acadian Ambulance to seek payment directly from the patient or guarantor.

Acadian Health team with patient at home

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