Medic Rescue offers a variety of services for Beaver County residents. New rules concerning medical emergency and non-emergency transports are always arriving on the scene. Unfortunately, the patient's insurance coverage determines whether or not a transport will be paid in full, paid in part or not paid at all. It is important that you know what is covered, what is not covered and what your co-payment requirements are from your insurance company. Your insurance company will pay only for what they deem medically necessary. Remember that what you may consider an emergency, your health insurance company may not.
- Emergency ambulance service: Most insurance companies consider an emergency to be what any prudent layperson describes as an emergency. Medicare, however, has very strict guidelines. The most basic guidelines include but are not limited to: uncontrolled bleeding, chest pain, difficulty breathing, unconscious or in shock, had to be restrained, and required emergency treatment enroute. Any life-threatening situation requires emergency ambulance service.
- Non-emergency transports: A "Certificate of Medical Necessity," or CMN, is required for any non-emergency transport, including transportation between medical facilities. In order for ambulance transportation to qualify as "medically necessary," the following are instances that would qualify for medical necessity, However, they are not all instances.
- The patient is bed confined; or
- The patient must not be able to get out of bed with or without assistance; or
- The patient must not be able to walk; or
- The patient must not be able to sit in a chair, including a wheelchair; or
- The patient had to remain immobile because of a fracture that had not been set or the possibility of a fracture (e.g., hip fracture); or
- The patient is in a body cast; or The patient has signs and symptoms of severe pain or distress or a medical condition or conditions that would be exacerbated by transport other than ambulance; or
- The patient must remain in a supine position; or
- The patient must be removed by stretcher because of a specific physical condition or limitation.
- Wheelchair Van: This is basic curbside transportation service. There must be no steps for the van driver to maneuver to qualify for the wheelchair van service.
The determining factor is the condition of the patient at the time of the ambulance pick-up. If you have any questions regarding Medical Necessity, please call 724-728-3621.