Like BLS, ALS, and SCT, Emergency and Non-Emergency Transportation are categories of the Levels of Service provided by ambulances. The main difference between them is the need for immediate treatment, which determines the required equipment and personnel.
According to the Texas Department of Insurance (TDI), most ground ambulance providers in Texas furnish both types of transportation.
Emergency Ambulance Services – Emergency Transportation
Emergency Transportation is the most common type of ride for ambulance services. As the name discloses, it happens in life-threatening situations where immediate medical attention is needed.
Some examples of needing emergency ambulance services are heart attacks, strokes, and severe injuries from a car accident. Per the Texas Administrative Code, Specialty Care Transports are appropriate as this type of transportation if the required treatment for the emergency medical condition is not available at the first facility.
To achieve successful reimbursement for emergency transportation, the EMS agency must provide detailed documentation to the EMS billing partner. Ambulance services are often out-of-network services, but because they are often emergent, there is no opportunity for advance approval. The cost of transportation is billed directly to the identified payer.
Non Emergency Ambulance Services – Non Emergency Transportation
As the term states, Non-Emergency Transportation occurs when the patient’s needs are not immediate. Some examples of non emergency ambulance services are scheduled medical appointments, scheduled transport to another facility for treatment, and transportation to the patient’s home after discharge from a hospital.
Generally, non-emergency runs are arranged in advance and disclose dates, times, pick-up and drop-off locations. This type of transport can also happen on a reoccurring basis.
Reimbursement processes for non-emergency transport strongly rely on detailed documentation to be completed. As the industry standard, Medicare pays for medically necessary non-emergency ambulance transportation with a written order from a doctor stating that the ride is medically needed.
EMERGICON’s teams are experts in understanding the Level of Service through the EMS agency’s documentation and processing claims efficiently. If you have questions about Emergency and Non-Emergency Transportation, contact our EMS & Client Hotline: 866-839-3671 | support@emergicon.com.
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