Medicare coverage for ambulance transport

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Old 02-20-2022, 09:01 AM
ljr811 ljr811 is offline
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Years ago my mom was in assisted living and throwing up. 911 was called transport and MC denied. I appealed it and it got paid. Worth a try especially since you couldn’t get up.
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Old 02-20-2022, 09:01 AM
Waltdisney4life Waltdisney4life is offline
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Thank you for sharing finally a thread that actually has some merit!!!
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Old 02-20-2022, 09:26 AM
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Thanks for the heads up and glad you are getting over the accident. Just curious were you on a ladder ?
No ladder, I slipped getting out of the hot tub, using the plastic steps, and fell on the concrete pad, I now have really nice wooden steps with a railing.
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Old 02-20-2022, 09:33 AM
Windguy Windguy is offline
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After years of CPR/AED classes, one very important thing I learned is that if you aren’t sure if you should call 911, CALL 911! You never have to take the ride and it won’t cost you if you don’t. Let the first responders decide if it is unsafe to take a car.

Another important thing is that if the problem is serious, don’t take a car if there is an ambulance available unless there is an extra person to watch the patient while in transit.
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Old 02-20-2022, 09:53 AM
Babubhat Babubhat is offline
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I had to fight for 3 months with ambulance service to get it right.
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Old 02-20-2022, 10:07 AM
CoachKandSportsguy CoachKandSportsguy is offline
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VT, get well soon, I have always appreciated your offers for help, and your abilities in tinkering. . .


hmmm. . . . from the injured person's point of view, $500 for priority service to ER for an unknown injury incident, might want to go and then dispute the charges later. . also, pictures, pictures, pictures of situation for claim support. .

Memories of Natasha Richardson or Bob Saget might come to mind with what appears to lay people as simple injuries which can be life threatening. . with a head injury, I might consider the money well spent. .
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Old 02-20-2022, 10:13 AM
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Thanks for the advice. All the best for a full recovery.
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Old 02-20-2022, 10:25 AM
kettlecove kettlecove is offline
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Search how to file an appeal and do so. It worked for me. However, I also learned the lesson you pass along now.
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Old 02-20-2022, 10:38 AM
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Appreciate the info, get better soon
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Old 02-20-2022, 12:40 PM
nevjudbaker nevjudbaker is offline
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Originally Posted by villagetinker View Post
“I had a fall accident at our house, severe enough I could not get up, hit my head and shoulder, wife and neighbors could not get me up. They made the decision to call 911, EMTs arrived in 2-3 minutes, ambulance about 10 minutes later. Here is the kicker, to get coverage for the ambulance trip ($500) it must be medically required as determined by a doctor (or apparently in this case) by the ambulance personnel, they did not do this, I get to pay. Also, they never mentioned I could go by our own car, once I was off the floor.

I am sending this out as a warning, apparently IF you can go by your own car, do not take the ambulance, you will probably be charged. At least ask the question if the ambulance will be medically qualified, then make your decision, I just learned the hard way.”

BTW, I am doing very well with physical therapy, and I am almost back to normal (so beware!!).
Call: Dispatch health 352-415-0991
Medicare pays. It is a emergency number who will come out & help. They are like a 911 coming out to help. After they evaluate the situation whether you should have to go to the emergency room. Medical pays all costs because it saves from everyone being taken to ER when it can be taken care of at home.
You can check them out on:
dispatch health.com
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Old 02-20-2022, 12:42 PM
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Feel better.
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Old 02-20-2022, 02:23 PM
jj121232163 jj121232163 is online now
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its time for a volunteer ambulance for the Villages.What are we paying the ad valorem for Fire
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Old 02-20-2022, 07:15 PM
thevillages2013 thevillages2013 is offline
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Originally Posted by villagetinker View Post
No ladder, I slipped getting out of the hot tub, using the plastic steps, and fell on the concrete pad, I now have really nice wooden steps with a railing.
Good deal glad you are doing well. I know you are a hands on guy so the ladder was my best guess. The hot tub tackled you but it will also help you through the aches and pains
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Old 02-20-2022, 07:18 PM
CoachKandSportsguy CoachKandSportsguy is offline
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Quote:
Originally Posted by nevjudbaker View Post
Call: Dispatch health 352-415-0991
Medicare pays. It is a emergency number who will come out & help. They are like a 911 coming out to help. After they evaluate the situation whether you should have to go to the emergency room. Medical pays all costs because it saves from everyone being taken to ER when it can be taken care of at home.
You can check them out on:
dispatch health.com
although true, if this is a medical emergency which requires immediate medical attention, such as a stroke, you are losing valuable time in deciding that you need immediate medical attention.

The defualt should be call the ambulance and transport if any doubt about seriousness. Then refile and argue the charges with the ambulance company.
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Old 02-21-2022, 08:29 AM
EviesGP EviesGP is offline
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In my humble(and former EMT) opinion, a transport was probably warranted. Some of the major factors involved in the decision, is not just whether the patient is ambulatory, but also the incident and cause. Incident being the what(fall, general malaise, etc), and how severe(concussion, etc)? Cause, being the tricky one?! Many times we just don't know(at the scene) whether the patient just lost their footing, or some underlying condition caused or contributed to it? That's where it could get dicey, as that condition could worsen, and that could be a liability, if the ambulance service refers you to personal transport? Good luck, Tinker, in your appeals.
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ambulance, medically, decision, minutes, coverage


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