January 13, 2011

Cost of making a choice

Cost of making a choice
Medicare patients could be billed for mileage

North or south?
That simple question, when asked by a crewmember of the Garrison-Max Ambulance District, translates simply as “Minot or Bismarck?”
The question is often posed prior to a medical transport from Garrison Memorial Hospital to one of three area facilities that offer a higher level of care – Trinity Hospital in Minot, St. Alexius Medical Center, Bismarck, and MedCenter One, Bismarck. The destination is generally chosen by the patient and is based on patient/family preference.
Mark Foss, manager of the local ambulance service, noted that a long-standing Medicare requirement states that Medicare-eligible patients be transported to the nearest appropriate facility.
Enforcement of the regulation was one of the issues discussed during a board meeting of the Garrison-Max Ambulance District this past week. During the meeting, Foss shared a recent letter from Golden Heart Services of Rugby. (The Rugby business provides billing services for the Garrison-Max ambulance service).
The letter stated that, for eligible patients, Medicare requires ambulance services to only bill mileage to the closest facility that can provide the required patient care. It reads, in part, “If a (Medicare) patient chooses to go beyond the closest appropriate facility, the ambulance service should be making the patient aware of the fact that, as the patient, he will be responsible for all mileage beyond the closest facility.” Foss noted that patients who choose transport beyond the nearest appropriate facility may be asked to sign a document stating their preference.

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