A bill from an ambulance ride can add stress to an-yone’s emergency situa-tion, especially if the charges are incorrect. In an emergency, the last thing anyone wants to think about is the bill. It’s important to know what your insurance coverage does for you and how it works. Original Medicare covers ground and air ambulance services when these criteria are met:
• The transportation is medically necessary and a wheelchair van or car could endanger the pa-tient.
• The ambulance and crew must meet certain standards and provide transportation to the nearest appropriate facility, such as a skilled nursing facility or hospital.
“Sometimes a provider will bill beneficiaries directly instead of billing Medicare, even though the provid-er participates in Medicare and the trip met cover-age criteria,” said Tiffany Erhard, NYS Senior Medi-care Patrol (SMP) Outreach Counselor.
Some other types of fraud schemes include provid-ers billing for more miles than the beneficiary was transported or billing non-emergency trips as emer-gency transport.
To stop ambulance fraud, the NYS SMP recom-mends that beneficiaries:
Review their Medicare Summary Notices (MSNs) and/or Explanations of Benefits (EOBs) and ensure the following:
• The services listed match what they actually re-ceived.
• The mileage billed isn’t more than the distance traveled.
• They weren’t billed for emergency transport if there wasn’t an emergency.
If you think you may have been a victim of fraud, call Tioga Opportunities, Inc.’s NY Connects at 607-687-4120, ext. 331.
