tci Medicare Compliance & Reimbursement - 2003 Issue 24

Ambulance: KNOW WHO TO BILL WHEN TRANSPORTING HOSPITALIZED PATIENTS

The HHS Office of Inspector General has its eye on ambulance providers who submit Medicaid claims for the transport of hospitalized patients between facilities. In a joint review with the Illinois health department focusing on how the issue plays out in the Prairie State, auditors found that 13 ambulance providers improperly billed Medicaid for transports of hospitalized patients to a second hospital for outpatient services not available in the facility of origin. Most of the inappropriate claims involved transports for magnetic resonance imaging testing, the OIG notes in "Partnership Review of Medicaid Claims by Ambulance Providers for Transportation Services...

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