Medicare Compliance & Reimbursement - 2003 Issue 24
Ambulance: KNOW WHO TO BILL WHEN TRANSPORTING HOSPITALIZED PATIENTS
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Article Overview
This article discusses a HHS Office of Inspector General review of Medicaid ambulance claims involving transports of hospitalized patients between facilities. It is aimed at ambulance providers, hospital billing staff, and compliance professionals who need a general understanding of when transportation charges may be billed to Medicaid versus another entity. The article summarizes the issue, the audit findings from an Illinois partnership review, and the broader billing concern tied to interfacility transports during inpatient stays.
Why This Topic Matters
It highlights a Medicaid billing compliance risk for ambulance providers and hospitals when patients are transported between facilities during an inpatient stay. Understanding the topic can help organizations review billing workflows and reduce improper claim submission.
What You Will Learn
- The article’s compliance focus and billing context for interfacility ambulance transports
- How a government review identified Medicaid claim concerns involving hospitalized patients
- Why transport billing responsibilities may differ when a patient is sent to another facility for outpatient services
- The general role of audit findings in shaping ambulance billing awareness
Who Should Read This
- Ambulance providers
- Hospital billing departments
- Compliance officers
- Medical coders
- Revenue cycle professionals
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