Ask The Expert: Medical Transportation
Brian Hathaway, Co-Owner of Spirit Medical Transport, LLC in South Greenville, Ohio
Q: What is the best time to call if I need an ambulance or want to schedule medical transportation?
A: Spirit Medical Transport, LLC is open 24 hours a day, seven days a week, 365 days a year and ready to respond at a moments notice. The service provides both demand-based and scheduled transportation services. Demand-based services are those that weren’t pre-planned and the need is immediate such a ride to the emergency room or an unexpected call from the doctor requiring you to be seen immediately.
Scheduled services are those that are planned in advance such as routine doctor’s appointments, dialysis treatments, etc. Our call center is available anytime, day or night, to take your transport request. Spirit Medical Transport, LLC is unique in that we call you the evening before your pre-scheduled appointment and remind you of your pick-up and appointment time. Our friendly, knowledge- able, and professional call takers are always willing to help and are fully certified Emergency Medical Dispatchers. Our call takers are trained to provide pre-arrival instructions to those who are ill or injured as our crews are responding to your needs in a time of emergency.
Q: How far will you travel?
A: At Spirit Medical Transport, LLC we are licensed to fully operate in Ohio and Indiana. However, we will travel anywhere in the nation providing the respective state law allows us to do so. While there is no real limit on how far we will travel, it is important to understand that many insurance companies have regulations on how many miles of travel they will cover. In Medicare situations, for an ambulance trip to be covered, the patient must be transported to the closest participating hospital which has appropriate facilities for treatment of the patient. In Medicaid situations, anytime we travel beyond 50 miles from a patient’s place of residence either by wheelchair van or ambulance, verification of the specialty need at the farther distance is required.
Q: What does my insurance cover?
A: Stipulations of insurance coverage vary from carrier to carrier. In many cases we will check on eligibility for a patient before their first transport to ensure they have proper coverage. In the cases of Medicare, to be covered, ambulance service must be medically necessary and reasonable. Medicare looks at two main factors when determining “medically necessary” and “reasonable.” Medical necessity is established when the patient’s condition is such that use of any other method of transportation is contraindicated. Additionally, Medicare will look at the reasonableness of the ambulance trip. An ambulance trip may not be covered on the grounds that the use of an ambulance was unreasonable in the treatment of the illness or injury involved notwithstanding the fact that the patient’s condition may have contraindicated the use of other means of transportation. Most Ohio Medicaid coverage plans cover ambulance or wheelchair van transportation to a physician’s office permitting the patient’s condition was medically necessary. For patients on Medicaid in Ohio, wheelchair van coverage is paid permitting the patient is “non-ambulatory.” Non-Ambulatory is defined as a patient who has a permanent or temporarily disabling condition which precludes transportation in a motor vehicle or motor carrier that has not been modified or created for transporting a patient with a disabling condition.
Q: What usually isn’t covered by insurance?
A: Ambulance service to a physician’s office or a physician-direct- ed clinic is not covered by Medicare in almost every case. Additionally, Medicare never covers any form of transport made by wheelchair van or ambulatory vehicle. In cases where patients don’t have insurance that will cover your medical trip, Spirit Medical Transport, LLC still provides the services to patients on a private-pay basis. We accept cash and personal checks, while payment plans are also available to those who qualify.
While there is no real limit on how far we will travel, it is important to understand that many insurance companies have regulations on how many miles of travel they will cover.
Brian K. Hathaway is the Co-Owner of Spirit Medical Transport, LLC founded in 2006. He is a licensed Ohio EMT-Intermediate who continues to actively care for patients on the ambulance and in the operations fleet of wheelchair and ambulatory transport vans. He is also an active member of the Ohio Medical Transportation and Ambulance Association and the American Ambulance Association. For more information contact Spirit Medical Transport at (937) 548 – 2800.