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Frequently Asked Questions Concerning the Ambulance Billing Process

Why is a signature required before ambulance treatment and transport?

In order for Adult Medical Transportation, Inc Services, inc. to bill for your ambulance transportation and
treatment, it is necessary for us to obtain a patient or guardian signature, which (1 ) authorizes our personnel to treat and transport the patient; (2) authorizes AMT to bill any insurance plans on the patient's behalf, including releasing necessary medical information concerning the claim submitted; (3) assigns any insurance benefits to AMT, allowing the insurance plan to pay AMT directly for the claim; and (4) acknowledges the receipt of
AMT's Privacy Policy.

What is the difference between a private ambulance service and a public ambulance service?

Public ambulance services, such as those provided by many fire departments, are
supported through both user fees and tax revenue. Taxpayers fund public safety agencies through tax revenues, whether or not they use those services. Private ambulance services, on the other hand, are funded exclusively by user fees, as they are not usually supported by tax revenue. Thus, for private ambulance service systems, you are only billed for the
services when you use them, unlike a public ambulance service system.

Do health insurance plans cover non-emergency services?

Insurance plans, including Medicare and Medi-Cal, will usually pay for ambulance
service transportation if the transport is deemed to be medically necessary. However, each insurance company, including Medicare and Medi-Cal, have established their own set of medical necessity criteria for use when determining whether or not ambulance transport is medically necessary. Therefore, it is important that you contact your insurance provider(s) in order to determine whether a non-emergency ambulance transport will be covered under your health plan. AMT's Patient Account Services Department will be happy to help you in determining whether or not non-emergency ambulance service will be
covered for you or your family members.

Medicare coverage of emergency ambulance transportation:

Medicare will usually cover medically necessary ambulance transportation to the nearest appropriate medical facility. Emergency ambulance transportation may qualify for Medicare coverage if the transport is a result of a sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity such that the absence of immediate medical attention could reasonably be expected to result in placing the patient's health in serious jeopardy, impairment to bodily function or serious dysfunction to any bodily organ or part. Medicare requires that ambulance transportation be medically necessary and reasonable. To be medically necessary, Medicare requires that the use of any other method of transportation would be hazardous to the patient's health, and that the patient had a reasonable belief that a medical emergency existed at the time the ambulance service was provided.

Medicare Coverage: Non-Emergency Ambulance

Medicare does not pay for non-emergency ambulance service unless the patient is unable to get out of bed without assistance and unable to walk, unable to sit in a chair or wheelchair, and/or that transportation by any other means would jeopardize the patient's health. Medicare will not pay for ambulance transportation to a preferred hospital or facility that is not the nearest appropriate facility or for the convenience of the patient, the family or physician. Medicare does not cover wheelchair, stretcher or gurney transportation.

For both emergency and non-emergency transportation service, Medicare will pay 80 percent of their allowable rate, which is set by law and is available on Medicare's website. The remaining 20 percent will be due from the patient or the patient's secondary insurance carrier. As a courtesy, bill the secondary insurance carrier on the patient's behalf but the patient is responsible for assuring timely payment by their secondary insurance carrier.

What does Medi-Cal cover?

Medi-Cal is a program funded by the state that provides medical insurance to assist patients who qualify under the program. Medi-Cal will usually cover emergency ambulance transportation services using the same guidelines that Medicare uses in determining medical necessity. In regard to non-emergency ambulance transportation services, Medi-Cal will cover non-emergency ambulance transportation services only if the transport is deemed to be medically necessary and that transportation by any other methods, such as private vehicle, taxi cab, wheelchair van, and/or gurney van, will jeopardize the patient's health.

What does my private insurance cover?

Most insurance companies will cover both emergency and non-emergency ambulance transportation services if the transport is deemed to be a medical necessity by the insurance provider. Each insurance company sets their own standards and processes by which they determine whether or not ambulance transportation services are medically necessary in a particular situation. Therefore, it is important for the patient to contact his or her private insurance company as soon as possible in order to determine whether or not ambulance transportation services are going to be covered in a particular situation. AMT's expert Patient Account Services Department staff will be glad to assist any of our clients in determining whether or not ambulance transportation services will be covered for a particular situation, including discussing the particular service(s) with your insurance company.

What if I have no insurance coverage?

If a patient does not have any type of insurance coverage that will cover our ambulance
transportation services, the amount of the bill will be due and payable from the patient within 30days of transport. However, we are more than willing to set up a payment plan with patients or their families in order to have the claim paid over an extended period of time in order to lessen the financial impact of the ambulance transportation fees.

How are ambulance service rates established?

In the areas in which AMT provides service, our fees are established by local government
agencies, such as the City of Los Angeles Department of Transportation for ambulance transportation within the City of Los Angeles, or the Los Angeles County Emergency Medical Services Agency for ambulance transportation in unincorporated areas of Los Angeles Gounty and those cities that either do not have their own ambulance transportation fee schedule or have adopted the County ambulance transportation fee

Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. If you have any questions about this notice, please contact our Privacy Officer. As an essential part of our commitment to our clients, AMT Ambulance Services, inc., ensures the privacy of confidential health care information about you, known as Protected Health information ("PHI"). We are mandated by law to protect your health information and to provide you with this Notice of Privacy Practices. This Notice outlines our legal duties and privacy practices with respect to your Protected Health Information. It not only describes our privacy practices and legal rights, but lets you, as our client, know, among other things, how AMT Ambulance is permitted by law to use and disclose Protected Health Information about you, how you can obtain access and copy the information that we maintain on you, how you may request amendments to that information, and how you may request restrictions on our use and disclosure of your Protected Health information. AMT Ambulance is required to abide by the terms of the version of this Privacy Notice currently in effect. In most situations, we may use the information as described in this Privacy Notice without your permission, but there are some situations where we may use it only after we obtain your written authorization, if required by law to do so. AMT Ambulance vows to respect your privacy, and treat all health care information about our clients under strict policies of confidentiality that all of our staff members are committed to following at all times.

Our Obligations Under Law

We are required by law to:
· Maintain the privacy of protected health inforrnation
· Give you this notice of our legal duties and privacy practices regarding health information about you
· Follow the terms of our notice that is currently in effect

How We May Use & Disclose Health Information

The following describes ways that we are allowed to use and disclose Protected Health
Information. Some of the categories include examples, but every type of use or disclosure of your Protected Health Information in a category is not listed. Except for the purposes described below, we will use and disclose your Protected Health Information only with your written permission. If you give us permission to use or disclose Protected Health information for a purpose not discussed in this notice, you may revoke that permission in writing, at any time addressed to our Privacy Officer. For Treatment. We may use Protected Health information to provide you with medical treatment and/or transportation services. We may disclose Protected Health information to other health care providers that are involved with your medical treatment, including people outside our facility. For example, we may tell your primary physician about the care we provided you or give Protected Health information to a specialty care provider to provide you with additional medical treatment or services For Payment. We may use and disclose Protected Health information so that we may bill or receive payment from you, an insurance company or third party for the treatment and services we provided to you. For example, we may provide your health plan information about your treatmenVtransport so that they will pay for such treatment. We also may tell your health plan about a treatment you are going to receive in order to obtain prior authorization or to determine whether your plan will cover the services and/or treatment. For Health Care Operations. We may use and disclose Protected Health information for health care operations purposes. These uses and disclosures are necessary to make sure that all of our clients receive the highest quality care and for our operational and management purposes. For example, we may use Protected Health information in order to conduct Quality Assurance Review of the services/transportation that was provided toyou.

Individuals involved in Your Care or Who Provide Payment for Your Care
We may
release Protected Health information to a person who is involved in your medical care or helps pay for your care, such as a family member or friend. We also may notify your family about your location or general condition and/or disclose such information to an authorized entity assisting in a disaster relief effort.

Special Circumstances
As Required By Law. We will disclose Protected Health information when required to do so by federal, state or local law. To Avert a Serious Threat to Health or Safety. We may use and disclose Protected Health information when necessary to prevent or lessen a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, will be to limited someone who is authorized by law to receive such information, such as law enforcement officers.

Business Associates
We may disclose Protected Health information to our business
associates that perform functions on our behalf or provide us with services if the information is necessary for such functions of services. For example, we may use another company to perform billing services on our behalf. All of our business associates are obligated, under contract with us, to protect the privacy of your information to the same extent as us and are expressly prohibited from using or disclosing any information other than as specified in our contract.

Organ and Tissue Donation
If you are an organ donor, we may release Protected Health
Information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary, to facilitate organ or tissue donation and transplantation.

Military and Veterans
If you are a member of the armed forces, we may release Protected
Health information as required by military command authorities. Worker's Compensation. We may release Protected Health information for worker's compensation or similar programs. These programs provide benefits for work related injuries or illness. Public Health Risks. We may disclose Protected Health information for public health activities. These activities generally include disclosures to prevent or control disease, injury or disability; report births and deaths; notify people of recalls of products they may be using; track certain products and monitor their use and effectiveness; notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and conduct medical surveillance of the office in certain limited circumstances concerning work place illness or injury. We also may release Protected Health information to an appropriate government authority if we believe a patient hasbeen the victim of abuse, neglect or domestic violence; however, we will only release this information if you agree or when we are required or authorized by law.

Health Oversight Activities
We may disclose Protected Health information to a health
oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws. Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose Protected Health information in response to a court or administrative order. We also may disclose Protected Health Information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Law Enforcement
We may release Protected Health Information if asked by a law
enforcement of Ficial for the following reasons: (1 ) in response to a court order, subpoena, warrant, summons or similar process; (2) limited information to identify or locate a suspect, fugitive, material witness, or missing person; (3) about the victim of a crime if, under certain limited circumstances, we are unable to obtain the person's agreement; (4) about a death we believe may be the result of criminal conduct; (5) about criminal conduct on our premises; and (6) in emergency circumstances to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.

Coroners, Medical Examiners and Funeral Directors
We may release Protected Health
Information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death National Security and intelligence Activities. We may release Protected Health information to authorized federal officials for intelligence, counter-intelligence, and other national security activities authorized by law, or pursuant to a valid court order or subpoena. Inmate or Individuals in Custody. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release Protected Health Information to the appropriate correctional institution or law enforcement official. This release would be made only if necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution. Any other use or disclosure of Protected Health Information, other than those listed above will only be made with your express written authorization, (the authorization must specifically identify the information we seek to use or disclose, as well as when and how we seek to use or disclose it). You may revoke your authorization at any time, in writing, except to the extent that we have already used or disclosed medical information inreliance on that authorization.

Your Rights

You have the following rights regarding Protected Health Information we maintain about

Right to Inspect and Copy
You have the right to inspect and copy Protected Health
Information that may be used to make decisions about your care or payment for your care. To inspect and copy this Protected Health Information, you must make your request, in writing, to our Privacy Offcer.

Right to Amend
If you feel that Protected Health Information we have is incorrect or
incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for us. To request an amendment, you must make your request, in writing, to our Privacy Offcer. Right to an Accounting of Disclosures. You have the right to get a list of instances in which we have disclosed your Protected Health Inforrnation. The list will not include disclosures we have made for our treatment, payment and health care operations purposes, those made directly to you or your family or friends or through our facility directory, or for disaster relief purposes. Neither will the list include disclosures we have made for national security purposes or to law enforcement personnel, or disclosures made before April 14, 2003.

Right to Request Restrictions
You have the right to request a restriction or limitation on
the Protected Health information we use or disclose for treatment, payment, or health care operations. In addition, you have the right to request a limit on Protected Health information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not share information about your surgery with your spouse. To request a restriction, you must make your request, in writing, to our Privacy Officer. We are not required to agree to your request. If we agree, we will comply with your request unless we need to use the information in certain emergency treatment situations.

Right to Request Confidential Communications
You have the right to request that we
communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we contact you only by mail or at work. To request confidential communications, you must make your request, in writing, to our Privacy Officer. Your request must specify how or where you wish to be contacted. We will accommodate reasonable requests. Right to a Paper Copy of this Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. To obtain a paper copy of this notice, contact our Privacy Offficer.

Changes to this Notice
We reserve the write to change this notice. We reserve the right to make the revised or changed notice effective for Protected Health Inforrnation we already have as well as any information we receive in the future. We will post a copy of the current notice at our office. The notice will contain the effective date on the first page, in the top right-hand corner.

If you believe your privacy rights have been violated, you may file a complaint with AMT Ambulance Services, inc., or the Secretary of Department of Health and Human Services. To file a complaint with AMT Ambulance, please contact 888-600-0014, and request to speak to the on-duty manager and/or the Privacy Officer. All complaints must be made in writing. You will not be penalized for filing a complaint.

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