“What’s the going rate for wheelchair transportation in New Jersey?”
The answer isn't as straightforward as you might think. Rates vary from company to company, but unfortunately, sometimes what really matters is, who’s asking? If you’re someone who handles regular referrals to ambulance companies, especially among Medicare patients, you’ve probably found that medical transportation company reps trip over themselves to offer you and your patients impossibly great deals. But if something looks too good to be true --- it probably is.
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Medicare,
Wheelchair Transportation,
Healthcare system
This month, On Time Ambulance President John Bush and Director of Customer Care Susan Delsandro traveled to Dallas to give a presentation to the Texas Ambulance Association on the Novitas Prior Authorization Program.
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CMS,
Medicare,
Repetitive Transportation
It's been a year and a half since Prior Authorization went into effect here in New Jersey. There have been some unintended consequences, but for the most part it seems that the program has been successful. As one of the state's largest ambulance and medical transportation companies, we have gained plenty of experience in complying with these new regulations.
To assist our various partners, we've put together a list of explanations and key terms that health care workers can use to increase chances of approval. This list is by no means exhaustive, but we think it's a good start. If you have questions that are more in-depth or specific to your organization, we'd be happy to schedule a compliance consultation visit.
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Medicare,
Medical Transportation,
Prior Authorization Program
Since their inception in March 2007, The Medicare Fraud Strike Force, a joint initiative between the DOJ and HHS, has charged defendants who together falsely billed more than $7 billion to federal healthcare programs. Through payment data analysis, investigations, and coordination with CMS, they are working diligently to stop fraud, abuse, and other healthcare crimes. A provision in the Affordable Care Act provided an additional $350 million in annual funding allowing the Strike Force to expand from two cities to nine. Here are some of their most eye-popping, remarkable, and unsettling busts.
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Medicare,
Fraud
Only about one in 10 Americans have a proficient level of health literacy. 90% of us can't understand and use health-related information in daily activites, and 40% of us can't explain the concept of a deductible.
Even educated and informed consumers can have serious trouble navigating our healthare system. Doctors, nurses, and EMS workers might not be surprised, but for the rest of us, here are six more stats that will make you stop and think.
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Medicare,
Healthcare system,
statistics
The information below comes directly from Medicare Coverage of Ambulance Services, a free resource made available by Medicare.gov. Some emphasis has been added for clarity purposes.
Have questions about your specific Medicare transportation coverage situation in New Jersey? Contact us online or give us a call at
(908) 298 9500.
The following information applies to all people with Traditional Medicare.
If you have a Medicare Advantage Plan (like an HMO or PPO) or another Medicare health plan, you have the same basic benefits, but the coverage can vary by plan.
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Medicare,
Medicare Prior Authorization,
Non Emergency Medical Transportation
While every industry has its fraud, unfortunately the non-emergency ambulance transportation world is especially plagued with shady practices. According to the Centers for Medicaid and Medicare Services, every year $350 million is ripped off by ambulance companies.
But not all ambulance companies are committing Medicare fraud. There are many providers that play by the rules and should therefore be applauded. This article is not about them. This article explains what the rules are, and how certain companies are systematically skirting them.
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Ambulance Companies,
Medicare,
Medicare Fraud
[updated: 3/8/17]
It seems like this phenomenon pops up in the news every week. Medical transportation is one of four major drivers of Medicare and Medicaid fraud. Some providers will attempt outrageous stunts to bill our health care system for expensive services. Below are a few examples from here in New Jersey and around the country.
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Medicare,
Medical Transportation,
Fraud
updated: 5/26/17
In December 2014, new Medicare rules on ambulance transportation went into effect here in New Jersey.
CMS implemented the new rules to weed out fraud from ambulance companies billing Medicare for transportation on a stretcher in an ambulance when other, less costly methods would have sufficed. While many welcomed these changes, there have been some unintended consequences.
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Medicare,
Medical Transportation,
Medicare Prior Authorization
When a loved one has been diagnosed with a terminal illness, an extremely challenging road often lies ahead. Along with coping with grief and making appropriate arrangements, many difficult decisions need to be made.
Navigating the healthcare landscape and determining what services are and are not covered for a person on hospice care can certainly feel overwhelming.
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Medicare,
Medical Transportation,
Hospice
On Time Ambulance featured on NJTV regarding new Medicare Prior Authorization rules. All employees should feel proud that you work for a caring, professional and HONEST medical transportation company.
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Medicare,
Prior Authorization Program,
On Time Ambulance