Medicare Compliance & Reimbursement

Independent contractors will look to facility for reimbursement.

When an ambulance transports an inpatient between his admission and discharge dates, the hospital must submit the claim on behalf of the ambulance service.

The HHS Office of Inspector General's Boston Regional Office reported numerous improper payments to independent suppliers of ambulance services to the Centers for Medicare and Medicaid Services, according to a July 29 transmittal.
 
In response, CMS directed its carriers to reject claims for an ambulance service within the admission and discharge dates because Medicare won't pay for them separately as a Part B service.

Instead, the facility must bundle these ambulance services with the inpatient stay.

Exceptions: Ambulance services that occur on the same date as the admission or discharge "are separately payable and not subject to the bundling rules," CMS notes.

CMS' guidelines differ for when an ambulance service transports an inpatient of a long-term care, inpatient psychiatric or inpatient rehabilitation facility to an acute care hospital to receive specialized services.

To read the transmittal, go to http://www.cms.hhs.gov/manuals/pm_trans/R622CP.pdf.