20 Apr 6 Crucial Medicare Tips Everyone Needs to Know
“The reality is that 80% of our patients are covered by Medicare.”
– Josh Watts, CEO
That patient population is, of course, made up of seniors primarily. But also of chronically ill patients with conditions like End Stage Renal Disease (ESRD), congestive heart failure (CHF), and chronic obstructive pulmonary disease to name just a few. MedTrust considers the needs of these patient types into its hiring practices. “So many of our employees reference their love for seniors in their interview…it’s why they want to work in medical transport instead of or in addition to Emergency Services (911).”
Medicare has a fairly complicated system and our patients and families want to work with MedTrust because we understand and explain their transport-related benefits. We spend a great deal of resources on maintaining compliance and have answers to most of their questions. It all comes down to building trust through that process of education and connection to other resources in the healthcare community. MedTrust has participated in the Lowcountry Senior Network group since 2012. We sponsor many events that bring awareness and raise funds for issues facing Medicare members such as the ARK (for Alzheimers) and the National Kidney Foundation (NKF) serving on their advisory and development boards.
Here are a few Medicare quick tips that we have learned at MedTrust over the last several years:
- Medicare will only pay for a medically necessary transport to a hospital with a few exceptions for Dialysis Clinics and some hospital-owned facilities. They will not pay for a stretcher transport to your Dr’s office, even if you are having a procedure done, labs drawn, getting an MRI, etc.
- Medicare WILL NOT pay for wheelchair or ambulatory transport. This is almost always patient responsibility unless you have Medicaid or certain Medicare Advantage plans that cover limited annual doctor transports.
- Your nurse or physician MUST validate the need for stretcher transport and that ANY OTHER transport method is contra-indicated through a document called a PCS, or Physician Certification Statement. In other words, you can’t walk up to the stretcher or have no need for medical monitoring. This is very different from a transport to the ER after calling 911.
- You DO NOT always have a choice in which facility or hospital to be transported to. Medicare will only pay for a medically necessary transport to the closest appropriate facility. That means, even if you live 2 hours away and were injured on your vacation to Charleston, Medicare doesn’t pay to discharge you or a family member to a rehab facility close to home, as
- Medicare only covers 80% of the transport charges. Unless you have a secondary insurance coverage that includes non-emergency stretcher transport coverage, you will be responsible for the remaining balance and any deductibles.
- YOU HAVE A CHOICE TO CHOOSE YOUR PROVIDER FOR ANY SERVICE PAID FOR BY YOUR PART B MEDICARE. In truth, there are many great private ambulance companies contracted with various hospitals and facilities. If they are providing great service, there is no reason to rock the boat. However if you are unhappy with the service and care or you simply want to work with an alternate provider like MedTrust, you are completely within your rights to make that request.
Feel free to email: Billing@RideMedTrust.com and let us answer any questions you may have regarding transport-related benefits and their coverage by Medicare.