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Case Managers and Ambulance Transport

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A Case Manager's role is critical to providing the appropriate medical transportation necessary for a patient.  It is not uncommon for Case Managers to have difficulty arranging medical transportation for clients, as it is barely touched upon during the educational process or training.  There are basic guidelines that Case Managers can follow that will assist with making medical transportation arrangements that coincide with the needs of their patients.

Guidelines[1]

  • Services
  • Support Services
  • Risk
  • Security
  • Cost

 

The process of engaging medical transportation for a client begins with assessing the medical needs of the patient during transport.  Make a list of the equipment the patient will require along with any personal needs that may be desired.  The medical transportation industry has grown tremendously over the last few decades, so be sure to ask which type of service provides the highest level of opportunity to meet the client's needs.

 

Services

  • Ground Ambulance vs. Air Ambulance
  • Helicopter vs. Airplane/Jet
  • Commercial Airline vs. Private Airline
  • BLS
  • ALS
  • Non-Emergency
  • Medical Escort

 

A Case Manager seldom handles only one case at a time.  Clear communication is essential for cohesive time-management.  Determining the level of support service that will be received by the service provider assists in making the transportation process run more smoothly.

Support Services

  • Administrative
  • Clinical-level of training
  • Access  to assistance

 

A Case Manager's job is to ensure the safety and security of the patient, even during transport.  The transportation service provider should ensure that all staff members are capable of providing the level of care that has been contracted.  A Risk Management Assessment helps determine if the service provider will be able to meet the Case Manager's requirements for transporting the patient.

Risk

  • Staff experience
  • Safety record of the service provider
  • Level of expertise
  • Liability Insurance

 

The hiring practices of the service provider are priority points of discovery when choosing medical transportation.  This, coupled with reviews of the level of care the service provider has given in the past, will assist a Case Manager in the decision-making process.

Security

  • Continuous quality care
  • Full back-ground investigation of staff prior to employment with the service provider
  • HIPAA trained/certified staff

 

A Case Manager is tasked with determining the safest, most affordable manner in which to transport a client.  This includes verifying what the insurance carrier will pay for, as well as if the insurance company approves the potential service provider.  Beyond the insurance coverage, it is necessary to determine the validity of the price given by the provider of services along with any outstanding costs that the client may be responsible for paying.

Cost

  • Basic Quote vs. Firm Quote
  • Charges based on Insurance Rate
  • How much charge per mile
  • Billing to the Insurance Provider
  • Up-front charges/Out-of-pocket expenses
  • Conflict Resolution Process

 

Inevitably there will be a few straggling details left to consider.

Other Considerations

  • Amenities
  • Time constraints
  • "Hand-off" protocols

 

The Case Manager's responsibilities can be overwhelming in choosing the best possible course of action with medical transportation.  The professional team at 1-800-Ambulance can assist in making these difficult decisions.

 


[1] http://www.artipot.com/articles/720473/air-ambulance-rules.htm

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