Life Line Ambulance

LifeCare Benefits

LifeCare Membership Privileges:

  • Affordable protection – covers your whole family for $50.73 per year – that’s only $4.23 per month!
  • Receive medical care and medically necessary transport from highly trained personnel at a fraction of the regular transport cost.
  • Provides transportation** out of our service area*/***
  • Unlimited local non-emergency transportation when ordered by your doctor**
  • Plan covers your spouse and unmarried children under 21 residing with you that require medically necessary transport as defined by Medicare
  • Enjoy freedom from the financial strain of an emergency
  • No one is refused membership

*Service area as defined by the Arizona Department of Health Services.
**Must meet medically necessary guidelines as defined by CMS (Medicare) (see below).
***You pay only a per-mile, one-way charge outside Life Line’s service area.  Non-members pay base rate, supplies plus mileage charge from point of departure to destination.

                  DEFINITION OF MEDICAL NECESSITY

AS DEFINED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS)

 

 

Medical NecessityMedical necessity is established when the patient’s condition is such that the use of any other method of transportation would be contraindicated.  In other words, no other type of transportation could have been used without endangering the patient’s health.  If the patient could have been transported safely by any other means, e.g., by wheelchair van, car, taxi, etc., then medical necessity does not exist.  It does not make a difference whether the other type of transportation is actually available in the locality at the time of service.

 

Medical necessity is determined based on the condition of the patient at the time of service.  CMS has set forth additional guidelines, regarding medical necessity in the CMS Internet Only Manual.  In the CMS Manual, Pub. 100-02, Chapter 10, Section 20, CMS instructs Medicare Contractors to presume that a transport is medically necessary whenever the patient:

 

·         Was transported in an emergency situation, e.g. as a result of an accident, injury or acute illness, or

·         Needed to be restrained to prevent injury to the patient or others, or

·         Was unconscious or in shock, or

·         Required oxygen or other emergency treatment on the way to his destination, or

·         Exhibited signs and symptoms of acute respiratory distress or cardiac distress, e.g. shortness of breath, chest pains, or

·         Had to remain immobile because of a fracture that had not been set or the possibility of a fracture, or

·         Exhibited signs and symptoms of a possible acute stroke, or

·         Was experiencing a severe hemorrhage, or

·         Was bed confined before and after the ambulance trip, or

·         Could be moved only by stretcher

 

Definition of “Bed Confined”

 

The Medicare regulations have established a national definition of “bed confined” (42 C.F.R. §410.40(d)(1).  A beneficiary will be considered “bed confined” if they are:

·         Unable to get up from bed without assistance, and

·         Unable to ambulate, and

·         Unable to sit in a chair or wheelchair.

 

Note:  All three conditions must be met for the patient to be considered bed confined.  While “bed confined” is listed in the CMS Manual as being “before and after”, CMS has clarified that the definition refers to whether the patient was bed confined at the time of transport.