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A ride in an ambulance can be a serious situa­ tion for a Medicare beneficiary. The last thing anyone wants to think about in an emergency is the bill. Unfortunately, the bill for an ambu­ lance ride can add additional stress – espe­ cially if the charges are incorrect and the provider won’t cooperate. The Senior Medicare Patrol (SMP) receives calls from individuals asking what to do in challeng­ ing situations like this. The SMP program edu­ cates Medicare beneficiaries on how to protect themselves from fraud and abuse and is the go­ to when people suspect they’ve been billed in­ correctly. Medicare covers ground and air ambulance transportation when: the transportation is med­ ically necessary; a wheelchair van or car could endanger the patient; it is the only means of transporting the patient safely; the ambulance and its crew meet certain standards; and the destination is the nearest appropriate facility that can treat the beneficiary’s condition. To stop ambulance fraud, Senior Medicare Pa­ trol recommends that beneficiaries: >Review their Medicare Summary No­ tices (MSNs) and/or Explanations of Ben­ efits (EOBs) and ensure the following: The services listed match what they actually received. The mileage billed isn’t more than the distance traveled. They weren’t billed for emergency transport if there wasn’t an emer­ gency. >Be on the lookout for upcoding (billing for more expensive care than was per­ formed) on transport claims from basic life support (BLS) to advanced life support (ALS). ALS vehicles must be staffed by at least two people, each of whom must be certified as an EMTInter­ mediate or an EMTParamedic by the state or local authority where the services are being furnished to perform one or more ALS services. Your local SMP is ready to provide you with the information you need to PROTECT yourself from Medicare error, fraud, and abuse; DETECT po­ tential error, fraud, and abuse; and REPORT your concerns. SMPs use trained senior volun­ teers to help educate and empower seniors in the fight against health care fraud. Your SMP can help you with questions, concerns, or com­ plaints about potential fraud and abuse issues. It also provides information and educational presentations. Senior Medicare Patrol (SMP): Call 18772728720 or visit www.stopmedicarefraud.org . Funded by the U.S. Administration for Community Living (ACL), Adminis‐ tration on Aging (AoA), Grant Number 90MP0194‐01‐01 www.southernsenior.info 21 Ambulance Fraud and Medicare Coverage