Emergency Ambulance Services Clause Samples

Emergency Ambulance Services. The PIHP may require submission of a trip ticket with ambulance claims before paying the claim. Claims submitted without a trip ticket need only be paid at the service charge rate. The PIHP must: a. Pay a service fee for an ambulance response to a call in order to determine whether an emergency exists, regardless of the PIHP’s determination to pay for the call. b. Pay for emergency ambulance services based on established Medicaid criteria for claims payment of these services. c. Either pay or deny payment of a clean claim from an ambulance service within 45 days of receipt of the clean claim. d. Respond to appeals from ambulance providers within the time frame described. Failure will constitute the PIHP’s agreement to pay the appealed claim in full.

Emergency Ambulance Services. Network Commercial ambulance charges for transportation to the nearest hospital where emergency care can be performed are not subject to deductible or coinsurance. Medically necessary emergency ambulance services will be subject to a $15 copayment.

Emergency Ambulance Services. Allowed Amounts for ground and Air Ambulance transport provided by an out-of-Network provider will be determined as described below under Allowed Amounts in this Schedule of Benefits. Ground Ambulance: 40% Yes Yes Air Ambulance: 40% Yes Yes Non-Emergency Ambulance Transportation Ground or Air Ambulance, as we determine appropriate. Ground Ambulance: 40% Yes Yes Allowed Amounts for Air Ambulance transport provided by an out-of-Network provider will be determined as described below under Allowed Amounts in this Schedule of Benefits. Air Ambulance: 40% Yes Yes Depending upon the Covered Health Care Service, Benefit limits are the same as those stated under the specific Benefit category in this Schedule of Benefits. Depending upon where the Covered Health Care Service is provided, Benefits will be the same as those stated under each Covered Health Care Service category in this Schedule of Benefits. Amounts which you are required to pay as shown below in the Schedule of Benefits are based on Allowed Amounts or, for specific Covered Health Care Services as described in the definition of Recognized Amount in the Policy, Recognized Amounts. The Allowed Amounts provision near the end of this Schedule of Benefits will tell you when you are responsible for amounts that exceed the Allowed Amount.

Emergency Ambulance Services. Allowed Amounts for ground and Air Ambulance transport provided by an out-of- Network provider will be determined as described below under Allowed Amounts in this Schedule of Benefits. Ground Ambulance: 40% Yes Yes Air Ambulance: 40% Yes Yes Non-Emergency Ambulance Transportation Ground or Air Ambulance, as we determine appropriate. Ground Ambulance: 40% Yes Yes Allowed Amounts for Air Ambulance transport provided by an out-of- Network provider will be determined as described below under Allowed Air Ambulance: 40% Yes Yes Amounts which you are required to pay as shown below in the Schedule of Benefits are based on Allowed Amounts or, for specific Covered Health Care Services as described in the definition of Recognized Amount in the Policy, Recognized Amounts. The Allowed Amounts provision near the end of this Schedule of Benefits will tell you when you are responsible for amounts that exceed the Allowed Amount.

Emergency Ambulance Services. For transportation to the nearest Hospital which can provide such emergency care only if a responsible person would have believed that the medical condition was an emergency medical condition which required ambulance services. $50 / Trip

Emergency Ambulance Services. The Host shall provide emergency medical services on an as requested basis. UDLP will reimburse the Host for direct labor and material costs.

Emergency Ambulance Services. Medically Necessary hospital to hospital transfers and emergency ambulance transportation by a licensed ambulance service (either ground or air ambulance) to or from the nearest hospital where Emergency Services can be provided.

Emergency Ambulance Services. GRANTEE employment of at least six (6) FTE ambulance paramedics, for staffing at least two (2) licensed/certified paramedics for emergency ambulance response twenty-four (24) hours each day of the fiscal year. This includes all roll-up costs and certification expenses, as outlined within the original grant application dated 4/27/2021. FY2022-23 $366,654.00 TOTAL $366,654.00 // In accordance with the terms of this Agreement, the DISTRICT shall disburse the following payment(s) to the GRANTEE: DATE PURPOSE AMOUNT 1 Within 30 days after grant agreement is fully signed. Quarterly lump sum payment for qualifying items specified within EXHIBIT A. Alternatively, during the term of this Agreement, GRANTEE may elect to pay for said items and then subsequently request reimbursement, in writing, within 180 days after paying for said items. Up to $91,663.50 2 On or after 10/15/2022 Quarterly lump sum payment for qualifying items specified within EXHIBIT A. Alternatively, during the term of this Agreement, GRANTEE may elect to pay for said items and then subsequently request reimbursement, in writing, within 180 days after paying for said items. Up to $91,663.50 3 On or after 1/15/2023 Quarterly lump sum payment for qualifying items specified within EXHIBIT A. Alternatively, during the term of this Agreement, GRANTEE may elect to pay for said items and then subsequently request reimbursement, in writing, within 180 days after paying for said items. Up to $91,663.50 4 On or after 4/15/2023 Quarterly lump sum payment for qualifying items specified within EXHIBIT A. Alternatively, during the term of this Agreement, GRANTEE may elect to pay for said items and then subsequently request reimbursement, in writing, within 180 days after paying for said items. Up to $91,663.50 Use and disbursal of Grant Funds is contingent upon GRANTEE using its best efforts at recruiting, hiring and retaining at least six (6) FTE paramedics which are appropriately licensed/certified, subject to normal and unanticipated vacancies, and GRANTEE’s quarterly written accounting and verification to DISTRICT of all offsetting GRANTEE revenues for services rendered with personnel funded by the Grant Funds. ▇▇▇▇▇▇▇’s quarterly written reports must report the number of capture service calls which exceed FY2020-21 levels and compare revenues received by GRANTEE due to increased staff funded by DISTRICT. GRANTEE must match each DISTRICT dollar utilized from the Grant Funds and any unencumbered Grant Funds ...