NON-EMERGENCY AMBULANCE TRANSPORTATION. Submit to DPH inspection, at Transportation Provider’s expense, upon request from the HST Office. The inspection is to ascertain if the vehicles and equipment are still in compliance with the requirements in 105 CMR 170.
NON-EMERGENCY AMBULANCE TRANSPORTATION. Upon request, provide the HST Office with DPH inspection documentation.
NON-EMERGENCY AMBULANCE TRANSPORTATION. We cover non-emergency ambulance transportation by a licensed ambulance service (either ground or air ambulance, as appropriate) between Facilities when the transport is any of the following: • From a Non-Network Hospital to a Network Hospital; • To a Hospital that provides a higher level of care that was not available at the original Hospital; • To a more cost-effective Acute care Facility; or • From an Acute care Facility to a sub-Acute setting.
NON-EMERGENCY AMBULANCE TRANSPORTATION. We Cover non-emergency ambulance transportation by a licensed ambulance service between Facilities when the transport is any of the following: • From a Non-Network Hospital to a Network Hospital; • To a Hospital that provides a higher level of care that was not available at the original Hospital; • To a more cost-effective Acute care Facility; or • From an Acute care Facility to a sub-Acute setting. Limitations/Terms of Coverage • We do not Cover travel or transportation expenses, unless: o For Emergency Services o For non-emergent, medically necessary facility transfers, o For transplant services • We do not Cover non-ambulance transportation such as ambulette, van or taxi cab. • Ambulance Services are subject to Medical Necessity review by Us. We retain the right to select the air ambulance provider. • Coverage for air ambulance related to an Emergency Condition or air ambulance related to non-emergency transportation is provided when Your medical condition is such that transportation by land ambulance is not appropriate; and Your medical condition requires immediate and rapid ambulance transportation that cannot be provided by land ambulance; and one (1) of the following is met: o The point of pick-up is inaccessible by land vehicle; or o Great distances or other obstacles (e.g., heavy traffic) prevent Your timely transfer to the nearest Hospital with appropriate facilities. Emergency Care (including Emergency Room Services) We Cover Emergency Services for the treatment of an Emergency Condition in a Hospital. For example, an Emergency Condition may include, but is not limited to, the following conditions: • Severe chest pain • Severe or multiple injuries • Severe shortness of breath • Sudden change in mental status (e.g., disorientation) • Severe bleeding • Acute pain or conditions requiring immediate attention such as suspected heart attack or appendicitis • Poisonings • Convulsions We will Cover Emergency Services to treat Your Emergency Condition worldwide. However, We will Cover only those Emergency Services and supplies that are Medically Necessary and are performed to treat or Stabilize Your Emergency Condition in a Hospital. We will review the emergency services claim under the prudent layperson standard. If We determine that We do not have sufficient information necessary to decide the emergency services claim, We will notify You and the healthcare provider(s) through the Explanation of Benefits. This notice will specifically describe the requi...
