The medical transport system includes scheduled services for patients who require assistance but are not facing an immediate life-threatening emergency. These non-emergency services ensure safe transit for individuals whose medical condition prevents them from using standard transportation options like a personal car or taxi. The process differs significantly from calling 911 because the patient’s condition is stable and the need is pre-planned.
Differentiating Emergency from Non-Emergency Transport
The distinction between emergency and non-emergency transport rests on the urgency and stability of the patient’s condition. Calling 911 is reserved for true medical emergencies where the absence of immediate attention could result in serious jeopardy to the patient’s health, such as a heart attack, stroke, or severe trauma. These situations often require rapid transport and Advanced Life Support (ALS), which involves administering intravenous medications and performing advanced airway procedures. Non-emergency transport is for medically stable patients who require assistance during transit due to a specific medical condition. This scheduled service typically involves Basic Life Support (BLS), which includes non-invasive care such as monitoring vital signs, administering oxygen, and providing basic first aid.
Appropriate Uses for Scheduled Medical Transport
A non-emergency ambulance is the correct choice when a patient is medically unable to use less specialized forms of transport, like a wheelchair van or private vehicle. A patient is often considered to meet the criteria for transport if they are bed-confined, meaning they are unable to get up from bed without assistance, cannot ambulate, and cannot sit in a chair or wheelchair. This inability to sit upright or move independently necessitates a stretcher-level transport. These scheduled services are frequently used for pre-arranged inter-facility transfers, such as moving a patient from a hospital to a skilled nursing facility or rehabilitation center. They are also appropriate for scheduled medical appointments, including recurring treatments like dialysis or chemotherapy, where the patient requires continuous monitoring or specialized equipment during the journey.
Navigating the Booking and Scheduling Process
The process for arranging non-emergency ambulance transport begins by identifying a local provider that offers this scheduled service, separate from the 911 emergency system. Because these trips are pre-planned, they should be scheduled well in advance to ensure availability, ideally at least 48 hours before the required pickup time. The ordering physician or facility social worker is responsible for arranging or certifying the transport. They must complete a Physician Certification Statement (PCS) or similar document that attests to the medical necessity of the ambulance, detailing why other transportation methods would be unsafe. This documentation must be signed and dated by the physician, often no more than 60 days before the trip. When booking, the caller must have specific information ready for the transport provider to ensure the correct level of care is dispatched:
- The patient’s full name, date of birth, current location, and precise destination address.
- The patient’s specific medical condition and mobility status.
- The required level of care, such as BLS or ALS.
- Any specialized equipment the patient needs, like oxygen or cardiac monitoring.
Understanding Costs and Insurance Coverage
Non-emergency ambulance transport can be expensive, and coverage is contingent upon the payer’s determination of medical necessity. For coverage by programs like Medicare, the transportation must meet strict criteria proving the patient cannot safely use any other means of travel. If the service is not deemed medically necessary, the patient is responsible for the full cost of the transport.
Many insurance providers require “prior authorization” for scheduled non-emergency transport, especially for repetitive trips. This process requires the ambulance supplier to receive approval from the insurance company before the transport occurs. Prior authorization confirms the payer acknowledges the trip and that necessary medical documentation has been submitted for review. Patients or their representatives should always confirm coverage and prior authorization status with their insurance provider before the transport is booked. If Medicare or another payer is likely to deny coverage, the ambulance provider must issue an Advance Beneficiary Notice (ABN) to the patient, informing them that they may be financially responsible.