Tip: Review ambulance medical necessity before the OIG audits your facility
Healthcare Auditing Weekly, July 4, 2006
If ambulance providers succumb to OIG pressure to stop providing medically unnecessary ambulance services, physicians may be tempted to alter medical charts to ensure that patients who are not as sick still qualify for ambulance transportation.
To ensure your facility's compliance, Kirk Ruddell, CHC, compliance officer at Island Hospital in Anacortes, WA, recommends taking the following steps:
1. Form a task force to address the problem
2. Map an appropriate procedure for patient transfers
3. Develop a medical necessity form and an ABN to present to patients who elect to be transported by ambulance rather than alternate means
Ruddell says conducting all of these steps at his facility took about two months. His current work plan also includes a periodic probe review of about 30 charts to ensure that each meets medical necessity or includes an ABN.
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