Re: Reimbursement for Transportation

[Guest guest]

In a message dated 11/10/1999 2:14:07 PM Eastern Standard Time,

mccartyp@... writes:

<< Does anyone know of or have heard of anything about reimbursement by

Medicare or other payors for transporting patients from home to an Out

Patient Clinic and back to home? >>

, Assuming that your FI is BC/BS of Texas, I recommend that you call the

Provider Audit Reimbursement Department (PARD) and ask them this question.

Better yet, have the person that does your cost report call his " contact " at

PARD. " In general " Medicare does not pay for transportation. On behalf of a

client in Texas last year I asked this question and the answer was " no " (as

expected). I have also done a training workshop with the Texas BC/BS people

and the Dallas HCFA Regional Office and they reported that " transportation "

was not covered.

Now for your assistant administrator. My recommendation is to suggest to him

that an " opportunity cost analysis " be done of the missed business due to

transportation problems (and the potential new business that could be

obtained) - and see if you can justify purchasing a van. (You have to roll

in all the depreciation, operating costs, driver etc.) I have done just

that at two large hospitals - and got the vans through a combination of

donations and capital. When I ran an outpatient clinic in Tampa I choose to

purchase a van to ensure patient compliance with appointments for a patient

clientele that was almost exclusively workers' comp. A real selling feature

that created a market advantage for the new player on the block!

If you have recreational therapy at your facility there is a high probability

that they would want to use the van on the evenings and weekends for

community reorientation - and with many payors this may be a " billable "

activity.

Also my 2 cents worth - transportation alone will not ensure a perfect

attendance, but will certainly improve attendance. Another issue that has

arisen is that once patients and families see that you have transportation

available everyone seems to want it: " if it's free, it's for me " !!!!!

Best Regards

Beckley

Bloomingdale Consulting Group

Tampa, Florida

[Guest guest]

we actually, just got rid of our " free " transportation and started charging

the same rate as commerical transportation for fear of it looking like an

inticement to use our facility. We do offer transportation, w/c van and car,

to/from OP therapy, but the pt has to pay. There is financial resources

available for hardship cases as well. When we switched, we had 0

cancellations because of lack of transportation and have very few people

using the fee for ride service (we were averaging 8-10 people a day coming on

transportation). Needless to say, we were very worried when we did away with

free, but it did not impact our cancellations etc much at all.

- PT in KC

[Guest guest]

might want to check legal issues with suppling free transportation, we did

away with ours due to inticement issues. There are private/state funds

(depending on states) available for hardship cases. But we do now charge (

$7) for one way trips

PT in KC

[Guest guest]

Our hospital start a transportation service about 5 years ago. It is a

free service for our patients. I am not aware of any reimbursement

available for this service. It is an extremely popular service. We

started with one van and I believe we are up to two vans and 2-3

station wagons that are in operation every day. It serves all out

patient areas of the hospital. It is a tremendous undertaking, but it

is extremely helpful in getting patients to the hospital on a timely

and consistent basis.

Kathy berger

Manager of Physical Therapy

Mercy Medical Center, Canton, Ohio

bcgbeckle-@... wrote:

original article:/group/ptmanager/?start=8467

> In a message dated 11/10/1999 2:14:07 PM Eastern Standard Time,

> mccartyp@... writes:

>

> << Does anyone know of or have heard of anything about reimbursement

by

> Medicare or other payors for transporting patients from home to an

Out

> Patient Clinic and back to home? >>

>

> , Assuming that your FI is BC/BS of Texas, I recommend that you

call the

> Provider Audit Reimbursement Department (PARD) and ask them this

question.

> Better yet, have the person that does your cost report call his

" contact " at

> PARD. " In general " Medicare does not pay for transportation. On

behalf of a

> client in Texas last year I asked this question and the answer was

" no " (as

> expected). I have also done a training workshop with the Texas BC/BS

people

> and the Dallas HCFA Regional Office and they reported that

" transportation "

> was not covered.

>

> Now for your assistant administrator. My recommendation is to

suggest to him

> that an " opportunity cost analysis " be done of the missed business

due to

> transportation problems (and the potential new business that could be

> obtained) - and see if you can justify purchasing a van. (You have

to roll

> in all the depreciation, operating costs, driver etc.) I have done

just

> that at two large hospitals - and got the vans through a combination

of

> donations and capital. When I ran an outpatient clinic in Tampa I

choose to

> purchase a van to ensure patient compliance with appointments for a

patient

> clientele that was almost exclusively workers' comp. A real selling

feature

> that created a market advantage for the new player on the block!

>

> If you have recreational therapy at your facility there is a high

probability

> that they would want to use the van on the evenings and weekends for

> community reorientation - and with many payors this may be a

" billable "

> activity.

>

> Also my 2 cents worth - transportation alone will not ensure a

perfect

> attendance, but will certainly improve attendance. Another issue

that has

> arisen is that once patients and families see that you have

transportation

> available everyone seems to want it: " if it's free, it's for me " !!!!!

>

> Best Regards

>

> Beckley

> Bloomingdale Consulting Group

> Tampa, Florida

>

[Guest guest]

In a message dated 11/11/1999 7:35:10 AM Central Standard Time,

douglaswhite@... writes:

<< So how is providing a service that has significant financial value,

and is unrelated to the professional service being billed, any different

that writing off the patient's portion of the bill or just handing a patient

$15 for every appointment they keep when the patient does not have a

financial

need? >>

, et al

As a former Auditor employed by Mutual of Omaha's HCFA Subcontracted Medicare

Intermediary (i.e., I used to be a " Medicare Auditor " ), I will attempt to

shed some light on this subject. Please do not take this answer as

irrefutable. If you have any questions, the ultimate answer should come from

your Medicare Intermediary. If you elect to provide transportation for your

patients, it should be provided consistently to all patients at the same

rate. In other words, you should not just make this free service available

to Medicare patients, it should be made available to ALL patients. It should

also be offered at the same rate. In other words, if it is offered for free

to one group of patients, it should be offered as free to ALL PATIENTS.

Again, I caution you not to accept my thought as definitive. If you have any

questions, contact your local Medicare Intermediary. I would also suggest

that opinions vary from Medicare Intermediary to Medicare Intermediary. So

if one person says their Medicare Intermediary is OK with free

transportation, it does not mean that they all will. Federal Intermediaries

are all subject to the HCFA guidelines. However, each Intermediary has their

own interpretation of what those regulations mean. CHECK WITH YOURS TO BE

SURE!!!

Jim Hall, CPA <///><

General Manager

Rehab Management Services, LLC

Cedar Rapids, IA 52401

319/365-6384

[Guest guest]

Absolutely, you are right on this issue. Whether the service for transportation

is free or partially subsidized, the over all cost of providing the service

must likely go to the black hole known as " indirect expense " .

>>> " M. White " 11/11/99 08:32AM >>>

[Guest guest]

our facilities have a free transportation service primarily for those who

dont have their own transportation. We are considering trying to see if we

can get reimbursed for this service, primarily to help offset the cost. I

understand that everyone has to be billed to defer selective billing. My

question is does the individual have to be wheelchair bound, homebound, or

just no available transportation to be reimbursed. If Medicare, in general,

does not reimburse for this, can selective fiscal intermediaries have their

own policies for this and therefore possibley pay for this. How can a fiscal

intermediary pay for a service when Medicare won't

thanks

J. Vilasi, MPT

Rehab Network Inc.