The Centers for Medicare and Medicaid Services (CMS) has contracted with Fed Pro Services, LLC to assist Medicare beneficiaries who receive non-affirmative prior authorization decisions for repetitive, scheduled, non-emergent ambulance transports (RSNAT).
A non-affirmed decision means that additional documentation to support the need for ambulance transportation is needed or the Medicare requirements are not met and the beneficiary does not qualify for ambulance transportation services.
The two specific areas we can assist you with are:
- Reviewing your non-affirmed decision for transportation to determine if additional information would help to get an affirmed decision, and
- Identifying other transportation to help you get to your medical appointment.
RSNAT services are defined as medically necessary, scheduled, non-emergency ambulance transportation for three or more round trips in a 10-day period or at least once a week for three weeks or more. Medicare Part B covers such ambulance transportation, provided that certain medical necessity criteria are met:
- The beneficiary is bed-confined, and
- It is documented that the beneficiary’s condition is such that other methods of transportation are contraindicated; or,
- If the beneficiary’s medical condition, regardless of bed confinement, is such that transportation by ambulance is medically required.