REGULATIONS, RATES AND CHARGES GOVERNING THE FOLLOWING SERVICES:

Transcription

1 BERNALILLO COUNTY HEALTH CARE CORPORATION d/b/a ALBUQUERQUE AMBULANCE SERVICE NMPRC Certificate No TARIFF No. 1-W Cancels TARIFF No. 1-V RULES, REGULATIONS, RATES AND CHARGES GOVERNING THE FOLLOWING SERVICES: Ambulance Service between all points and places in the State of New Mexico, over irregular routes, under non-scheduled service, with equipment stationed in Bernalillo County only. (' C"':.J '.:i:l "n ~:"t) ;;0 N CO ISSUED: April 19, 201 EFFECTIVE: April 28, 201~ FOR INFORMATION CONTACT: Kurt Krumperman Executive Director Albuquerque Ambulance Service 4500 Montbel Pl., N.E. Albuquerque, New Mexico (505) kkrumperi1lan(9~s. org

2 Section I-Rules and Regulations Page No. Additional Professional Attendan~s, Charge for. Destination, Definition of Disposition of Fractions. Distances, Method,of Computing 8 Section 2-Rates and Charges Patient Evaluation. Rates, Emergency Transportation, Single Patient. Rates, Scheduled Transfer, Single Patient. Rates, Specialty Care Transport. Stand-By Charges Taxes. Team Transport

3 SECTION 1 - RULES AND REGULATIONS DISTANCES, METHOD OF COMPUTING The mileage or distance rates shown in this tariff shall be determined by the odometer in each ambulance. Each ambulance is required to determine mileage from the point of patient pickup to the point of destination of the patient. All determined mileages or distances shall be recorded in the dispatch log to the 1/10th of a mile. DISPOSITION OF FRACTIONS (Miles) Fractions less than.5 shall be omitted; fractions of.5 or greater shall be increased to the next whole unit. TAXES The rates and charges described in this tariff are exempt from the New Mexico Gross Receipts Tax pursuant to NMSA 1978, Section (A). However, any other taxes and assessments applicable to the Bernalillo County Health Care Corporation or the services provided pursuant to the authority granted by NMPRC Certificate No shall be assessed and collected as required in addition to all other charges applicable under this tariff. DESTINATION, DEFINITION OF The destination is the point at which the patient is ultimately delivered or accepted, and the vehicle released.

4 SECTION 2 - RATES AND CHARGES RATES FOR SPECIALTY CARE TRANSPORT Applies when a level of inter-facility transportation of a critically injured or ill patient at a level of service beyond the scope of practice for Emergency Medical Technician Intermediates or, Emergency Medical Technician - Paramedics, is provided. First Patient Mile $1, All Patient miles after first $ RATES FOR EMERGENCY TRANSPORTATION OF A SINGLE PATIENT ALS, LEVEL 2 First Patient Mile $ This tariff shall apply when, where medically necessary, the patient receives non-scheduled prehospital or interfacility care and treatment from a Paramedic or EMT-Intermediate on-scene or during transport which involves at least three different administrations of medication and/or the provision of one or more of the following ALS procedures: Manual defibrillation/cardioversion Endotracheal intubation Central venous line Cardiac pacing Chest decompression Surgical airway Intraosseous line NOTE: When ambulance services are requested but upon arrival at pickup point no emergency medical services, as defined in NMAC (F) (or any amendments thereto), are provided by Albuquerque Ambulance Service personnel, 4

5 the above charge of $91.00 will not apply. RATES FOR EMERGENCY TRANSPORTATION OF A SINGLE PATIENT ALS, LEVEL 1 First Patient Mile $ This tariff shall apply when, where medically necessary, the patient receives non-scheduled prehospital or interfacility care and treatment on-scene or during transport involving the provision of an assessment by a Paramedic or EMT-Intermediate and/or the provision of one or more interventions at advanced levels as defined by 18 NMAC (or any amendments thereto). NOTE: When ambulance services are requested but upon arrival at pickup point no emergency medical services, as defined in NMAC (F) (or any amendments thereto), are provided by Albuquerque Ambulance Service personnel, the above charge of $ will not apply. RATES FOR EMERGENCY TRANSPORTATION OF A SINGE PATIENT, BLS First Patient Mile $ This tariff shall apply when, where medically necessary, the patient receives non-scheduled prehospital or interfacility care and treatment on-scene or during transport at non-advanced levels. NOTE: When ambulance services are requested but upon arrival at pickup point no emergency medical services, as defined in NMAC (F) (or any amendments 5

6 thereto), are provided by Albuquerque Ambulance Service personnel, the above charge of $ will not apply. PATIENT EVALUATION $10.00 per patient Emergency response to patient location culminating in an evaluation of patient by a paramedic with a current special skills designation issued by the Emergency Medical Services Bureau followed by either, (i) a determination that ambulance transportation is not medically indicated by the current Albuquerque/Bernalillo County Emergency Medical Services System Protocols and Guidelines or, (ii) ambulance transportation is refused by patient or patient's family. The evaluating paramedic must be the paramedic with patient care responsibility as defined by the current Albuquerque/ Bernalillo County Emergency Medical Services System Protocols and Guidelines. RATE FOR SCHEDULED TRANSFER OF A SINGLE PATIENT ALS, LEVEL 1 First Patient Mile $ This tariff shall apply when, where medically necessary, the patient receives scheduled pre-hospital or inter facility care and treatment on-scene or during transport involving the provision of an assessment by a Paramedic or an EMT-Intermediate and/or the provision of one or more interventions at "advanced levels," a~ defined by NMAC 1B..14.7(A) (or any amendments thereto). NOTE: For purposes of this tariff, "scheduled transfer" is defined as a request for ambulance transportation made not less than 60 minutes prior to the requested time of patient pick-up. When scheduled transfer services are requested but on arrival at pickup point are not used, the above charge of $ will be payable by the party or facility requesting the service. RATE FOR SCHEDULED TRANSFER OF A SINGLE PATIENT, BLS 6

7 First Patient Mile $80.00 This tariff shall apply when the patient receives scheduled pre-hospital and inter facility care and treatment on-scene or during transport at non-advanced levels. NOTE: For purposes of this tariff, "scheduled transfer" is defined as a request for ambulance transportation made not less than 60 minutes prior to the requested time of patient pick-up. When scheduled transfer services are requested but on arrival at pickup point are not used, the above charge of $80.00 will be payable by the party or facility requesting the service. STAND-BY CHARGES When an ambulance is requested to stand-by for special events, the following charge will apply: Rates Per Hour First Hour (or fraction thereof) Additional Hours (calculated in 15 minute increments) $ $10.00 NOTE: In the event the ambulance is called upon to make a service run while on stand-by service, all other additional applicable charges in the this Tariff will then apply and Stand-By charges cease. When stand-by service is reestablished, the above $10.00 per hour charge becomes applicable. ADDITIONAL ATTENDANT $75.00 per Additional Attendant When necessary for patient or attendant safety or clinical care purposes, the staffing specified by NMAC for the level of service being provided may be supplemented with an 7

8 additional attendant. TEAM TRANSPORT $ Each Leg of Trip Transportation of a specialized medical/surgical team and equipment requiring expedited transport to conserve time that can only be provided by an emergency vehicle. The rate is applied to each leg of a trip, i.e., a round trip will consist of an out leg and an return leg. 8