1) Both Curtis and Ryan Bros. will accept the UWHC Prescription for Ambulance form we have developed. All other ambulance vendors should also be encouraged to use our form.
2) DNR patients must have an "Out of Hospital" DNR bracelet placed prior to transport.
3) Ambulance requests should include the following information:
- Does the patient require O2?
- Does the patient have an IV?
- Is the patient in isolation?
- Include weight if >250#
4) All arrangements for ambulance transportation should be discussed with the patient and family as appropriate. This includes an estimate of cost and responsibility for payment. The Resource Center can assist you with calling the insurance company to check benefit coverage. Please try to do this with everyone as appropriate. Don't just assume that the patient and family are unable to pay.
5) When you are requesting that UWHC cover the cost of ambulance transportation, you must do the following:
- Call and get a cost estimate from the ambulance vendor;
- Email the "Discharge Arrangements - Special Requests" and request a financial screening be completed so we can determine if patient meets Community Care funding criteria. This must be done at least 24 hours prior to sending the patient home. You do not have the authority to authorize UWHC coverage of ambulance transport on your own. Include the cost estimate of ambulance transport in the email request;
- Complete the Ambulance Authorization log form and give to Mickey. This allows COC to pay the ambulance invoice when it is submitted;
- Requests for ambulance transport to the MRI - Open Scanner just need an Ambulance Authorization log form.
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