Who decide if a patient is bed confined and need ambulance transportation?

Answer 1

I assume by the way the question is asked that it references "need" for ambulance transportation in the sense that a medical insurer would define it. That being the case, the insurer themselves sets the standard for what criteria must be met before a patient is deemed to "need" ambulance transportation. As you can imagine, this gets tricky.

The concept of "bed confinement" is even trickier - and may or may not necessitate ambulance transportation in and of itself in the eyes of the payor. In most cases in the US, a patient is defined as "bed confined" by medicare standards if they are unable to stand or walk without assistance, unable to sit in a wheelchair without assistance, and unable to leave the bed without assistance. But again, different organizations have different definitions.

Generally, a written and signed physician's statement is enough to justify ambulance transportation. However, for certain payors and in certain circumstances, a reason must be given for why a patient must be transported by ambulance as opposed to any other means. This can range from stating that the patient is "bed confined" to explaining, in detail, why the patient must go by ambulance in terms of what services must be provided to the patient during transport (cardiac monitoring, oxygen therapy, or medication administrations being the most common).

Again, depending on the situation at hand, this may or may not answer your question. Feel free to ask more!

NJM