Many Blue Cross and Blue Shield of Alabama contracts include benefits for medically necessary ambulance transportation to the nearest facility able to treat the patient’s condition. In most cases ambulance services are covered under the Major Medical portion of the contract, with applicable coinsurance and deductibles. Ambulances can be hospital-based or independent.

Hospital-Based Ambulances 

Listed below are claims filing instructions for hospital-based ambulances: 

1. When a hospital-based ambulance picks up a patient at the site of an emergency and takes the patient to the owner hospital where the patient is admitted, the ambulance service must be included on the inpatient hospital bill and reimbursed as part of the hospital’s per diem. No separate payment can be made for the ambulance.  
2. When a hospital-based ambulance takes a patient to a non-owner hospital, the ambulance provider should bill services on a separate claim form. These services are not included on the inpatient bill.  
3. When a hospital-based ambulance takes an admitted patient from one hospital to another hospital for a service that cannot be rendered at that hospital and returns the patient to the original hospital, there is no separate reimbursement for the ambulance. This ambulance service should be included on the hospital claim where the patient is classified as an inpatient. 
4. When a hospital-based ambulance picks up a patient from a hospital for the purpose of transferring the patient to another hospital where they are admitted to a non-owner hospital (because the originating hospital cannot provide the necessary care), a separate ambulance claim is submitted. These services are not included on the inpatient bill. 
5. When a hospital-based ambulance picks up a patient from a hospital for the purpose of transferring the patient to another hospital where they are admitted to the owner hospital (because the originating hospital cannot provide the necessary care), the ambulance service should be included on the admitting hospital’s bill. 

Independent Ground Ambulance 

Ground ambulance transports can include transports from a scene/residence to a facility and/or transport from one facility to another. In-network ground ambulance claims should be filed to Blue Cross and Blue Shield of Alabama, when pickup is within our service area or a contiguous county. 

Air Ambulance 
Air ambulance transports can include transports from a scene to a facility and/or transport from one facility to another. 
As of 04/19/2015, per the Association, air ambulance claims must be filed to the Plan where the patient was picked up.

Alacura 
Blue Cross and Blue Shield of Alabama has partnered with Alacura for navigation of facility-to-facility transports. It is the expectation all air ambulance transports taking place from facility to facility be completed by an in-network Air Ambulance entity. Alacura helps facilities in arranging these transports. 
Alacura can be reached at 1-866-671-6572 to assist in arranging in-network facility-to-facility air ambulance transports. 

Additional Air Benefits: AirMed International 

AirMed International is a fixed-wing medical transport provider that some of our employer groups have as an added rider. This service provides non-emergency transport to get members to medical facilities closer to home when the patient is more than 150 miles away.

To confirm that a patient has this rider, while viewing eligibility and benefits, select the service type “Air Transportation.”

AirMed International can be contacted toll-free 24 hours a day, seven days a week at 1-877-872-8624 or 1-205-443-4885 regarding any questions about air transportation. If the patient is involved with case management, you can also arrange transport through that case manager.  

For All Ambulance Services (Hospital-Based or Independent) 

Ambulance origin/destination modifiers are required when filing claims to Blue Cross and Blue Shield of Alabama. These modifiers should be placed to the right of the ambulance HCPCS code, with the origin modifier listed first, and the destination modifier listed second. Following is a list of ambulance origin/destination modifiers:

    
Ambulance Provider Credentialing

To become a credentialed ambulance provider please complete the documents detailed on ProviderAccess.

Select the RESOURCES Tab → ENROLLMENT & CREDENTIALING
Providers can be either/or ALLKids or Blue Advantage^® without being in the commercial network.

• To be in the commercial network, providers must be IN for all lines of business.
• For questions regarding credentialing, please contact credentialing@bcbsal.org.

Ambulance Network Consultants 

To find the Provider Engagement Consultant for your area, go to the Air and Ground Ambulance map.