Policies & Guidelines
- Compliance
- Definitions
- Ambulatory Surgical Services
- Billing Policy
- Children's Services
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- Clinic Services
- Dental
- HCBS Elderly Waiver
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- Inpatient Hospital Notification and Authorization
- Laboratory/Pathology, Radiology and Diagnostic Services
- Long-Term Care
- Mental Health Services
- Optical Services
- Pharmacy Services
- Physician and Professional Services
- Rehabilitative Services
- Requirements for Providers
- Service Authorization
- Substance Use Disorder Services
- Transportation
- Tribal and Indian Health Services
- Legal References
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- Ambulatory Surgical Services
- Billing Policy
- CFSS
- Children's Services
- Chiropractic Services
- Clinic Services
- Dental
- Equipment and Supplies
- HCBS Elderly Waiver
- Home Care
- Hospice
- Hospital Services
- Housing Stabilization Services
- Immunizations and Vaccinations
- Inpatient Hospital Notification and Authorization
- Laboratory/Pathology, Radiology and Diagnostic Services
- Long-Term Care
- Member Eligibility
- Mental Health Services
- Optical Services
- Pharmacy Services
- Physician and Professional Services
- Recuperative Care
- Rehabilitative Services
- Requirements for Providers
- Service Authorization
- Substance Use Disorder Services
- Transportation
- Tribal and Indian Health Services
- Quality: HEDIS
- Policies & Procedures
Transportation
Definitions
Adult: A person over the age of 21 authorized to make transportation decisions for a minor.
ALS: Advanced Life Support.
Advanced Life Support, Level 1 (ALS1): Transportation by ground ambulance vehicle, and the provision of medically necessary supplies and services, including an ALS assessment by ALS personnel or the provision of at least one ALS intervention.
Advanced Life Support, Level 2 (ALS2):
- Three or more different administrations of medications by intravenous push or bolus or by continuous infusion excluding crystalloid, hypotonic, isotonic, and hypertonic solutions (Dextrose, Normal Saline, Ringer’s Lactate), or transportation, medically necessary supplies and services, and
- The provision of at least one of the following ALS procedures: manual defibrillation or cardioversion, endotracheal intubation, central venous line, cardiac pacing, chest decompression, surgical airway, intraosseous line.
Ambulance Service: The transport of a member whose medical condition or diagnosis requires medically necessary services before and during transport.
Ancillary Services: Health services incidental to ambulance transportation services that may be medically necessary on an individual basis but are not routinely used and are not included in the base rate for ambulance.
Attendant: An employee of a NEMT provider who meets all Minnesota Department of Transportation (MnDOT) driver certification requirements.
Basic Life Support (BLS): Transportation by ground ambulance vehicle and medically necessary supplies and services, plus the provision of BLS ambulance services.
BLS Emergency: When medically necessary, the provision of BLS services as described in the BLS definition, in the context of an emergency response.
Member: A person enrolled in PrimeWest Health eligible for and using using medical transportation services.
Member reimbursement: Member mileage reimbursement provided to clients who have their own transportation.
Common Carrier Transportation: The transport of a member by bus, taxicab, other commercial carrier, or by private automobile.
Community Paramedic: An individual certified to provide the services and meets the requirements as noted in MN Stat. sec. 256B.0625, subd. 60.
Local agency Nonemergency medical transportation (NEMT): Transportation services coordinated, provided, or reimbursed by the county or tribe (previously referred to as “Access Transportation Services [ATS]”).
Medical Transportation: The transport of a member for the purpose of obtaining a covered service, or transport of the member after the service is provided. The types of medical transportation are defined by Modes 1 – 7.
Minnesota Department of Transportation (MnDOT): The principal Minnesota State agency to develop, implement, administer, consolidate, and coordinate State transportation policies, plans, and programs (Minnesota Statutes 174).
Child: A person under the age of 21.
Neonatal intensive-care unit (NICU): A unit of a hospital specializing in the care of ill or premature newborn infants.
No-Load Transportation Miles: Medical transportation miles driven as part of a one-way member transport to a medically necessary appointment when the PrimeWest Health member is not in the vehicle. Providers are able to bill no-load miles beginning where the transport originates. PrimeWest Health does not pay for the provider’s miles from their garage to pick up the member.
No Show: Member is not at pickup location when scheduled or member has cancelled a scheduled trip within the following:
- Less than two hours before the scheduled pickup time for trips under 30 miles
- Less than four hours before the scheduled pickup time for trips over 30 miles
Nonemergency Medical Transportation (NEMT): Local county- or tribal-administered and PrimeWest Health-administered transportation services provided to enable PrimeWest Health members access to medically necessary covered services or to attend PrimeWest Health services related Appeal hearings.
Responsible Person: An adult or emancipated minor who is needed to make medical decisions, learn about the member’s medical care, or is necessary to allow the member to receive a covered medical service.
Transportation coordinator: A PrimeWest Health-employed staff person that is responsible for coordinating the appropriate level of transportation for a member.
Trip or trip leg: The transport of a member from the pickup (origination) location to the drop-off (destination) location. This is the unit of billing.
Volunteer transport: A transportation program that provides transportation by volunteers using their own vehicles.
PW_03-19_149
Updated_01/11/2023
