Reminder: Air and Water Ambulance Non-Emergency Transportation Prior Authorization Requests

Blue Cross Blue Shield of North Dakota (BCBSND) is reminding our provider community that air and water ambulance transport is a covered service only if the facility to which the individual is transferred is the nearest with appropriate facilities to treat the member’s condition. The transport must also be deemed medically necessary and appropriate.

To streamline air and water ambulance non-urgent requests, BCBSND is requesting that providers submit the following documents with each prior authorization/ precertification request.

1. Documentation as to the medical condition requiring transportation, and why it cannot be provided by land ambulance
2. Verification that the air and water ambulance is going to the nearest appropriate medical facility, except for well-documented extraordinary circumstances (example: blizzard conditions).

If the transport is not going to the closest medical facility documentation needs to be provided showing that closer facilities were contacted and did not have capacity and/or bed availability to meet the member’s needs.