does blue cross blue shield cover ambulance rides does blue cross blue shield cover ambulance rides

Coverage Details. In the event of life-threatening illness or injury (chest pain, signs of stroke, difficulty breathing/moving) call 911 or visit your nearest emergency room. 2 of the bills could be paid completely. The air ambulance may take you to the nearest facility, depending on your health coverage, or it may take you all the way home if your contract provides for a higher level of coverage. What Employee Health Insurance Options Are Right for You? Medically necessary refers to the care needed to prevent, diagnose, ortreat an illness, injury, condition, or disease by current standards. z[?UzjU*YHdUq1:qOO(SNV:2yw7Ybz*(l4 fgIrE$|,T2ORM.=Cltf#P9"$[4na1)ROExyd$pE9okFBMHaj(9- d^W8S z`H4NsqT>TLDQLn"3w9;\_GIQcUXp0Y}_=}e"@PETL-z^.nS\f|38Oz{zrEf*uK*bVIW \Y1@X0_=c}]V~*H=MgcPGsB YUXE*aCT 8tnx+#FR t-?I Vn/NIPFW|al=k/O{YPQB[*n[+(m/>&>>O8BU YNB(d"s&;yoEKoi?C[R[${- C[Ys\^|KCd/~Z'!,@$. Advanced Life Support I and II: $3,717.40 plus mileage. Our Nurse Line is available 24/7 for general questions about health issues or where to go for immediate care. Non-Michigan providers should fax the completed form using the fax numbers on the form. A0428 Ambulance service, basic life support, nonemergency transport, (BLS) A0430 Ambulance service, conventional air services, transport, one way (fixed wing) A0431 Ambulance service, conventional air services, transport, one way (rotary wing) A0434 Specialty care transport (SCT) A0435 Fixed wing air mileage, per statute mile Care Coordinators are encouraged to use the BlueRide portal which is linked on the Bridgeview Care Coordinator tool. Your insurer generally must approve the recommendation. A member is hospitalized at Hospital A as an inpatient. If you have questions about a ride you set up or need to change or cancel it, or if your ride has not arrived within 15 minutes of your pick-up time, call: Cardinal Care Medicaid Ride Assist: 1-877-892-3988 (TTY 711), option 2. We report because the news impacts all of us. Age 65 and over: $100 per day, up to 30 consecutive days of hospitalization. The campuses are in two different locations (a campus is defined as areas located within 250 yards of main buildings) AND the member is not in an inpatient status at the time of transport. But unless you qualified for Medicare before January 1, 2020, you wont be able to buy Plan C or Plan F. So, depending on the Medicare Supplement insurance plan you have, the plan may cover your Part B coinsurance, and possibly even your Part B deductible. Wannabe travel nerd. How health insurance provides coverage for ambulance bills, When insurance does not cover ambulance costs. Want care quickly? Added this statement under air ambulance billing guidelines: Claims billed by a facility that includes air ambulance services as part of the facilitys negotiated arrangement are to be filed to the facilitys local plan. This is to clarify if a facility includes air ambulance services, claims should be filed to their local plan instead of pick-up location. Ambulance service is covered under emergency conditions and under non-emergency conditions that are specified below. The call is free. Blue Cross Complete of Michigan can help you get there; just call our transportation provider at 1-888-803-4947. Our use . Hospital A would be responsible for reimbursing the Ambulance Company and Hospital B services they provided. It's also common when injury occurs in a remote place where regular transport isn't accessible or when large distances must be traveled in a short time. Rick Dupon, its EMS chief, said the service has four paramedics on duty around the clock to staff emergency vehicles. Even then, your insurance probably wont cover the full cost of your ambulance ride. However, you will need to pay the deductible and 20% of the costs. On the other hand, other firms may charge you for being sent to the site, even if you don't travel in the ambulance. 4510 13th Ave. S. We will give you mileage reimbursement if you arrange your own private ride. Generally, Medicare Part B pays 80% of the Medicare-approved costs for air ambulance services. If you don't have dental or vision coverage, and you would like to get it, don't fret; we can help. FEP Blue Focus: 30% of our allowance* and ground ambulance transportation is 30% of our allowance. All rights reserved. That tells me the system is broken, he told Bridge Michigan. According to the Centers for Medicare & Medicaid Services, you can get a ride through Medicaid if you don't have a functioning car, or if you don't have a driver's license. 15 by air if that. Medicare information is everywhere. Please note that plan options not . A member has a procedure performed in a facilitys ASC and is transported to the same facilitys outpatient hospital for additional non-emergent care/routine post-operative recovery. Get plan recommendations that match your needs. Blue Cross and Red Crescent Societies For ambulance services, Blue Shield offers a . Air transport is often used in cases involving stroke,heart attack,burn care, head or spinal cord injury, and transplant. Updated on Tuesday, January 18 2022 | 0 min. The member requires diagnostic tests and is transported by ambulance to Hospital B for the test and then returns to Hospital A for continued inpatient care. One option is Adobe Reader which has a built-in reader. Two years later after a Detroit television reporter took up the familys cause the company issued a statement that the billing had been resolved. "Air Ambulances10 Year Trends in Costs and Use.". Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. They are available Monday through Friday, 8:00 a.m. to 5:00.p.m. First Transit will ask questions to see if you qualify for this service. Medicare Medical Insurance, or Part B, typically covers standard ground ambulance transport for emergencies. Attached is the list of particlpating air ambulance providers with Anthem in Indiana, Kentucky, Missouri, Ohio and/or Wisconsin. They started calling him within days of the accident for a total of $40,000. endobj The average cost was $27,894 in 2017, which increased by 166% for planes, to $41,674 in the same year. They have partnered with the Department of Healthcare and Family Services (HFS) to offer this service. First Transit is a prior approval vendor. An ambulance ride can cost anywhere from a few hundred to a few thousand dollars if you dont have insurance or if your insurance wont cover the trip. You may need to pay toward your health insurance plans deductible before this kind of coverage kicks in, too. Heres what the laws are now, Michigan State shooting update: 2 more students released from hospital, Michigan has far more power outages this week than other Midwest states, Michigan outraged toxic waste from Ohio derailment shipped to Belleville, MSU shooting: fourth victim identified, discharged from hospital, Michigan lawmakers send Whitmer tax cuts; $180 payments are dead, Michigans lousy infrastructure has many begging: Fix the damn noisy roads, Michigan State shooting: Alerts to students delayed as police rushed to campus, Michigan coronavirus unemployment, map, curve, updated COVID-19 news, Michigan coronavirus testing numbers, trends, COVID-19 data. All products are not available in all areas and are subject to applicable laws, rules, and regulations. We cover non-emergent ambulance . Life Flight Network. According to the Michigan Association of Ambulance Services, a 911 call in Michigan summons a response from one of 285 licensed EMS agencies throughout the state. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. The Standard Option copay is $30, Basic Option is $35 and FEP Blue Focus is $25. Michigans nonpartisan, nonprofit news source. The cost breakdown is as follows: Standard Option: 15% of our allowance* and ground ambulance transportation is $100 per day, Basic Option: $175 per day and ground ambulance transportation is $100 per day. Mileage: $16.00 per mile. Speeds vary based on the specific helicopter but generally range between 150 and 170 miles per hour. This should not add any more than 45 minutes to your travel time. According to theNational Association of Insurance Commissioners, the service can cost tens of thousands of dollars. Call or check your mobile app 3 days prior. "Ambulance Services." Medicare. Beginning with dates of service on or after September 1, 2019, Empire will implement the new professional reimbursement policy, Ambulance Transportation. Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. 198577M 55-2386 (07/19) Created Date: Some Medicare Supplement plans may cover other Medicare out-of-pocket costs. Thats a cost it cant cut if its going to serve the community, even on days when it handles just a few patients. Will Medicare Supplement insurance cover ambulance transportation? You need to go right away to a hospital, skilled nursing facility, or critical access hospital. BCBSND may contract with an air ambulance provider, if the air ambulances patients will be picked up in a location that is within BCBSNDs service area based upon the zip code of the point of pickup. This coverage may be included in health insurance or travel insurance. The insurance company pays either the median negotiated amount in the region for that medical service or 150 percent of what Medicare would pay whichever is greater. In addition, some sites may require you to agree to their terms of use and privacy policy. But Saltsman, the Farmington Hills lawyer, said the system still leaves too many patients vulnerable. Your email address will not be published. This type of healthcare can refer to either services or supplies. Call 911 if you need emergency transport. Ambulance and any other modes of transportation to or from services including but not limited to physician appointments, dialysis, or diagnostic tests not associated with covered inpatient hospital care. Arkansas Blue Cross and Blue Shield also offers individual and family dental and vision products in our Shop section. The cost breakdown is as follows: *The calendar year deductible applies in this situation. If you get the high-deductible option, you must pay for Medicare Covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of $2,700 in 2032 before your policy pays anything, and you must also pay a separate deductible ($250 per year) for foreign travel emergency services. If we are not allowed to collect on deductibles or coinsurance, then you would see a dramatic loss of EMS agencies in our state, Madden said. When billing for mileage, report the number of loaded miles in the units field. Be sure to ask your insurance rep. To go to a provider who is outside our provider network (without special authorization from BCBSIL) If you need a ride to the doctor, call Member Services at 1-877-860-2837 (TTY/TDD: 711) at least three days before your appointment. The Mental Health Parity and Addiction Equity Act of 2008 required healthcare plans to provide mental health benefits equal to medical and surgical coverage. We also cover medically necessary emergency care provided at the scene when transport services are not required. Get the information you need for your health insurance in Virginia. Reviewing a plan's SBC may make it easier to understand its benefits and coverage. x\m AjV|K@v\hi{4RecixmYg^W]}_w_c~~]P]^]xKEn^F| +(zV/_|x }}I"8+'Y9O?|$}aGQi=q,'4tX@*i^Ovy^oOvUZrR.3 \7z&/#$"NK{6 Youll be connected with a registered nurse via phone, email or secure message and all at no cost to you. Standard Option: $350 per person or $700 per family. You can learn more about cost-sharing, coverage limitations, and if you need a referral to see a specialist. Search parameters include distance from your location (zip code, address or county). You may need it if you're bleeding beyond the control of regular services or if you need oxygen, life support, or other aid during transportation. *The calendar year deductible applies in this situation. Surgical and Anesthesia Services Provided by Physicians and Other Healthcare Professionals, 5(c). This usually means you need medical attention right away, like after a car accident or when you call 911 from home. Anthem Blue Cross says the $51,000 helicopter ride wasn't "medically necessary." But doctors, amid a medical emergency, believed otherwise. Call: (833) 511-1213 | Agents available 24/7. This policy provides direction on correct billing for ambulance services. The services you receive while in the ambulance. You can also find information in the benefits booklet you received separately. Ask your insurer about out-of-network air ambulances and what you should do if you need one. Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, and/or Horizon Healthcare Dental, Inc . Youll be connected with a registered nurse via phone, email or secure message and all at no cost to you. BCBSNC does not cover services that are not medically necessary and will not reimburse for any services, procedures, drugs or supplies . According to Medicare.gov, Medicare Part B also covers non-emergency ambulance rides in some situations. Air Ambulances10 Year Trends in Costs and Use. If you care about Michigan, please support our work. Make sure your coverage will accept the air transport service you're using, even if air transport is covered. Call 911 if you need emergency transport. Mental Health and Substance Use Disorder Benefits, 5(h). Read more to learn about our Compliance Program. Medicaid is one exception to all the above. <> The Standard Option copay is $25, Basic Option is $30 and FEP Blue Focus is $10 each for the first 10 visits. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. How much does an ambulance ride cost in Illinois. For example, if you have end-stage renal disease (ESRD, or kidney failure), Medicare might cover an ambulance ride to a dialysis facility. But Dupon said those payments fall well below meeting its average cost of about $1,100 per ride, the reimbursement total it would need to sustain operations. The solution is to pass similar protection for patients who ride in ground ambulances.. . Thats because a Medicare Supplement plan typically covers at least part of your Medicare Part B copayments and coinsurance. Blue Cross Blue Shield of Texas, Khan's insurer, paid $11,972, after initially refusing altogether; the medevac company billed Khan for the . Miles incurred after member is loaded onto ambulance for transport. Dupon said many of the people it transports have insurance under Medicaid or Medicare, which pay fixed rates for ambulance service under a complex formula that weighs the level of care, the regions labor costs and mileage. Other plans charge a copay with a flat fee or coinsurance of 10% to 50%. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Any of your transportation needs are provided through our partner, ModivCare* (formerly LogistiCare). How much does it cost for an ambulance to come out? Criteria Request Form (for non-behavioral health cases) (PDF ) Acute inpatient hospital assessment form (PDF) Michigan providers should attach the completed form to the request in the e-referral system. Call one of our agents at 800-392-2583 to discuss your options. Pick-up locations outside the United States, U.S. Virgin Islands and Puerto Rico, the provider must submit these claims to the BCBSGC medical assistance vendor for processing through the BCBSGC Program. Coverage Guidelines Blue Cross may authorize air ambulance transport from an acute care facility to another acute care facility when the following time and clinical criteria are met: Air Ambulance Transport: Clinical Criteria All you need to do is search ModivCare on either Google Play or the Apple App Store to download. BlueRide Q&A. But your doctor needs to write an order stating theyre medically necessary. However, this might be subject to a deductible and to the co-insurance clause of your plan, so you could still end up paying part of the costs out of pocket. Please review the terms of use and privacy policies of the new site you will be visiting. For example, if an FEP member is picked up in Minnesota and brought to North Dakota, the FEP claim should be filed to Minnesota. TTY users should call 711. New program to recognize the value of EMS services. We offer plans from a number of insurance companies. If you have a minor injury and you call an ambulance to take you to the hospital because your vehicle wont drive or you dont have a vehicle, your insurance probably wont pay any of the bills. But, depending on the details of your health insurance policy, you may be responsible for part of the cost, such as . A benefit of using your car insurance coverage for an ambulance ride is that you won't have to pay a copay or deductible. Air transport can be covered by health or travel policies when the emergency doctor recommends it due to being medically necessary. Blue Shield Promise Medi-Cal lets you use a lot of different ways of getting to your medical appointment for Medi-Cal covered services. Or you might need medical supervision while going from your doctors office to the hospital. Ambulance owned/operated by a hospital for purposes of providing ambulance transport. Your browser does not support JavaScript or it has been disabled. Network Coverage In-network care only, except in certain situations like emergency care Out-of-Pocket Maximum (PPO) . Services Provided by a Hospital or Other Facility, and Ambulance Services, 5(e). only for what insurance won't . Fargo, N.D., 58121. Or, members can log in to start a Live Chat with us. Another 10 percent comes from people with no insurance, bills that in many cases Huron Valley simply writes off about $6 million in bad debt a year. Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc., independent licensee of the Blue Cross . Ambulance rides are expensive. Call the Blue Cross Blue Shield Global Core Service Center at 800-810-2583 or call collect at 804-673-1177 to locate doctors and hospitals, or obtain medical assistance services when outside the United States. Medically necessary transports between provider sites will be reimbursed for the following conditions: Examples of transports eligible for payment: Examples of transports not eligible for separate payment: When multiple patients are transported simultaneously either by ground or air, regardless of whether it is billed by UB-04 or a CMS-1500 Claim Form, the following rules apply: Claims from providers of emergency and non-emergency ground ambulance services provided within the United States, U.S. Virgin Islands and Puerto Rico are to be filed to the local Plan. Claims billed by a facility that includes air ambulance services as part of the facilitys negotiated arrangement are to be filed to the facilitys local plan. The 10 mile ambulance ride cost $1,155 and Blue Cross and Blue Shield paid about $700, leaving her responsible for paying more than $450 out of pocket. Surgical and Anesthesia Services Provided by Physicians and Other Healthcare Professionals, 5(c). Virginia FAQs. It can get you help fast if being transported by ground is impossible or will provide a risk to your health. Is ambulance covered by insurance Massachusetts? The purpose of this site is the solicitation of insurance. These regulations apply to only air ambulance providers licensed in the state of North Dakota and only to members of fully insured groups. This is no longer effective as of March 18, 2021. Under the reforms signed in October, bills for emergency services from medical providers outside a patients network are negotiated between providers and a patient's insurance company, with the patient no longer involved. This policy provides guidelines for coverage and reimbursement of ambulance services including ground and air ambulance transports. If your doctor states in writing that ambulance transportation is medically necessary, Medicare might cover it. Care may be required during transport, but the timing of the transport isn't critical. See the cost breakdown of different forms of care for each of our health plans. How much does moving in an ambulance with a blue cross blue shield cost? All benefits are subject to the definitions . It totaled about $6,600 for a 26-mile ambulance ride that took an infant girl named Kenna from Henry Ford West Bloomfield Hospital to Childrens Hospital of Michigan in Detroit. BlueCard rules for claims incurred in an overlapping service area and contiguous county apply. If you get health insurance from an employer or from the marketplace set up by the Affordable Care Act, youll probably have to deal with out-of-pocket costs after you call an ambulance. This policy allows reimbursement for ambulance transport and services and supplies associated with transport to the nearest facility equipped to treat the member. I cannot remember anyone bringing it up. Want to start a conversation about care? With headquarters in Ann Arbor, Huron Valley Ambulance is a nonprofit EMS organization that serves all of Washtenaw County and parts of Wayne and Oakland. Its important to seek emergency care in the event of a true medical emergency like difficulty breathing or moving, poisoning and signs of a stroke or heart attack. More than 7 in 10 ground ambulance rides had that potential, a Health Affairs study found. Wellness and Other Special Features, 5(i). Medicare supplement plans A, B, C, D, F, G, K, L, M, and N provide the following benefits: The out-of-pocket limit in 2023 is $6,940 for Plan K, and $3,470 for Plan L. Additionally, Plan C and F isnt available to people new to Medicare on or after January 1, 2020. Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals, 5(b). TRICARE doesn't cover: Ambulance service you use instead of taxi service when your condition would have permitted use of regular private transportation. Highmark Blue Cross Blue Shield (Highmark BCBS) seized an opportunity to work with ambulance companies in the region to improve patient care, reduce member out-of-pocket costs and avoid unnecessary trips to the emergency room. If you were eligible for Medicare before 2020, you might be able to buy Plan C or Plan F. Medicare generally only covers ambulance transportation to the closest medical facility thats appropriate and can deliver the care you need. If an Advanced Life Support (ALS) vehicle is used but no ALS service is performed, the appropriate Basic Life Support (BLS) codes should be used. Itll also cover ambulance rides to critical access hospitals and skilled nursing facilities. You could look into reducing costs using coordination of benefits in such cases. Services, Drugs, and Supplies Provided Overseas, Non-FEHB Benefits Available to Plan Members. Nor does federal billing reform legislation buried within the $900 billion COVID stimulus measure signed Dec. 27 by President Trump. What you pay for an ambulance ride without insurance depends on a few factors, including: Note: some cities provide free ambulance rides to residents. Page 7. Walk-in appointments with shorter wait times than the ER are available at an urgent care center. For Medicare, it's about $550. Secondly, there's a per-mile charge. *ModivCare is an independent contractor that arranges and manages non-emergency transportation benefits for select Blue Cross and Blue Shield of Illinois plans. Other cities operate subscription programs that keep ambulance fees and charges to a minimum. This new site may be offered by a vendor or an independent third party. Weve been there for you with daily Michigan COVID-19 news; reporting on the emergence of the virus, daily numbers with our tracker and dashboard, exploding unemployment, and we finally were able to report on mass vaccine distribution. You do not need an OK from BCCHP in the event of an emergency. How much is an ambulance ride in Minnesota? ModivCare is available Monday through Friday, 8:00 a.m. to 6:00 p.m., CST. You can also get transport to and from a Blue Door Neighborhood Center at no cost to you! Requests for or offers to contract with out-of-state air ambulance providers are reviewed on a case-by-case basis. Walk-in appointments at a retail clinic in your nearby pharmacy are good for health screenings, vaccinations and minor illness or injury. "Medicare Coverage of Ambulance Services." I have Highmark Blue Shield PPO, and I was told that they do cover "air ambulance," but as an out of network provider I would pay 20%. Scope: Products included: . eHealth and Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. After Blue Cross rejected the bill the first time, Air Methods tried contacting the insurer on his behalf again to show the helicopter ride had been a medical emergency. That is where fully understanding the coverage you've purchased becomes essential. If bills are an issue, you should know that some cities provide free ambulance rides to residents. But Dupon said those payments fall "well below" meeting its average cost of about $1,100 per ride, the reimbursement total it would need to sustain operations. They will decide whether it is necessary by current standards. 2020 Blue Cross Blue Shield Association. "Air Ambulances10 Year Trends in Costs and Use." Medicare. Note: Claims without a point of pickup zip code or with multiple zip codes, will be rejected. Bus passes can be provided to get you to and from your doctors appointment. Total Bill: $56,603 for an air ambulance flight. Removed statement: Effective January 1, 2018, all payments made by North Dakota insurers for air ambulance services shall be at the same in-network level and considered as payment in full, even for out-of-network air ambulance services. Alison is an SEO Analyst at QuoteWizard, with experience covering auto insurance topics. If you live within two blocks of a mass transit bus stop, you can get free bus passes for your doctor's appointments. When Is It Covered by Health or Travel Policies? It can also be covered if you receive aletter of medical necessity. All Rights Reserved. Check out the changes and updates to our plan in 2023. A member who demonstrates severe behavioral health issues is seen in a providers emergency room (ER) and is transported by ambulance for admission to the same providers psychiatric unit located outside of the campus containing the ER or to the psychiatric unit that has a different NPI. In the event of life-threatening illness or injury (chest pain, signs of stroke, difficulty breathing/moving) call 911 or visit your nearest emergency room. The circumstance where your insurance pays just a fraction of your bill and you end up with an $800 bill, thats a rare circumstance for us. or you might not be covered. All rights reserved. This coverage kicks in after you pay your Part B deductible. Typical costs: Ambulance service typically is covered by health insurance when medically necessary. A member having a surgical procedure done in the Ambulatory Surgery Center (ASC) has a severe hemorrhage and requires transport to the hospital for additional care. You can use public transportation like a taxi or bus. Angela Madden, the associations executive director, acknowledged the current system can hit patients with unexpected bills. All content and services provided on or through this site are provided "as is" and "as available" for use. Requests for or offers to contract with out-of-state air ambulance providers are reviewed on a case-by-case basis. Lifelong gamer. Benefits . CallModivCare at1-877-831-3148(TTY/TDD: 1-866-288-3133) at least two weeks before your appointment. To use the tool, go to www.anthem.com and follow these steps in our "Find a Doctor" tool: Select "all plans . Pick-up locations outside the United States, U.S. Virgin Islands and Puerto Rico, regardless of where the providers headquarters is located, must file claims to the Blue Cross Blue Shield Global Core (BCBSGC) medical assistance vendor for processing through the BCBSGC Program. You can always call your doctors office for an appointment, and many offer night and weekend hours as well. The air ambulance has medical professionals on board, along with a mini-hospital where they can begin treating you as you fly. Ambulance services. In addition, some sites may require you to agree to their terms of use and privacy policy. 2 more by Medicaid at $105 each. All Rights Reserved 2023 All Insurance FAQ. But we have to be careful we dont solve the problem for 2 percent of the people and create a problem for the other 98 percent.. The rest may go uncollected due to the fact that the patient didn't have insurance coverage or an address to send out the costs. During an immediate medical emergency, like being injured in a serious car accident, you may need an ambulance to transport you to the hospital for treatment. State Rep. Roger Hauck, R-Mount Pleasant, who sponsored two bills in the four-bill legislative package, told Bridge he did not recall any complaints about ground ambulance billings in hearings prior to the packages passage. You can search for participating ground providers using our online tool, Provider Finder, located at www.anthem.com. You may file a grievance with us at any time. QuoteWizard.com LLC makes no representations or warranties of any kind, express or implied, as to the operation of this site or to the information, content, materials, or products included on this site. This is usually in the form of a deductible or copay. If you're using Medavie Mobile, just hit the Coverage button and you'll be . Required fields are marked *. Air Ambulance Providers. to request an ambulance.