Private ambulance taux de remboursement?

[Chancer]

I have just received a facture for a private ambulance (called by Samu) journey to the hospital A&E department and very reasonable it was too.

Does anyone know if it is remboursable and at what taux? Or can they direct me to a site with the relevant info?

Many thanks.

[Clair]

Without looking into the details, I found this page, which would imply the costs should be reimbursed

Art. R. 322-10. - Sont pris en charge les frais de transport de l'assuré ou de l'ayant droit se trouvant dans l'obligation de se déplacer :

« 1° Pour recevoir les soins ou subir les examens appropriés à son état dans les cas suivants :

« a) Transports liés à une hospitalisation ;

«

b) Transports liés aux traitements ou examens prescrits en application

de l'article L. 324-1 pour les malades reconnus atteints d'une

affection de longue durée ;

« c) Transports par ambulance justifiés

par l'état du malade dans les conditions prévues par l'arrêté mentionné

à l'article R. 322-10-1 ;

« Art. R. 322-10-1. - Les transports pris en charge par l'assurance maladie peuvent être assurés par les moyens suivants :

« 1° L'ambulance ;

« 2° Le transport assis professionnalisé, véhicule sanitaire léger et taxi ;

« 3° Les transports en commun terrestres, l'avion ou le bateau de ligne régulière, les moyens de transport individuels.

«

Un référentiel de prescription arrêté par le ministre chargé de la

sécurité sociale précise les situations dans lesquelles l'état du

malade justifie respectivement la prescription des modes de transport prévus au présent article en fonction de l'importance des déficiences et incapacités et de leurs incidences.

[Chancer]

Thank you very much Clair

Do you think they will be able to write out a feuille de soins? I have had problems before getting the hospital to issue one (they had to get the original surgeon to sign it) to enable me to claim as it was something out of the ordinary for them.

The cost was actually very reasonable at €134 considering that the journey took 45 minutes with a driver and a paramedic (perhaps they both were) plus the initial emergency treatment and the handover at the hospital which wasnt at all rushed.

There had been an RTA involving a Dutch and Polish group and I ended up translating for them as one of them spoke English, the hospital booked a taxi for them to a motel less than a quarter of the distance that I was carried and it was over €30.

Editted

I had a quick look at the site and it looks like the prescription (as they called it) can be done postierieurement in cases of emergency but I fear that it would have to be SAMU that issue it.

[TWINKLE]

I do know that the CPAM are really clamping down on transport now and you will probably have to get a letter from the doctor or surgeon authorising the journey and fax it to the directeur du responsable des transports.

[Chancer]

An update

The situation was complicated by the ambulance being ordered directly by SAMU as I had lost consciousness, had they sent a Médecin he would have written an ordonnance, I went to the bureau de sécurité social and they said that I would have to get an ordonnance or prescription from Samu but were unable to advise me how to.

I next went to the ambulance company and they were realy helpfull (which is a rare surprise in these parts, probably only the second time in 3 years), they showed me what they would give me when I paid the facture, this resembled a feulle de soins but had a reference number number from Samu which they reckoned would do the trick.

Best of all after dicussing options with them they proposed to send it off to the CPAM, get the remboursement direct and ask me to pay them the balance (which looks to be 35%) when it is settled, they would not let me pay them at this stage. It was the solution that I had hoped to encourage them to do but I was really pleased that they suggested it without prompting.

I also visited the doctor today who in turn has made appointments for me with 2 other specialists for unrelated health matters and generally had lots of discussions in French and achieved quite a lot, it reminded me of a recent posting where someone else related what they had done that day and asked the question "how on earth do people get on without speaking the language,"