• A flat rate per patient dependent on the classification of the Call Centre facility (identified by practice number suffix supplied by BHF)
• Only the transporting service will charge an incident management fee
• LEVEL 1:
• By Default
• LEVEL 2:
• 24 Hr on-site facility with dedicated staff
• Voice Logging facility
• Access to Doctor or ALS via Telephonic support
• LEVEL 3:
• 24 Hr on-site facility with dedicated staff in a call centre
• 24 Hr on site Doctor/ALS/Nurse on duty in call centre
• Voice Logging facility and electronic mapping equipment, i.e. full electronic management with full audit trail
• Minimum of 30 incoming lines for communication system, (i.e. resource management)
• Full off-site disaster recovery programme on separate site

• A flat rate charged per kilometre travelled, for patient-carrying kilometres only.
• Only the transporting service will charge a transportation fee
• Distance for the transportation fee is calculated from the Ambulance kilometres only (i.e. response vehicle kilometres not included)
• Charged at the level of care the patient required

• A per kilometre fee to be charged for those patients treated, but not transported,
  e.g. patient who refuses transportation, patient who is air-lifted from the scene,
  patient who is declared dead on scene.
• Calculated as the distance from dispatch to scene for the vehicle which transported the treating crew member only.
• This fee will never be charged together with the transportation fee above.
• Charged at the level of care the patient required.
• Please note that in the case of patient being treated and not transported, relevant other Fee Categories may also
  be billed, including the Assessment Fee, Incident Management Fee, Consumable Fee and Oxygen Fee (if applicable).

• Charged at the level of qualification of the emergency care practitioner (ECP) who assesses the patient and makes
  treatment decisions.
• Charged from when the emergency care practitioner arrives at the patient
• Defined as the first 10 minutes after arrival for a BLS or ILS practitioner, and the first 15 minutes after arrival for an ALS practitioner
• For interfacility transfers, charged at level of patient treatment required
• Charged at BLS, ILS and ALS level
• Not linked to Ambulance Service practice number but to HPCSA practitioner number
• In circumstances where the assessment of the patient indicates a higher level of care required than the current level
  of practitioner, with a higher level of care being called in to manage the patient, a SECOND assessment fee may be levied.
  To be charged by the transporting service. To be included in the single account and or invoice forwarded for the payment of
  account by the transporting service ONLY. If another service assessed the patient, then that service should charge the transporting service and NOT the patient.
• The signature of the assessor along with qualification and HPCSA registration number must be included. Where
  another service has assessed, a copy of the assessment form must be included with the patient documentation.

• Charged per 15 minute interval (or part thereof) starting at the end of the Assessment Interval (defined above)
• To be charged at level of patient care required and not qualification level of practitioner.
• Only the ambulance service transporting the patient may raise this fee.
•  The Monitoring Fee to be calculated until arrival at destination and the following acceptable handover times to be
  added to the time calculation for the monitoring fee;
  
  • BLS and ILS = 10 minute handover time
  • ALS = 20 minute handover time
  • ICU = 30 minute handover time (defined as a patient being handed over to an ICU facility)
• During the transportation phase, a value of maximum 90 seconds per kilometre may be charged, unless motivating
  circumstances are documented for prolonged transportation time.
• Scene times are to be allowable up to a maximum of 20 min for a primary case (i.e. outside a registered hospital environment), regardless of level of care unless extraordinary reasons are documented for prolonged scene time.
• Scene times for transfer from one recognised registered hospital to another registered hospital are to be limited to 30
  min for BLS & ILS and 45 min for ALS, unless extraordinary reasons are documented.

• Charged at the level of care which the patient required (i.e. same level as the Monitoring & Treatment Fee)

• Certain consumable items may be charged for separately; (must display NAPPI code for item):
• Intraosseous needle
• Adenosine
• Amiodorone
• Anexate
• Thrombolytics/Fibrinolytics
Pacing Pads Specialised infusion sets

• Charged per 15 minute interval or part thereof during which the patient had oxygen administration
• This fee may be charged when used, by each assessing, treating and/or monitoring practitioner, involved in the patient case.

REGULATIONS DEFINING THE SCOPE OF THE PROFESSION OF EMERGENCY CARE

1. General Rules

In the event that multiple casualties are transported in one ambulance – the fee for transportation fee & incident management fee is to be divided equally amongst the number of patients being transported. Full Assessment, monitoring, consumable and oxygen (where appropriate) fees are to be charged to each patient.

In the event that a patient requires a higher level of care, and a provider activates their own expertise to assist their own crew, then only the higher fee may be charged, and not an initial lower level assessment fee as well.

2. Guidelines for information required on each account:

• Name of service
• BHF practice number
• Address
• Telephone number
• The name of the patient
• Diagnosis of patient's condition
• Summary of medical procedures undertaken on patient and vital signs of patient
• Summary of all equipment used
• The date on which the service was rendered.
• Name and HPCSA registration number of care providers