Stanford Med · Unit 5B Medicine·Day shift·Mon · 9:42 AM

Logistics library

How patients physically get from the hospital to the next setting
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MC
Discharge mapRoutesLogisticsNeeds × coverageResource hub
The last mile of every discharge. The right logistics option turns a plan into an actual departure; the wrong one (or a missed booking) slips the discharge a day. OpenBed AI picks the lowest-cost adequate option, pre-validates payer coverage, and books with lead time built in.
Patient drives self
Immediate lead

Patient drives their own vehicle home — only after clearance.

Books
Patient (RN confirms)
Cost
$0
Auth required
No
Vendors
—
When appropriate
  • ●Cleared from sedation / opioids
  • ●No procedure-specific driving restriction
  • ●Patient is the typical driver
Payer coverage
Medicare FFS
N/A
Medicare Advantage
N/A
Medicaid
N/A
Commercial
N/A
NotesDocument MD clearance; never assume. Patients with falls or recent sedation should not drive.
Family / friend pickup
1–4h notice typical lead

Caregiver or family member picks up at hospital entrance.

Books
Patient / family (CM confirms in portal)
Cost
$0
Auth required
No
Vendors
—
When appropriate
  • ●Ambulatory or wheelchair-transferable
  • ●Caregiver available + has appropriate vehicle
Payer coverage
Medicare FFS
N/A
Medicare Advantage
N/A
Medicaid
N/A
Commercial
N/A
NotesMost common path. Confirm with family in portal pickup tab to avoid no-shows.
Healthcare rideshare
On-demand or 30 min lead

Pre-credentialed Uber Health / Lyft Pass / Roundtrip for ambulatory patients.

Books
Case Manager via vendor portal
Cost
$15–60 per ride (plan-covered when eligible)
Auth required
No
Vendors
Uber Health, Lyft Pass, Roundtrip
When appropriate
  • ●Ambulatory, no medical equipment needs
  • ●Within metro area
  • ●No safety / cognitive concerns
Payer coverage
Medicare FFS
Not covered as transport benefit
Medicare Advantage
Often covered as supplemental SDOH benefit (varies)
Medicaid
Many state plans contract directly with Uber Health for NEMT-lite
Commercial
Some employer plans; HSA-eligible
NotesLowest-friction option for ambulatory patients without insurance NEMT benefit; HIPAA-safe partner programs.
NEMT — wheelchair van
24–48h advance booking lead

Non-emergency medical transport with wheelchair lift for non-ambulatory patients.

Books
Case Manager via state broker or plan-specific vendor
Cost
$60–200 per leg (plan-covered when eligible)
Auth required
Yes
Vendors
ModivCare, MTM, American Medical Response
When appropriate
  • ●Wheelchair-bound or non-ambulatory but stable
  • ●Going to / from SNF, ARU, dialysis, infusion
Payer coverage
Medicare FFS
Not routinely covered (limited 'ambulance-equivalent' criteria)
Medicare Advantage
Plan benefit (typically 4–12 rides/year); auth may be required
Medicaid
Covered (NEMT is federal Medicaid requirement)
Commercial
Per plan; often case-by-case
NotesMost common SNF transfer option. Book early to avoid weekend gaps. Confirm pickup time with patient + family.
NEMT — stretcher van
12–48h lead

Stretcher transport for bed-bound but non-emergent patients.

Books
Case Manager via vendor
Cost
$200–600 per leg
Auth required
Yes
Vendors
ProTransport-1, ModivCare stretcher fleet
When appropriate
  • ●Bed-bound + stable vitals
  • ●SNF/ARU/LTAC transfer without ambulance need
Payer coverage
Medicare FFS
Covered only if ambulance medically necessary (Part B); else patient pays
Medicare Advantage
Per plan; auth typical
Medicaid
Covered when medical necessity met
Commercial
Per plan
NotesBridge between wheelchair NEMT and ambulance. Document medical necessity to support coverage.
BLS ambulance
1–4h lead

Basic life support ambulance — EMT level, monitoring during transport.

Books
Hospitalist + Case Manager
Cost
$500–1,800 per leg
Auth required
Yes
Vendors
AMR, Falck, Local fire/EMS contract
When appropriate
  • ●Hemodynamically stable but needs monitoring
  • ●Inter-facility transfer to higher-acuity setting
Payer coverage
Medicare FFS
Part B if medically necessary (must rule out lower-acuity options)
Medicare Advantage
PA + medical necessity review
Medicaid
Covered with documentation
Commercial
Per plan; medical necessity criteria
NotesDocument medical necessity; payers deny if a lower level of transport was possible.
ALS ambulance
1–4h lead

Advanced life support — paramedic level, IVs / cardiac monitoring / meds in transit.

Books
Hospitalist + ICU + Case Manager
Cost
$1,200–3,500 per leg
Auth required
Yes
Vendors
AMR, Falck, Paramedic-staffed fleets
When appropriate
  • ●Cardiac, neuro, vent-dependent, or unstable transfer
  • ●Active drips or airway management required
Payer coverage
Medicare FFS
Part B with strong medical necessity
Medicare Advantage
PA + necessity review
Medicaid
Covered with documentation
Commercial
Per plan
NotesDocument drips, airway, monitoring requirements. Confirms with receiving facility.
Critical care transport (CCT)
2–6h lead

Nurse + paramedic team, vent-capable rig — sickest non-flight transfers.

Books
ICU attending + transfer center
Cost
$3,000–8,000 per leg
Auth required
Yes
Vendors
University specialty transport teams, Reach
When appropriate
  • ●ICU-to-ICU transfers
  • ●Vent + multiple drips
  • ●Pediatric / neonatal specialty teams
Payer coverage
Medicare FFS
Part B with strong medical necessity
Medicare Advantage
PA
Medicaid
Covered when necessary
Commercial
Per plan
NotesCoordinated by transfer center; typically inter-facility within network.
Air ambulance (fixed-wing / rotor)
1–3h dispatch lead

Air transport for distance or terrain that ground cannot cover.

Books
Hospitalist / ED + transfer center
Cost
$15,000–60,000 per leg
Auth required
Yes
Vendors
Reach Air, PHI Air Medical, Mayo One
When appropriate
  • ●Trauma activation
  • ●Long-distance organ transplant / specialty referral
  • ●Rural / no ground access
Payer coverage
Medicare FFS
Part B with very strict necessity criteria
Medicare Advantage
PA + necessity
Medicaid
Per state
Commercial
Per plan; balance billing risk under NSA depends on contracting
NotesSurprise-billing risk; involve case manager + financial counseling early.
Public transit pass / voucher
Same day lead

Bus / rail pass or token for ambulatory patients with no other resource.

Books
Social Worker + charity desk
Cost
$3–10 per ride
Auth required
No
Vendors
Local transit agency, Hospital charity pass
When appropriate
  • ●Fully ambulatory + safe
  • ●Patient experiencing homelessness or fixed-income
  • ●Within transit reach of destination
Payer coverage
Medicare FFS
Not covered
Medicare Advantage
Some SDOH plans
Medicaid
Some state Medicaid programs
Commercial
Not covered (charity / hospital funded)
NotesLast-resort lever for marginal cases; document plan and confirm patient can navigate.
⚙How this screen works
Logistics library is the last mile · turns plan into actual departure
Inputs
What this screen reads
  • Chosen disposition (locks viable logistics options)
  • Patient mobility status + medical needs
  • Payer NEMT benefit + state Medicaid broker contract
  • Family availability for pickup
Engine
What it computes
  • Picks lowest-cost adequate option (rideshare > NEMT > ambulance)
  • Pre-validates payer coverage before booking
  • Books with ≥24h lead for SNF transfers
Outputs
What it writes / routes
  • Booking action via ModivCare / Uber Health / AMR API
  • Submission row with externalRef from vendor
  • Portal pickup confirmation pushed to caregiver
Refresh trigger
When it updates
  • Disposition lock (Route choice changes viable options)
  • Family pickup confirmation in portal
  • Vendor slot confirm callback
Partners involved:ModivCare (Medicaid NEMT broker)Uber Health (rideshare healthcare program)AMR / Falck (ambulance)Twilio (vendor voice confirm)
Demo data · no PHI · mocked Epic + payer endpoints