There are countless number of patients who get transported via ambulance who don't need one. Don't give me that excuse please. These people get told by some family member how much money they could make taking MRS. TINKELBOTTOMS to dialysis so they start their own ambulance company with a bunch of EMTs who play dress up for a while until slowly but surely, the rules start getting bent a little bit to eventual full blown fraud. I'm not discounting companies that do the right thing, but Medlife my friend, was doing some dastardly things and they got shutdown for it. Not everything has a paper trail.
Trust me when I tell you there is plenty of paper trail. There is regular audit. Yes i am sure rules get bend a little but if they committed total fraud they would be in the news like Alpha Ambulance was.