Medical Necessity
While I'm sure there are many upstanding departments operating in the Houston area, the city is notorious for Medicare Fraud. The standard set by Medicare is pretty much the standard for all insurance carriers (whether that be Medicaid, HMO, PPO, etc.) The Medicare standard is: an ambulance claim can only be billed if the condition of the patient at the time of transport suggests any lower level of transport is contraindicated (Medicare defines this as Medical Necessity). My guess, and I openly admit I'm not looking at the patient or the PCR, is that a patient that schedules a cellular phone repair appointment, could (insert sarcasm here) probably use another means of transport other than ambulance to get where they're going (like a wheelchair van or taxi cab). As long as you honestly document on your PCR the actual condition of your patient, you aren't doing anything wrong, even though your boss could end up in jail. And, by the way, if you start altering run tickets because your job is threatened or you're told to leave something off a run ticket, that would be illegal on their end to ask and on your end to comply; and you don't want to be on the bad side of the federal government. Ignorance of the law is no defense.
