Electronic Signatures Copyright St. Francois Co Ambulance District - 2013
Reason for Electronic Signatures Signatures provide the district the permission to bill. Without signatures, the call CAN NOT be billed. As of today we can no longer submit paper forms into the state of Missouri. Expected this year, we will be submitting all calls and signatures electronically to all insurance carriers. Medicaid/Medicare is already being submitted electronically. 80% of our claims fall in the Medicaid/Medicare category. This training is extremely important, as Billing Claims make up over 60% of our budgeted income.
Changes to the system: By the end of FY2013 Unless we have the CORRECT electronic signatures on file, we will NOT be able to bill for the call. Electronic Signatures for EMS Crew, Patient (Or representative(s)) and Transfer of Care Provider is mandatory on all calls. Refusal of Care will need to be documented electronically, as we are no longer ordering the refusal pads.
Few simple rules to remember. 1. You can NOT have any writing or Signatures on sections you are not utilizing. Example: If you are using Section # 3 because your patient is unable to sign DO NOT write of fill anything out in Section # 1. The computer looks for writing in the boxes, and if you have writing in multiple sections, it errors out and prevents the claim from being processed.
Few simple rules to remember. When utilizing section # 3 You need to be sure to document exactly why the patient was unable to sign. It needs to be descriptive, as the Insurance Carriers review all Section 3 Descriptions before pushing the claim through. If there is NOT supporting documentation as to why the patient did NOT sign, then they will deny the claim.
Few simple rules to remember. When using Section # 3 Be sure to have the receiving facility sign both Section # 3 and Transfer of Care sections.
Lets discuss each section. Section 1 Section # 1 This is used when the patient is able to sign. If the patient is a minor, or has a power of attorney You will need to use Section # 2 Section 1
Lets discuss each section. Section 1 Section 1 Patient Signs Here!
Lets discuss each section. Section 1 When using section # 1 Be sure to get a witness signature. This provides proof someone was there and witnessed the Patient providing Verbal and Written consent to bill their insurance. Be sure to get signatures in BOTH sub-sections
Section II (Authorized Rep) Section # 2 is used for a minor, a person with a Power of Attorney or guardian. This section will need the reason why the patient is unable to sign, the relationship drop down box of who the signature represents, their signature, their printed name and address. Be sure to fill out all boxes!
When using Section II If the patient is a minor, we need the following information of their parent/guardian: First & Last Name Social Security Date of Birth *The following information can be documented on the hospital face sheet.
Section # 3 (Amb Crew/Rec Facility) This section is utilized whenever the patient is unable to sign, and there is not an authorized representative. (This section falls under Implied Consent). You will need to have both crew members sign Section # 3 Subsection # 1 (Ambulance Crew listed as IIIA) and the Receiving Facility under Section # 3 Subsection # 2 (Receiving Facility listed as IIIB)
Section IIIA For Crew Members In Section IIIA Both crew members must sign
Section IIIB For Receiving Facility In Section IIIB The Receiving Facility must sign.
When getting Signatures.REMEMBER We must have First & Last Names & Titles Printed out in the upper portion. This applies in every section!
Refusal of Care The main signature screen wraps around to a second screen. Be sure to carefully select the appropriate Refusal of Care. The arrow in the bottom right allows you to page forward. Page Forward
Some items from Page # 1 Carry Forward to Page # 2 Carried forward from Page 1 Carried forward from Page 1 Carried forward from Page 1
Refusal of Care Refusal of care is now mandatory via electronic signature. We will no longer be using the Refusal Pads. Treatment Refusal Pat Refused to Sign is used when the patient is refusing treatment/transport, but also will not sign. During this situation, you will need to have a witness sign. Be sure to include in your narrative why you utilized this section in detail.
Refusal of Care Pat Refused to Sign can be found on Page # 1or Page # 2 Here!! Here!! Page # 2
Refusal of Care - Continued Refusal of Care Pat/Guardian This section is used when the Patient or Guardian will sign the Refusal of Care. Be sure to document thoroughly in your narrative why the refusal of care was obtained. All refusal of cares require the signature of the patient and a witness signature!
Refusal of Care Pat/Guardian Screen Be sure to get 2 Signatures On Patient and one Witness If the patient is a Minor or has a Power of Attorney, the legal representative will need to sign. They are to sign under the subsection Guardian as shown above.
Transfer of Care This section is used to document when Transfer of Patient Care occurred. Be sure to fill out the Title & Name Section. (We need first and last name of the healthcare professional assuming care of your patient) Medicaid/Medicare will audit this, so be sure to get correct spelling of names.
Be sure to Fill Out Transfer of Care Screen
When transporting prisoners. Utilize section # 3, have both crew members & receiving facility sign for the prisoner. Be sure to document the Inmate Number on the hospital face sheet. REMINDER: Scan and Attach the documentation!
Transports to the Morgue One of the most common mistakes on these type of calls is the call is marked as a Dry Run. This is NOT a dry run, it should be marked as Scene Response. Section III will need to be used, be sure to have the receiving facility (morgue) sign section IIIB and Transfer of Care.
Transports by Air In the event your patient is transferred to an Air Ambulance: DO NOT DELAY PATIENT CARE.we will obtain the signatures from the Air Ambulance Service. USE SECTION # 3A and Sign. BE SURE TO ATTEMPT TO GET PATIENT IDENTIFICATION. IF YOU DO NOT KNOW AT SCENE, MAKE PHONE CALLS PRIOR TO SUBMITTING YOUR REPORT.
When submitting your report: Get a copy of the following: Face Sheet Copy of Drivers License Copy of Insurance Card(s) Transfer Packet Paperwork Medication List(s) Patient History List(s) Other pertinent documenation New.Be sure to start getting copies and scanning in!
Treat and Releases.. Be sure to change your response type from Scene Response to Treat and Release. DO THIS FIRST, TO ELIMINATE UNNECESSARY FIELDS. Be sure to document any interventions, procedures & etc. We do bill for Treat and Releases.
Other things to remember: Always ALWAYS ALWAYS put in the Patient s SSN# first. This will allow the system to import any information entered previously. This function will override any information you have already entered, if you don t search first. Be sure to get completed transfer packets when completing Routine Transfers. Be sure nurse and/or doctors names are legible somewhere on the documentation.
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