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Ambulance Medical Necessity

This recorded webinar occurred on 10/21/2024. What does Medicare use to prove a transport is medically necessary? Why is the Physician Certification Statement needed and how does it support medical necessity? What should you look for when determining if a transport meets Medicare’s medical necessity requirements? This education provides the answers to these questions. We will review your presubmitted questions and scenarios to ensure we meet your needs. We will provide: • Information on the assessment • Physician Certification Statement • Answers to your Presubmitted questions and scenarios Resources Office of Inspector General: Ambulance Services - Supplier Compliance with Payment Requirements Review https://oig.hhs.gov/reports-and-publi... WPS Advanced Life Support (ALS) Ambulance (A0427) https://med.wpsgha.com/guides-resourc... RAC Approved Topics List https://www.cms.gov/data-research/mon... MLN905364 - Complying with Medicare Signature Requirements https://www.cms.gov/mln905364-complyi... Sample Physician Certification Statement (PCS) for Ambulance https://med.wpsgha.com/forms/view/1000 Ambulance Services Center https://www.cms.gov/medicare/coverage... Ambulance Open Door Forum https://www.cms.gov/training-educatio... Medicare Benefit Policy Manual, Chapter 10 - Ambulance Services https://www.cms.gov/regulations-and-g... Medicare Claims Processing Manual, Chapter 15 - Ambulance https://www.cms.gov/regulations-and-g... Prior Authorization and Pre-Claim Review Initiatives https://www.cms.gov/data-research/mon... Ambulance Documentation Requirements https://med.wpsgha.com/guides-resourc... Professionals Ordering Ambulance Services Checklist https://med.wpsgha.com/guides-resourc... Prior Authorization for Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) https://med.wpsgha.com/guides-resourc... Physician Certification Statement (PCS) for Ambulance https://med.wpsgha.com/forms/view/1000 Chapters 00:00 Intro 03:37 Agenda and objective 05:06 Background 16:42 Question Regarding Patient's Hospital Choice 19:02 EMT Assessments 28:56 Signature and Dates 32:20 Air Transport 35:44 Physician certification statements (PCS) 47:39 Scenarios 55:21 Questions and answers 1:00:05 Resources 1:00:43 Closing comments