Billing Compliance Issues for Ambulance Services-Signature Requirements

This is the second article in the series dealing with common medical billing compliance issues for ambulance services.

Medicare and other payers have very strict and specific requirements regarding patient signatures when submitting ambulance claims. Not only are valid signatures required by Medicare before a claim can be submitted for payment, other payers may have other signature requirements as well. Claims that will be submitted to motor vehicle carriers likely have a specific assignment of benefit form that must be submitted before the claim is processed for payment.

If the patient is physically or mentally incapable of signing the appropriate forms, the rules allow for certain individuals to sign on behalf of the patient, such as a family member, power of attorney, caregiver. or the representative of an institution where the patient resides. In the cases where the patient is not ale to sign on their own behalf, the reason must be clearly documented in the medical record.

If the patient is physically and/or mentally incapable of signing, and there are no other authorized representatives available to sign on the patients behalf, Medicare rules allow for what is called the "ambulance exception". To use the "ambulance exception", both the crew member and an authorized representative of the receiving facility may sign. Medicare regulations indicate, in order to utilize the "ambulance exception", both crew and facility signatures must be contemporaneous or at the time of service.

As part of a sound revenue cycle process, crew members should make every effort to obtain a valid signature at the time of service. Although signatures can be obtained at a later date, this significantly increases the amount of time to submit a proper claim to the insurance carrier for payment. It creates a significant amount of work for the ambulance biller and increases the overall cost of processing the claim. Medicare regulations allow for lifetime signatures, however as a best practice these should be avoided and only used if absolutely necessary.

The billing and compliance specialists at Summit Public Safety can assist your organization with navigating confusing and complex regulations for proper patient signatures. Contact us today for a comprehensive evaluation of your processes and reviews of your claims to ensure compliance with regulations.