Medicare has strict regulations §424.36 for all providers including ambulance services to submit claims to Medicare. One of these regulations is the requirement to obtain a beneficiary’s (patient) signature to submit a claim to Medicare. Medicare is the largest payer and compliance with their regulations is critical to the survival of your ambulance service.
Medicare requires a beneficiary’s signature for every claim submitted. The only exception is when the patient is physically or mentally incapable of signing. The important part of that statement for every EMS provider to understand is “incapable of signing” doesn’t mean they are not present to sign when the chart is completed. When charts go through the review process the chart must support the reason why the patient couldn’t sign. On every assignment of benefits form the EMS provider must provide the reason why the patient couldn’t sign.
When a patient is physically or mentally incapable of signing there is an acceptable list of alternatives. A signature from one of the acceptable alternatives must be accompanied by an acceptable form of secondary verification. Secondary verification includes a copy of any of the following: a hospital registration/face sheet, or other internal hospital records.
Who can sign when the patient is physically or mentally incapable of signing? On every assignment of benefits form there is a list of acceptable signers. A signature from one of these signers accompanied with a hospital face sheet/registration form will allow you to submit a claim to Medicare.
- Patient’s legal guardian.
- Relative or other person who receives social security or other governmental benefits on behalf of the patient.
- Relative or other person who arranges for the patient’s treatment or exercises other responsibility for the patient’s affairs.
- Representative of an agency or institution that did not furnish the services for which payment is claimed (i.e., ambulance services) but furnished other care, services, or assistance to the patient.
Medicare reimbursement is the heartbeat of your organization. This is why its so important that all your providers understand the Medicare regulations.
If you’re looking for training for your staff or you need help understanding these regulations, please reach out to us at firstname.lastname@example.org.