Lifetime Billing Authorizations in EMS

August 24, 2016
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Ambulance Lifetime Billing Authorizations

Billing authorization forms are necessary when billing Medicare for ambulance services.  Some forms contain language that allow ambulance patient signatures to be used for future service dates.  This language is what makes a typical billing authorization, a “lifetime” authorization.  In the past this language was inserted for provider and patient convenience, so that the patient did not need to sign a new authorization during every transport.  However, the signature requirements were updated a few years back by Medicare.

Ambulance Patient Signature Requirement

were updated to clarify when a signature was required, when it could be skipped, who could sign in the patient’s place and when.  The new rules also expanded the options for allowing an employee of the receiving / referring facility to sign for the patient.

As a result of the updated requirements a lot of training was provided to the ambulance industry by Medicare and EMS attorneys at billing and administrator’s conferences.  New forms were designed and released into the public domain and electronic charting programs even imported them for provider convenience.  Most forms were three step or three phase forms, functioning almost like a decision making tree that the EMT could use on the fly in the field.  The one subject that was not discussed the “lifetime” authorization.

Medicare Rejecting Ambulance Lifetime Billing Authorizations

Medicare auditors have been denying claims based on lifetime authorizations.  Railroad Medicare has stated in their training material for ambulance services that “lifetime” authorizations are not acceptable.  Medicare Part B has not addressed the subject directly in our local jurisdiction but Railroad and Part B Medicare are managed by the same carrier in WV, VA, NC & SC.

Medicare is working very hard to reduce payments for repetitive ambulance patients, and these are the patient claims that might rely the most on a lifetime authorization.  This is one of the reasons we encourage our clients to embrace technology in the field without apology.  Handheld devices and laptops are useful for so many reasons, documentation is only one of them.

It is our opinion that a billing authorization should be signed during every transport, even frequent flyers.  Medicare regulation and policy assumes that providers are doing this.  Lifetime authorizations may have provided some convenience to the EMT in years past, but that value seems to have been lost.  The ambulance lifetime billing authorization presents more risk than convenience when used to authorize ongoing claim submission.

If you need help locating a suitable billing authorization form, contact our office.  We have a few options that we can share with you.  PMC is an ambulance billing company, dedicated to he needs of the EMS industry for twenty plus years.

Billing office keeping you awake at night???  Call today!!! 1-800-635-7577



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