MEDICARE NEWS

Medical record reviews of Part B ambulance services continue to identify errors. This is one example of the most common error:

•Lack of a beneficiary acknowledgement form for authorization to bill Medicare for the services provided.

For detailed information, refer to:

•Medicare Benefit Policy Manuel Pub 100-02, Chapter 10,Section 20.1.2

This is why we stress so much on the need for all services to utilize the software provided to you. This is just one example why. Ever heard if it’s not documented it did not happen? That is the most common error.

Some cases it may be present but merely illegible or wrong signatory. Proper use of good electronic reporting software would resolve these errors.

If the beneficiary is truly unable to sign and no other representative available to sign on their behalf the following people may sign on their behalf:

1. The beneficiary’s legal guardian
2. A relative or other person who receives Social Security or other government benefits on behalf of the beneficiary
3. A relative or other person who arranges for the treatment or exercises other responsibility for the beneficiary’s affairs
4. A representative of an agency or institution that did not provide the , but furnished other care, services, or assistance to the beneficiary
5. A representative of the provider (which is a facility not your agency) or the nonparticipating hospital claiming payment for services it has furnished, if the provider or nonparticipating hospital is unable to have the claim signed in accordance with 42 CFR 424.36(b) (1-4)
6. A representative of the ambulance supplier who is present during an emergency and or nonemergency transport, provided that the ambulance supplier has documented in its records and maintains for at least 4 years from the date of service. This documentation should reflect why the beneficiary, representative or any other representatives of beneficiary was unavailable or not able to to sign.

Again remember Medicare does not require that the signature be obtained at time of service, but merely before submitting claim.

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