Gates County Rescue & EMS in an effort to provide on going medical support to the citizens of Gates County as well as help off set the uncovered expense of providing 911 ambulance service begin providing non-emergent ambulance transport services in October 2010. This service is conducted by career part timers who staff additional ambulances needed to support the non-emergent transport schedule each day. These ambulances also support 911 services with Gates County when they are staffed and not assigned to a non-emergent transport.
In order for a patient to be transported non-emergent by ambulance the patient must have a Physician Certification Statement for Non-Emergency Ambulance Service (PCS) signed by a Physician, Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, Discharge Planner, or a Registered Nurse in order to be transported by Ambulance.
In January 2016 The Centers for Medicare & Medicaid Services (CMS) implemented a prior authorization model for repetitive scheduled non-emergent ambulance transports to test whether prior authorization helps reduce expenditures, while maintaining or improving access to and quality of care. Prior authorization does not create new clinical documentation requirements. Instead, it requires the same information necessary to support Medicare payment, just earlier in the process. Prior authorization allows providers and suppliers to address issues with claims prior to rendering services and submitting claims for payment, which has the potential to reduce appeals in the case of disputed claims. This will help ensure that all relevant coverage, coding, and payment requirements are met before the service is rendered to the beneficiary and before the claim is submitted for payment.
A repetitive non-emergent ambulance transport is defined by CMS as a medically necessary ambulance transportation that is furnished 3 or more times during a 10-day period; or at least once per week for at least 3 weeks. Repetitive ambulance services are often needed by beneficiaries receiving dialysis or cancer treatment.