By The health professional`s signature must be handwritten, but the rules allow for an electronic signature, which is a handwritten signature produced by computer. The acceptable electronic signature would be where the health professional signs with an electronic pen on a computer signature pad that generates the facsimile signature on the CPS, rather than the physician signs with an ink pen on paper. In other words, it would not be acceptable to sign the LPN floor nurse who does not take on the specific role of discharge planner. However, the LPN, which has a leave planner function, would be an acceptable signature. The PCS is required for all non-emergency Medicare transfers. Its purpose is to certify the medical necessity of non-urgent patient transport. The mere existence of the signed medical certificate does not prove that the transport was medically necessary and does not exempt the ambulance provider from meeting all other coverage documentation criteria. Ambulance employees are not permitted to complete this form. PCS must be completed before the transport can be deployed.
Therefore, “Suzy Smith, RPN, Leave Planner” would be an acceptable signature for CPS as long as that person`s title and function are well defined and there is a proven track record of this person occupying a specific “leave planner” role at the facility you are serving for transportation, preferably with that specific title and job description. All PCS forms for all patients require a physician`s signature. The only acceptable solutions to a physician`s signature are the signatures of a physician assistant, registered nurse, certified nurse, discharge planner or resident of a teaching hospital. In all cases, the ambulance provider must keep the appropriate documents and produce them upon request. If the medical record does not contain a valid CPS or documentation of the attempt to obtain it upon request, the ambulance service will be rejected. The existence of the signed certificate or signed return receipt does not in itself prove that the ambulance was medically necessary. All other program criteria must be met for payment to be made. In these cases, the PCS must be signed by the patient`s treating physician. For Medi-Cal, transportation is only covered if the patient`s medical and physical condition does not allow him to travel by bus, passenger car, taxi or any other means of public or private transport. An unacceptable signature would be a signature that is an “electronic signature” generated by password and printed on the page in some way as “electronically signed”. From now on, use the updated Doctor`s Attestation Declaration (PCS) form to document a member`s specific transportation restrictions due to a medical condition, and request non-medical transportation (NMT) or non-emergency transportation (NEMT) for Medi-Cal members.
Finally, it is important for this discussion that the physician who signs the PCS always dates his signature. This is a must! The date on which the person signs the PCS must be indicated next to the signature, and this field is separate from the delivery/transport date indicated at the top of the PCS document, as is the case with common PCS documents that are widely used in the ambulance industry today. We recommend that signers be asked to sign legibly if possible, but if this is not possible, that the signer always print their name and credentials on the page. Signatures must be legible to be accepted. If a signature is illegible (looking at the signature does not reveal the identity of the signer, but only by visualization), it is important that the name is always printed next to the signature. The best way to cover this is for the undersigned physician to always print their name next to a signature, legible or illegible, and for that person to provide their credentials. PCS for scheduled/repeated transports can only be signed by a doctor. Period! It is always best for signatories to sign with their full first and last name, but signing with a first and last name with the name nearby would be acceptable. Physicians or D.O. are the only health care professionals who can sign a DBS for a patient who is transported at least three times over a ten-day period or once a week for three consecutive weeks.
No other person can sign an PCS for the transport of these patients. A “discharge planner” is a person, usually in an institutional setting, who holds the title that defines his or her place in the system. For example, while the regulations do not allow authorized general practitioners to sign a CPS, it is possible for an RPN in the position of hospital discharge planner to sign the CPS, but not within the scope of the LPN, but in their role as designated discharge planner. The same scenario would apply to a social worker. DBS for unplanned/non-repetitive transport may be signed by the following healthcare professionals as long as the healthcare professional has direct knowledge of the patient`s general condition. The person who signs the CPS, other than a physician (MD or DO), may be a registered nurse (RN), a certified nurse (CNS), a physician assistant (PA), a nurse (NP) or a “discharge planner”. When signing, it is important that the doctor signs his name legibly and prints his level of certification as described above. Keep in mind that Medicare requires a PCS to be purchased and stocked for each non-emergency routine shipment. The difference between using the PCS for repetitions and non-repetitive is when the PCS is received (before transport for repetitives) and who can sign (doctors must sign repetitives). Providers are encouraged to access the CHSP online provider portal at www.CAHealthWellness.com for real-time information, including eligibility verification, claims status, pre-approval status, plan summaries, and more.
If you have any questions about the information contained in this update, contact the CSDP at 1-877-658-0305. In our last blog post, we introduced new rules regarding repetitive transportation and the implementation of the Physician Certification Statement (PCS). This article mainly focuses on how to make sure that the person signing for the PCS you received is correct.