Documents

Important Documents from our Information Library

Preparing for Ambulance Billing
PreparingForBillingDetailedpdf


Required Information for Ambulance Billing
EMSRequiredBillingItems.pdf


Provider Information Form
SDW_Provider_Information_Form.pdf


Ambulance Transport Level of Service Categories
ServiceCategories-Definitions.pdf


Deposits, Payments & Local Banks
DepositingPayments.pdf


Federal Poverty Guidelines (with Alaska)
2015_Federal_HHS_Poverty_Guidelines.pdf
2016_Federal_HHS_Poverty_Guidelines.pdf
2017_Federal_HHS_Poverty_Guidelines.pdf

Documentation & Billing Training Materials
   PowerPoint Presentation
        documentation_and_billingwebver.pptx  (3MB)
   Presenter Notes
      pdf_docs/doc_and_billing_notes.pdf
   Handouts
      pdf_docs/doc_and_billing_handouts.pdf

Website Links

Important Links to Useful Information

Page, Wolfberg and Wirth EMS Law
www.pwwemslaw.com

Sample Medicare & Billing forms
www.pwwemslaw.com/resources/forms/medicare-and-billing-related-forms

Medicare Provider Application
www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads/cms855b.pdf

Medicare Electronic Funds Authorization Agreement
www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads/cms588.pdf

Medicare Learning Network--Ambulance Fact Sheet
www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN

Medicare Compliance Tips for Ambulance Services (Emergent and Non-Emergent)
www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN

Medicare Ambulance Claims Manual
www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c15.pdf

Health & Human Services Guidance for Ambulance Suppliers (HIPAA Rules)
www.oig.hhs.gov/fraud/docs/complianceguidance/thirdparty.pdf

Noridian
www.noridianmedicare.com