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Documents

Important Documents from our information Library

Preparing for ambulance billing
PreparingForBillingDetailed_000.pdf

Required Information for ambulance billing
EMSRequiredBillingItems.pdf

Provider information form
Provider Information Form.pdf

Ambulance transport level of service categories
ServiceCategories-Definitions.pdf

Deposits, Payments & Local Banks
DepositingPayments.pdf

Federal Poverty Guidelines (with Alaska)
2009-2010_Federal_HHS_Poverty_Guidelines_doc.pdf

Federal Register - Extension of 2009 Poverty Guidelines
09extensionfedreg.pdf

Important website Links to useful information:

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

Patient Signature forms
www.pwwemslaw.com/content.aspx?id=326

Medicare provider application
www.cms.hhs.gov/cmsforms/downloads/cms855b.pdf

Medicare electronic funds authorization agreement
www.cms.hhs.gov/cmsforms/downloads/cms588.pdf

Medicare ambulance claims manual
www.cms.hhs.gov/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