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Printed Date: 9/22/2015
Medicare requires the signature of the beneficiary, or that of his or her representative, for each date of transport, for both the purpose of accepting assignment and submitting a claim to Medicare. If the beneficiary is unable to sign because of death or a mental or physical condition, the following individuals may sign the claim on behalf of the beneficiary:
A representative of the ambulance provider or supplier who is present during an emergency and/or nonemergency transport. In this circumstance, ambulance suppliers may submit a claim to Medicare if the following documentation is obtained and maintained for at least four years from the from the date of service for each date of transport:
A provider/supplier (or his/her employee) cannot request payment for services furnished except under circumstances fully documented to show that the beneficiary is unable to sign and that there is no other person to sign.
Medicare does not require that the signature to authorize claim submission be obtained at the time of transport for the purpose of accepting assignment of Medicare payment for ambulance benefits. When a provider/supplier is unable to obtain the signature of the beneficiary, or that of his or her representative, at the time of transport, may obtain this signature any time prior to submitting the claim to Medicare for payment.
If the beneficiary/representative refuses to authorize the submission of a claim, including a refusal to furnish an authorizing signatures, then the ambulance provider/supplier may not bill Medicare, but may bill the beneficiary (or his/her estate) for the full charge of the ambulance items and services furnished. If, after seeing the bill, the beneficiary/representative decides to have Medicare pay for these items and services, then a beneficiary/representative signature is required and the ambulance provider/supplier must afford the beneficiary/representative this option within the claims filing period.
These requirements apply to both emergent and non-emergent ambulance transports.
Code of Federal Regulations, 42 CFR 424.36
CMS Internet Only Manual, Publication 100-2, Chapter 10, Section 20.1.2 (PDF, 164 KB)
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Last Updated: 09/09/2019