![#1- Illegible Signatures
Medicare requires hand written signatures to be legible and
authenticable by the ordering practitioner
Mainly attributable to two factors:
• Short on time –
– Staff and Physicians simply don’t slow down and take time
needed in order to produce a legible signature, or print their
name
• They are unaware of the requirement
– Many practitioners simply don’t know what is
required of them when signing documents
Reference: CMS “Medicare Program Integrity Manual” (Publication [Pub.] 100-08), Chapter 3, Section 3.3.2.4
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The Seven Most Common PCS Errors - and how to fix them
- 1. The Seven Most Common PCS Errors and how to avoid them www.PCSForm.com © 2013 Intellidocs, LLC
- 2. #1- Illegible Signatures Medicare requires hand written signatures to be legible and authenticable by the ordering practitioner Mainly attributable to two factors: • Short on time – – Staff and Physicians simply don’t slow down and take time needed in order to produce a legible signature, or print their name • They are unaware of the requirement – Many practitioners simply don’t know what is required of them when signing documents Reference: CMS “Medicare Program Integrity Manual” (Publication [Pub.] 100-08), Chapter 3, Section 3.3.2.4 © 2013 Intellidocs, LLC
- 3. #2 – Non-standard Abbreviations While collecting a complete picture of a patient’s medical history is very important in the reimbursement process, use of non-standard abbreviations can delay claim payment. • Some abbreviations are “banned” by JCAHO – Likely to be avoided by most healthcare providers • Others may be poor practice, particularly when attempting to communicate clear necessity for ambulance transport. “Patient requires ambulance transport by stretcher due to bilateral below the knee amputations, altered mental status, and end-stage renal disease” Rather than – “Pt. hx of BBKA, AMS, ESRD” Reference: http://www.jointcommission.org/standards_information/npsgs.aspx © 2013 Intellidocs, LLC
- 4. #3 – Signature not dated properly Date is either missing, clearly not affixed at signing, or pre-dated • Again, attributable to neglect or ignorance – Short on time – Unaware of the requirement • In general, all PCS documents should be signed on the date of service, or up to 21 days following © 2013 Intellidocs, LLC
- 5. #4 Insufficient Background Information This mistake is easily made by those not routinely ordering ambulance services • In order to stand the highest likelihood of reimbursement, PCS documents should be completed with as much medical history and pertinent facts as possible • It’s not enough to say what the patient’s history is, but also why those conditions necessitate ambulance transport – “Patient requires continuous oxygen administration for saturation reading consistently below 95% and is unable to self-administer due to Left side hemiparesis following CVA Instead of - – “Patient on O2 at 3 LPM Nasal Cannula” © 2013 Intellidocs, LLC
- 6. #5 – Too much information is required This isn’t a problem with the provider as much as it is with your service’s form. • Some services request extraneous information on PCS documents, i.e. Medicare Number, SSN, etc. • Providers simply “wear out” and fail to complete the critical portions in favor of non-critical portions – Keep your form simple, concise, and only require information that establishes identity or necessity © 2013 Intellidocs, LLC
- 7. # 6 – Missing Credentials While it is easily overlooked, it is vital that the signer’s credentials are clearly marked • Again, credentials must be legible • Use proper credentials instead of common terms – – “MD” or “DO” instead of “Doctor” – “RN” instead of “Nurse” or even “Nursing Supervisor” © 2013 Intellidocs, LLC
- 8. #7 – Inappropriate Signer Often misunderstood or mistaken, but Medicare Guidelines are clear on who may sign a PCS Remember – • MDs or DOs are the ONLY providers allowed to sign for necessity of a repetitive patient • LPNs may not sign unless their primary job function is Discharge Planner • A PCS form is certification of a Physician’s determination that ambulance transport is necessary © 2013 Intellidocs, LLC • MD or DO • Physician Assistant • Clinical Nurse Specialist • Nurse Practitioner • Registered Nurse • Discharge Planner
- 9. To learn more about Physician Certification Statements for ambulance transport, or our electronic system for collecting more accurate PCS documents, please visit us at: www.PCSForm.com © 2013 Intellidocs, LLC