The Billing section of Billing, Outcomes & External Reporting gives the user the ability to capture billing information for the incident. The following are included in the Billing section:

• Primary Payment Method* - The primary method of payment or type of insurance associated with this EMS encounter.

• Transport Type* - Non-Emergency, Scheduled Non-Emergency, Unscheduled, Under direct care of a physician, other. 
  

• PCS Form - Indication of whether a physician certification statement (PCS) is available documenting the medical necessity or the EMS encounter. If yes, the following are required:
  

  • Date PCS Signed - The date the Physician Certification Statement was signed.

  • Signed by - The type of healthcare provider who signed the Physician Certification Statement.

  • First Name of Signature - The first name of the healthcare provider who signed the Physician Certification Statement.

  • Last Name of Signature - The last name of the healthcare provider who signed the Physician Certification Statement.

  • Copy of PCS - A digital copy of the PCS form.

• Response Urgency - The urgency in which the EMS agency began to mobilize resources for this EMS encounter.

• Patient Transport Assessment - Documentation of the patient's transport need based on mobility and/or physical capability.

• Specialty Care Transport Care Provider Type - Documentation to show the patient care provided to the patient met the Specialty Care Transport Base Rate requirements.

• Ambulance Transport Reason - The CMS Ambulance Transport Reason Code for the transport.

• Round Trip Purpose Description - Description providing the purpose of the round trip EMS transport.

• Stretcher Purpose Description - Documentation providing the reason for use of a stretcher in the EMS patient transport.

• Ambulance Conditions Indicator - Documentation indicating the condition(s) requiring an ambulance.

• Mileage Closest Hospital - The mileage to the closest hospital facility from the scene. Documented only if the patient was transported to a facility farther away than the closest hospital.

• ALS Assessment Perform Warranted - Documentation that the patient required an ALS assessment and it was performed.

• CMS Service Level* - The CMS service level for this EMS encounter.

• CMS Transport Indicator - The CMS Ambulance Fee Schedule Transportation and Air Medical Transportation Indicators are used to better describe why it was necessary for the patient to be transported in a particular way or circumstance.

• Reason for Physician Certification Statement - The reason for EMS transport noted on the Physician Certification Statement.

• Transport Authorization - Prior authorization code provided by the insurance carrier/payer.

• Prior Authorization Payer - The Payer who has provided the Prior Authorization Code.

• Payer Type - Payer type according to X12 standard.
  

Emergency Department Disposition - The known disposition of the patient from the Emergency Department (ED).

Hospital Disposition - The known disposition of the patient from the hospital, if admitted.

Hospital Admission Date & Time - The date/time the patient was admitted to the hospital.

Hospital Discharge Date & Time - The date/time the patient was discharged from the hospital.

Neurological Outcome Hospital Discharge - The level of cerebral performance of the patient at the time of discharge from the Hospital.

Outcome at Hospital Discharge - The patient's functional status at time of hospital discharge.

Emergency Department Chief Complaint - The patient's reason for seeking care or attention, expressed in the terms as close as possible to those used by the patient or responsible informant.

First ED Systolic Blood Pressure - The first recorded Emergency Department Systolic Blood Pressure.

Total ICU Length of Stay - The total number of patient days in any ICU (including all ICU episodes).

Total Ventilator Days - The total number of patient days spend on a mechanical ventilator (excluding time in the operating room).

Emergency Department Recorded Cause of Injury - The documented cause of injury from the Emergency Department record.

Hospital Diagnosis - The hospital diagnosis of the patient associated with the hospital admission.

Emergency Department Diagnosis - The practitioner's description of the condition or problem for which Emergency Department services were provided.