Purpose

1. To explain how to complete the Billing, Outcomes & External Reporting section of an ePCR.
   
   

Related Articles

1. Completing an ePCR - 1. Response
2. Completing an ePCR - 2. Information
3. Completing an ePCR - 3. Assessment
   
4. Completing an ePCR - General Assessment
5. Completing an ePCR - 4. Vital Signs
   
6. Completing an ePCR - 5. Treatments
   
7. Completing an ePCR - 6. Billing, Outcomes & External Reporting (This Article)
   
8. Completing an ePCR - 7. Disposition & EMS Narrative
   
9. Completing an ePCR - 8. Signatures

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Background

The First Due ePCR workflow is designed to follow the following a typical EMS incident:

1. Response
   
2. Information
   
3. Assessment
   
4. Vital Signs
   
5. Treatments
   
6. Billing, Outcomes & External Reporting
   
7. Disposition & EMS Narrative
   

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Directions

1. Navigate to Incident Documentation > EMS Incident List.
   
   
   
   
   
   
   
2. Once you have completed the Assessment section of an incident, select the Vital Signs section from the menu of the left side of the ePCR.
   
   
   
   
   
   
   
   
   
   

   IMPORTANT: All NEMSIS required fields are notated with an asterisk (*). Depending on your state protocols, additional information could be required.
   
   
   
   
3. The Consumables section of Billing, Outcomes & External Reporting is used to document any consumable items and quantities used on an incident. Select the  button to notated the item and quantity. Select the  button when complete. 
   
   
   
   
   
   
   
   
   
   
4. 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:
   
1. Primary Payment Method* - The primary method of payment or type of insurance associated with this EMS encounter.
2. Transport Type* - Non-Emergency, Scheduled Non-Emergency, Unscheduled, Under direct care of a physician, other. 
   
3. 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:
   
1. Date PCS Signed - The date the Physician Certification Statement was signed.
2. Signed by - The type of healthcare provider who signed the Physician Certification Statement.
3. First Name of Signature - The first name of the healthcare provider who signed the Physician Certification Statement.
4. Last Name of Signature - The last name of the healthcare provider who signed the Physician Certification Statement.
5. Copy of PCS - A digital copy of the PCS form.
4. Response Urgency - The urgency in which the EMS agency began to mobilize resources for this EMS encounter.
5. Patient Transport Assessment - Documentation of the patient's transport need based on mobility and/or physical capability.
6. Specialty Care Transport Care Provider Type - Documentation to show the patient care provided to the patient met the Specialty Care Transport Base Rate requirements.
7. Ambulance Transport Reason - The CMS Ambulance Transport Reason Code for the transport.
8. Round Trip Purpose Description - Description providing the purpose of the round trip EMS transport.
9. Stretcher Purpose Description - Documentation providing the reason for use of a stretcher in the EMS patient transport.
10. Ambulance Conditions Indicator - Documentation indicating the condition(s) requiring an ambulance.
11. 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.
12. ALS Assessment Perform Warranted - Documentation that the patient required an ALS assessment and it was performed.
13. CMS Service Level* - The CMS service level for this EMS encounter.
14. 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.
15. Reason for Physician Certification Statement - The reason for EMS transport noted on the Physician Certification Statement.
16. Transport Authorization - Prior authorization code provided by the insurance carrier/payer.
17. Prior Authorization Payer - The Payer who has provided the Prior Authorization Code.
18. Payer Type - Payer type according to X12 standard.
    
    
    
    
    
    
    
5. EMS Condition Codes can also be documented in this section. Select the  button to add a new entry then select .
6. The Outcome section of Billing, Outcomes & External Reporting documents patient outcomes. This section includes the following:
   
1. Emergency Department Disposition - The known disposition of the patient from the Emergency Department (ED).
2. Hospital Disposition - The known disposition of the patient from the hospital, if admitted.
3. Hospital Admission Date & Time - The date/time the patient was admitted to the hospital.
4. Hospital Discharge Date & Time - The date/time the patient was discharged from the hospital.
5. Neurological Outcome Hospital Discharge - The level of cerebral performance of the patient at the time of discharge from the Hospital.
6. Outcome at Hospital Discharge - The patient's functional status at time of hospital discharge.
7. 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.
8. First ED Systolic Blood Pressure - The first recorded Emergency Department Systolic Blood Pressure.
9. Total ICU Length of Stay - The total number of patient days in any ICU (including all ICU episodes).
10. Total Ventilator Days - The total number of patient days spend on a mechanical ventilator (excluding time in the operating room).
11. Emergency Department Recorded Cause of Injury - The documented cause of injury from the Emergency Department record.
12. Hospital Diagnosis - The hospital diagnosis of the patient associated with the hospital admission.
13. Emergency Department Diagnosis - The practitioner's description of the condition or problem for which Emergency Department services were provided.
    
    
    
    
    
    
    
    
7. In the Outcome section, Hospital and Emergency Department Procedures can also be documented. Select  to include a new procedure. 
   
   
   
   
   
   
   
8. The External Reporting section of Billing, Outcomes & External Reporting allows external reports to be identified or attached to the ePCR. Select the  button to include an external report. Once added, select the  button.