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Policy for Intake and Dispatch Personnel <br /> I. INTRODUCTION <br /> A.Dispatch Personnel play a vital role in NSMT's operational success and in NSMT's ability to comply with <br /> policies, procedures, complex health care laws and regulations. Dispatch Personnel are the "voice"NSMT and <br /> are the first contact patients or sources of patients (such as hospital)have with NSMT. <br /> B.NSMT has designed this Policy(the "Policy")to help you better understand the importance of your job tasks <br /> in light of these laws and regulations so that you can aid NSMT in complying with these laws and regulations. <br /> C. This Policy is in addition to any other Dispatch Personnel policies,procedures, or job descriptions. <br /> H. GENERAL DUTIES FOR INTAKE PERSONNEL <br /> A.As a Dispatch Person, you are responsible for making an initial assessment of"medical necessity" for each <br /> request for non-emergency transport before scheduling takes place. This determination is extremely important <br /> because payors generally do not reimburse NSMT for transports that are not "medically necessary". Also, <br /> inaccurate determinations of"medical necessity" may violate applicable law and/or make NSMT financially <br /> responsible for NSMT's ambulance services without recourse to the patient. In order to help you make accurate <br /> determinations of"medical necessity", you must obtain certain information during the phone call. This process <br /> should be in accordance with NSMT Operating Procedures. It is recommended that, at a minimum,the <br /> following information be requested: <br /> 1. The name of the requesting party/facility. The name and phone number of the person calling from the <br /> requesting organization; <br /> 2. The name of the primary payor and any secondary payor. (Local or regional policy may provide for <br /> additional questions regarding the payor(s)); <br /> 3. The origin and destination of the transport for the patient(important to verify addresses with the caller); <br /> 4. The reason for the transport(e.g., "patient discharged for rehabilitation post CVA" or "patient requires MRI") <br /> 5. For hospital to hospital, obtain the reason for the transfer: <br /> 6. Requires higher level of care or specialty services not available at sending facility((e.g. cardiac cath, <br /> pediatric neurology, liver transplant); <br /> B.Patient request(e.g. want to be closer to home—regular doctor does not practice at sending facility). <br /> 1. The condition of the patient that requires ambulance transportation(e,g, "immobilized fracture"); and <br /> 2. Inpatient status. <br /> C.NSMT must attempt to obtain a Physicians' Certification Statements (PCS)before it can bill Medicare for <br /> scheduled repetitive non-emergency transports and for other scheduled and unscheduled non-emergency <br /> ambulance transports of patients under the direct care of a physician. The specific requirements for a PCS <br /> depend on whether the transport is a repetitive transport or a non-repetitive transport. Dispatch Personnel must <br /> understand these requirements so that, when appropriate,they can explain them to requesting facilities and <br /> provide Operations and Billing Personnel with the information they need to comply with the PCS requirements <br /> 37 <br />