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Documentation Guide

MILEAGE TRACKING:

Use the trip odometer to track mileage to the 10th of a mile.

Medicare / Medicaid requires a decimal point.

DO NOT LOG THE PRIMARY ODOMETER MILEAGE

Reset the trip odometer BEFORE TRANSPORT or once staged at venue.

Start mileage should always be 0.0 in WARDS and in the narrative.

Log into WARDS and create your patient file.

Run number format: 

T = TRANSPORT -           T-MMDDYYYY-Last Name

NT = NO TRANSPORT -  NT-MMDDYYYY-Last Name

I = INTERCEPT -              I-MMDDYYYY-Last Name

IFT = INTERFACILITY -    IFT-MMDDYYYY-Last Name

An approved run number format must be used to identify to our billing company which 

runs should be billed or ignored. Improper formatting will be rejected and corrections will have to be made by the member who created the run.

Example: 

2019-07-09.png

Report Requirements

  1. Patient Name

  2. D.O.B.

  3. SS Number

  4. Billing Address

  5. Phone Number

  6. Pick up location & Address

  7. Pick up time

  8. Destination & Address 

  9. Drop off time

  10. Vitals

  11. Assessment

  12. R-CHART Narrative

  13. Total mileage

  14. Transferred care to

Paperwork Requirements​

  1. Signed HIPAA

  2. Hospital FIN (Face Sheet)

  3. Insurance Info (May be on the face sheet)

  4. Completed Narrative

  5. Completed WARDS Report

  6. Scan or Store Documents​

SAMPLE - Narrative Template - Copy/Paste into WARDS

​

R: (Response) Great Lakes EMS Inc was on site providing ambulance service to a a venue.
Unit 3Z** was staffed at the ALS or BLS level for transport.
EMS Crew:  Your Name EMT-? and Partner Name - EMT-?

 

Mileage at Origin 0.0

 

C: (Chief Complaint) - 

 

H (History) - Dispatched to said venue for these reasons and who called.

​

A (Assessment) - Pain, vitals, GCS, etc, does not hurt to include multiple assessments including your rapid trauma in the field then your detailed assessment in the ambulance.

​

Rx (Rendered Treatment) -  Position of comfort, patient monitoring, ---- monitor oxygen, vitals. (etc etc etc what you did)

​

D (Destination) - The patient was transported to?  HOSPITAL. The destination was determined by protocol and proximity and patient acuity.

​

 

HIPAA signed by patient or guardian / PATIENT NAME, witnessed by EMT NAME AND LICENSE LEVEL

 

Arrival at destination 00:00  

​

Mileage 000.0

HIPAA Example: 

SECTION I -    Signed by the patient.

SECTION I -    If minor child: PARENT SIGNS.

SECTION I -    EMT Should sign as a witness.

SECTION II -   Why patient is not signing.

SECTION II -   Legal guardian, spouse or POA. >18

SECTION III -  Signed by EMS and Hospital staff. 

HIPAA DEFINED CLICK HERE for details. 

HIPAA GLEMS 2019 WEB SAMPLE.jpg
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