Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 201 - Transportation Services
Chapter 1 - Emergency Transportation Services
Rule 23-201-1.6 - Documentation
Universal Citation: MS Code of Rules 23-201-1.6
Current through September 24, 2024
A. Providers must maintain required documentation in accordance with Miss. Admin. Code Part 200, Rule 1.3, and must maintain auditable records to substantiate claims submitted to the Division of Medicaid or designated entity.
B. Ambulance providers must maintain documentation in the medical record including, but not limited to:
1. Time the emergency was
reported,
2. The person reporting
the emergency,
3. Nature of illness
or injury,
4. Documentation of
medical necessity of emergency ambulance services,
5. Documentation of medical necessity for the
level of care provided,
6.
Beneficiary's condition including, but not limited to:
a) Vital signs,
b) Level of consciousness, and
c) Ability to sit, stand, and/or
walk.
7. Location of
pick-up, time of pick-up, location of destination, and time of
arrival,
8. For ground ambulance
providers, the recording of odometer reading at pick-up and point of
destination or the mileage as documented by an onboard global positioning
system (GPS) which can store and retrieve trip data,
9. Detailed record of all services and
treatments administered to the beneficiary,
10. Documentation that the beneficiary was
taken to the closest appropriate facility or the reason that nearest
appropriate facility was unable to accept the beneficiary causing the
beneficiary to be taken to another appropriate facility, and
11. Trip ticket that indicates the date,
mileage, crew, origin, destination, and type and level of ambulance service
provided.
C. Ground ambulance providers must document the following to receive reimbursement for mileage including, but not limited to, the following:
1. The vehicle's actual odometer readings at
pick-up and destination sites or the mileage as documented by an onboard GPS
system which can store and retrieve trip data, and
2. Documentation that the beneficiary was
taken to the closest appropriate facility able to provide treatment.
42 C.F.R. § 422.113; Miss. Code Ann. §§ 41-59-41, 43-13-117, 43-13-121.
Disclaimer: These regulations may not be the most recent version. Mississippi may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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