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How to fill out the PCS FORM Click To Open/download - ATS Medical Services online
Filling out the PCS form is essential for obtaining non-emergency ambulance transportation services. This step-by-step guide will help users understand how to complete each section of the form accurately and efficiently, ensuring compliance with medical and insurance requirements.
Follow the steps to successfully complete the PCS form.
- Click ‘Get Form’ button to obtain the form and open it in an online editor.
- Complete the Patient Information section: Enter the patient’s name, date of birth, and the date(s) of transportation. If it is for a single scheduled or unscheduled transport, write the date of the transport on the first line and write N/A on the second line. For repetitive transports, enter the beginning and ending dates within the 60-day effective period.
- Answer the Bed Confinement questions accurately. Select YES or NO for both questions required within this section.
- Indicate any Medical Condition(s) at the time of transport. Mark all applicable options from the listed medical conditions and utilize the 'Other' line if necessary.
- Complete the Hospital to Hospital Transports section if applicable. This section requires marking reasons for hospital transfers and should not include personal preferences.
- Fill out the Ordering Physician’s Information and Signature section. This includes printing the name of the ordering physician, providing the NPI number, contact number, and signature. If someone other than the physician signs the form, ensure their name is printed and credentials included.
- Review all sections for accuracy and completeness. After filling out the form, save changes, download, print, or share the completed document as needed.
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