Ill. Admin. Code tit. 89, § 140.494 - Record Requirements for Medical Transportation Services
a) The record must,
at a minimum, contain a dispatcher's log and individual trip tickets that
document:
1) Identification of the client
(name, address and client number);
2) Name and address or facility name of
person or entity requesting service;
3) A copy of the Transportation
Invoice;
4) Identification of the
type of vehicle used (for example, ambulance, medicar, service car) and the
vehicle's license plate number; and
5) The name of the driver and attendant, if
applicable.
b) The trip
ticket must document medical necessity for the following:
1) Non-emergency transportation that does not
require an approval request;
2) Use
of an ambulance;
3) Administration
of oxygen;
4) Use of an attendant
by a medicar, service car or a taxicab company; and
5) Use of a stretcher by a medicar.
c) Advanced Life Support
transportation services must also maintain a copy of the Emergency Medical
Services Run Sheets or other forms as required by the Illinois Department of
Public Health.
d) In absence of
proper and complete records, including, but not limited to, failure to provide
documentation of safety training certification as required in Section
140.490(f),
payments previously made shall be recouped.
Notes
Amended at 32 Ill. Reg. 17133, effective October 15, 2008
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