New PCS Form for Non-Emergency Ambulance Transfers Now Available

December 4, 2018

MEMORANDUM

New PCS Form for Non-Emergency Ambulance Transfers Now Available

The Illinois Department of Healthcare and Family Services (HFS) has made available the updated Physician Certification Statement (PCS) form that a hospital must complete and provide to an ambulance provider prior to transport of a non-emergency patient. Hospitals must have this new form implemented by Feb. 1, 2019.

This form was developed in collaboration with IHA as part of the enactment of Public Act 100-0646. HFS issued a provider notice regarding the PCS on Nov. 21. Detailed information about new requirements for hospitals can be found in an August IHA memo.

The updated PCS requirements are in response to challenges that ambulance providers have had in receiving a correct or completed PCS from some hospitals. The PCS is an important document for ambulance providers, particularly when transporting Medicaid patients as many Medicaid Managed Care Organizations and HFS will deny the ambulance provider’s claim without a completed PCS.