Release of Beneficiary Information to Ambulance Providers of Repetitive Scheduled Non-Emergent Transports

Ambulance providers requesting documentation for prior authorization are reminded to ensure that the dialysis center or physician being asked for documentation has the authorization to release this information. This statement may be considered as an addition to the release:

“The purpose for this release of information is to assist in providing information required by transportation companies. It should be noted that absence of this documentation may result in the denial of the transportation request.”

Nephrologists caring for dialysis patients are reminded that per the Medicare Claim Processing Manual, provision of the data required for the certification for dialysis transport would be considered to be part of the requirements for the billing of the Monthly Capitation Payment (MCP) for that patient.

CMS Reference: Medicare Claims Processing Manual, Chapter 8 (PDF, 1.8 MB), Outpatient ESRD Hospital, Independent Facility and Physician/Supplier Claims, Section 140 Monthly Capitation Payment Method for Physicians Services Furnished to Patients on Maintenance Dialysis.