Criteria for PAN, McPAN, and PCS

AngelTrack automatically decides whether each dispatch needs a PAN, McPAN, and/or PCS, based on the circumstances of the call and the patient's insurance on file.

The criteria used in making this determination are as follows.


Criteria for 'Emergent'

A trip is emergent if any of the following are true:

This is how AngelTrack implements the CMS regulation which states:

An emergency response is one that, at the time you are called, you respond immediately. A BLS emergency is an immediate emergency response in which you begin as quickly as possible to take the steps necessary to respond to the call.

Prior Authorization Number [PAN]

AngelTrack reports that a dispatch needs a prior authorization if all of the following are true:

When all of those conditions are met, then it is almost certainly necessary to submit a prior authorization request.

AngelTrack expects to receive a copy of the request or the reply, with or without a scan of the document. Until such record is created, AngelTrack will report that the dispatch still needs a prior authorization.


Medicaid Prior Authorization Number [McPAN]

When AngelTrack is configured to track Medicaid prior authorizations, it will report that a dispatch needs a McPAN if all of the following are true:


Physician Certification Statement [PCS]

PCS documents protect your company in case an audit raises questions about the medical necessity of your BLS+ transports.

AngelTrack reports that a dispatch needs a PCS document if all of the following are true:

When all of those conditions are met, then a PCS document is almost certainly necessary. To learn more about PCS documetns and their tricky legal requirements, read the PCS Requirements Guide.

Collection of PCS by crews while on-scene

When the above criteria suggest that a dispatch needs a PCS document, and no such document is yet recorded in AngelTrack, then AngelTrack will prompt the crew to collect one while on-scene.

Whether this prompt is also a demand (required in order to send their run report onward to QA) is determined by your PCS completion mode setting. Depending on that setting and on the circumstances of the transport, AngelTrack may permit a one-shot PCS document to be signed by a PA, NP, CNS, RN, or discharge planner. In that case it is usually quick and easy to get a PCS signed during patient pickup.

Thanks to 2015 revisions to Medicare regulations, AngelTrack can collect electronic signatures on electronic PCS forms. This means a crew member can load the form on their mobile device, and then just pass the device to the discharge planner or LVN or whoever to fill out. The mobile device must have a touchscreen and GPS capability.

You can also use old-fashioned paper PCS forms, and use a mobile device photograph them into AngelTrack while on-scene. Or the paper forms can be carried back to headquarters for scanning. What happens to the paper form afterward is a matter for you to dictate in company policy.


Document Requirements Chart

This chart visualizes the documentation requirements for different insurance types, for non-emergent dispatches that are marked ☑ Bill insurance:

Patient insurance
(primary or secondary)
Documents needed
Medicare ✓ PCS
✓ PAN if all of the following are true:
  • Medicare is the primary insurance;
  • the service provided is BLS+;
  • the priority is "Scheduled"; and
  • you have ticked the ☑ Medicare requires prior authorization for non-emergent transport checkbox under Preferences.
Medicaid ✓ PCS if the PCS Completion setting is "Always"
✓ McPAN if ☑ Medicaid requires prior authorization for non-emergent transport is checked
Private ✓ PAN if the Private insurance policy is the primary
✓ PCS if the PCS Completion setting is "Always"
Workers' Comp ✓ PAN if the Workers Comp policy is the primary
✓ PCS if the PCS Completion setting is "Always"
Other government coverage ✓ PAN if the Other Government policy is the primary
✓ PCS if the PCS Completion setting is "Always"
[Not recorded] ✓ PCS, in case the patient turns out to have Medicare

Using the Prior Authorization Queue to track missing documents

The Prior Authorization Queue is designed specifically to help you identify and track down missing PANs, McPANs, and PCS documents. The queue uses the above rules, plus filters for date range and originating facility, so that you can quickly resolve all missing documents for each contracted facility with just one phone call.

To learn more, read the Prior Authorization Guide.


Collection and Storage

You don't need a copy of the actual document in order to tell AngelTrack that it has been filed; Billers are permitted to upload documents to AngelTrack without providing any scanned images. However, it is better if you do obtain a copy of it and upload a scan to AngelTrack: that way it can appear in the run reports of all applicable dispatches, ensuring that they are approved by the insurance carrier.



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