The problem of the PCS and customer service.

[Aidey]

So we are having a problem around these parts, and I'm looking for advice on how to fix it.

A common complaint from our facilities is that we are asking "why are you sending this person to the hospital?" or "Why did you call the ambulance". They have indicated that these questions are being asked outside of the clinical report the staff give.

I instantly knew why this happens, and what the problem is, the PCS forms are NEVER filled out properly. Ever. Usually the patient demographic information is mostly filled out, and it is signed. Part of the time the section asking why the patient can't travel by other means is kind of filled out, and usually the section asking them to explain what makes the ambulance necessary is blank. A good amount of the time when something is written in either section it is one or two words, "Dizzy" or "O2" or "Can't walk", without any further explanation.

I would like to think I am polite, but about 8/10 times I have to get the PCS fixed the staff* are pissy about it. When I brought up the fact that if the PCS forms were filled out properly there would be less attitude problems I was informed that we are the ones who have to do better.

So, I'm looking for suggestions on how to address this with management. When doing some poking around I found a "How to fill out a PCS" guide that is a few pages long and and explains how to fill out each section, line by line.

I want to suggest that when our business relations guy does his rounds he drops off copies of this to all the facilities, along with a nice letter explaining why it is so important that it is filled out thoroughly and explaining that we (the ambulance people) are not allowed to fill them out ourselves.

I'm not sure if that is the best option, and was wondering how you guys all address the PCS issue at your companies.



* Both hospital and SNF.

 

[MediMike]

I'd do my best to make it perfectly clear to the staff that without a properly filled out PCS there will be significant administrative difficulties regarding payment for the transport, as well as the fact that an improperly or faked PCS will result in incredibly huge fines for the facility. (In a polite and tactful manner of course) Also if they have an issue with it...well they could probably learn to get over it

 

[NYCWatchdog]

PCS compliance is an issue with most facilities. Part of it is fear that there may be a Medicare/Medicaid audit and the MD or RN doesn't want to get caught up in potential fraud charges, and part of it is definitely a lack of education. I would suggest the following:

1) Have your account rep sit down with the highest adminstrator possible with that simple guide. Make sure he explains that PCS compliance has been an issue but that is essential in order for the service to be properly re-imbursed by the insurance companies for the work being done. Have him offer free training sessions for their staff if they want it.

2) If they want those training sessions, send someone in their uniform to provide the training. It's important that MDs/RNs make the connection of PCS compliance with the uniform. It's also important to explain to the MDs/RNs why the PCSs have to be filled out accurately, because the service needs to be properly re-imbursed.

3) Train your staff on the handout manual and how to do an impromptu inservice of hospital staff if needed. Make sure they carry two or three copies of the document with them.

If the above doesn't work, then the facility you are dealing with is considering you as just a service and not a partner in providing patient care. At that point if you're in the negative because of PCS non-compliance send your rep back in, once again to the head, and let them know that any transports kicked back for PCS non-compliance will now be billed directly to the facility or they can find another service willing to lose money on the transports.

Just my $.02

 

[MediMike]

Way to make me look like an *** with such a informative response

 

[Aidey]

I'd do my best to make it perfectly clear to the staff that without a properly filled out PCS there will be significant administrative difficulties regarding payment for the transport, as well as the fact that an improperly or faked PCS will result in incredibly huge fines for the facility. (In a polite and tactful manner of course) Also if they have an issue with it...well they could probably learn to get over it

This is what is happening now, and it isn't working. Well, I should say the paperwork gets filled out, but the facilities are complaining.

PCS compliance is an issue with most facilities. Part of it is fear that there may be a Medicare/Medicaid audit and the MD or RN doesn't want to get caught up in potential fraud charges, and part of it is definitely a lack of education. I would suggest the following:

1) Have your account rep sit down with the highest adminstrator possible with that simple guide. Make sure he explains that PCS compliance has been an issue but that is essential in order for the service to be properly re-imbursed by the insurance companies for the work being done. Have him offer free training sessions for their staff if they want it.

2) If they want those training sessions, send someone in their uniform to provide the training. It's important that MDs/RNs make the connection of PCS compliance with the uniform. It's also important to explain to the MDs/RNs why the PCSs have to be filled out accurately, because the service needs to be properly re-imbursed.

3) Train your staff on the handout manual and how to do an impromptu inservice of hospital staff if needed. Make sure they carry two or three copies of the document with them.

If the above doesn't work, then the facility you are dealing with is considering you as just a service and not a partner in providing patient care. At that point if you're in the negative because of PCS non-compliance send your rep back in, once again to the head, and let them know that any transports kicked back for PCS non-compliance will now be billed directly to the facility or they can find another service willing to lose money on the transports.

Just my $.02

So in short, you think the guide is a good idea? I was kind of concerned that it would be seen as us telling them how to do their jobs.

 

[katgrl2003]

So in short, you think the guide is a good idea? I was kind of concerned that it would be seen as us telling them how to do their jobs.

But if the PCS isn't getting filled out correctly, then they aren't doing their jobs. If a guide helps, go for it.

 

[firetender]

ANSWER: Show me the money!

I'd do my best to make it perfectly clear to the staff that without a properly filled out PCS there will be significant administrative difficulties regarding payment for the transport...

NYCWatchdog[/B]]
...sit down with the highest administrator possible with that simple guide. Make sure he explains that PCS compliance has been an issue but that is essential in order for the service to be properly re-imbursed by the insurance companies

Case closed.

 

[NYCWatchdog]

So in short, you think the guide is a good idea? I was kind of concerned that it would be seen as us telling them how to do their jobs.

The guide is a good idea, but the top level administrators need to understand that their personnel are not correctly filling out the PCS and because of that your service is bearing the fiscal repercussions from that. It's also important for them to understand that if their staff does not become compliant, the service they receive will be negatively affected. Whether its interpreted as them being told how to do their job or not is dependent on how you present it and the philosophy of the facility you're dealing with.

Honestly it's a hard thing to walk into an account and basically tell them that if they don't comply with the PCS they'll need to pay for the transports, which makes it easier for them to walk away from your service... but to be honest after we did it twice we realized that the money we were loosing on those calls was greater than what we were bringing in from the calls that did pay with the proper PCS filled out from that facility.