SIGNATURE FORMS
Obtain signatures to be included in your PCR report.
- Forms included:
- Signature Form (Medicare compliant)
- Informed Patient Refusal Form
- Transport Varience Authorization Form
- Narcotic Administration Form
Form Layout
- The Call Details
- This makes up the form header
- This header will be included at the top of each form.
- Required fields are indicated by a red bar
- Next listed is each available form.
- When completed a green check will appear on the right.
- Form Fields: Each form has additional header questions
- Below this are all available signatures in this form
- Before signing additional questions must be answered. Mostly the name of who is signing.
- Once signed these fields are locked.
- Tap the check button and hand the device to the signer
- The screen will display exactly what the person is signing. This is how it will appear on the form.
- Tap the check and rotate the device to the landscape position
- Have the person sign using a fingure or appropriate device pen.
- Tap lock and the digital signature is locked and time stamped
- The signature and timestamp can not be edited only deleted
- Complete all required signatures to complete the form
- Export Options
- This will export only the completed forms in PDF format
- Select which forms to be included in the export
- Save to device or email
- Add additional narcotic forms
Signature Form
Medicare regulations (42 C.F.R. 424.36 as amended by CMS-1385-FC and CMS-1403-FC) require a patient's signature before submitting a claim to Medicare. This form is designed to comply with the variuos requlatory documentation requirements for each of the signature rule provisions.