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Getting Patient Signatures

Published Sunday, February 10, 2019



Medicare requires that an agency obtain the signature of a patient in order to bill for the transport. Sometimes, this can be trickier than it seems.

The best practice is to get the patient’s signature in the field—that is, just before or during the transport. Depending on the patient’s condition, however, obtaining a signature may not be possible. In that case, you’re required to get the signature of a Medicare Alternative Signer. This includes:

  • Patient’s legal guardian
  • A person who receives government benefits on the patient’s behalf
  • The patient’s healthcare power of attorney (not to be confused with other types of power of attorney designations)
  • A person who arranges treatment for the patient or who handles the patient’s affairs
  • A representative of an institution that furnished care, services and/or assistance to the patient


If you’re unable to find a Medicare alternative signer, you’ll need to complete a Statement of Affidavit explaining the medical reason why the patient was unable to sign for themselves. This affidavit must be signed by a crew member and the appropriate staff members at the receiving facility.

Another best practice is to have language on your patient care record that makes the patient’s signature a lifetime authorization. That way, if a crew fails to meet signature requirements on a future run, you have the authorization you need on file.

Taking a few moments to review signature requirements with your crew can make a big difference on Medicare billing reimbursements. The more you adhere to standard signature procedures, the better the chances that your Medicare claim will be successfully processed.

If you'd like more information on getting patient signatures, please click one of the buttons below.

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