Facility PCS or Standby Request

If you are a medical facility who needs to print a Physician Certification Statement (PCS), click on the icon below. We highly recommend you to use our PCS form. Our form ensures correct payment from Medicare, Medicaid, and private insurances. There is not anything on the form we cannot do without. If you use another form, and the correct information is not available on the form, Medicare, Medicaid, and the insurance companies will automatically deny the claims. This could leave your patients with thousands of dollars in bills unnecessarily. Our Medicare, Medicaid, and insurance approved form is below:

Do you need an ambulance standby? We have two kinds of standby services:

  1. Non-dedicated Standby: This is free of charge, but this also means we cannot guarantee the ambulance to be at the event. This standby request means that if we are not on calls, and in the area, we can standby at your event, if approved.
  2. Dedicated Standby: A dedicated standby is when we dedicate an ambulance and crew to your event. They do not leave your event unless a patient from your event needs transported. The charges for dedicated standby’s are as follows: EMT level ambulance=$115/hr or Paramedic level ambulance=$140/hr. These requests are subject to availability.