Signatures

Most transports will require at least one signature -- during patient dropoff. Signatures are collected inside the PCR; press the "Patient Care Records" button to access the PCR, and then choose the Signatures tab.

PCR Signatures
The electronic signatures page, full of signature forms ready to go.

Required Signatures

The Signatures tab automatically opens whichever signature form is most likely to be the one needed. These are AngelTrack's built-in rules for signature collection:

Service Signatures Needed
Car service
Wheelchair van
Gurney van
If transport occurs, you must collect any one of:
  • Receiving facility
  • Receiving facility refusal to sign
  • Patient discharge
  • Patient discharge Against Medical Advice
BLS
ALS
MICU
If transport occurs, you must collect any one of:
  • Payment authorization
  • Patient authorization when patient unable to sign
  • Patient authorization by guarantor
...and any one of:
  • Receiving facility
  • Receiving facility refusal to sign
  • Patient discharge
  • Patient discharge Against Medical Advice
...and if the trip is not covered by insurance:
  • Non-covered destination / A.B.N.
    (see notes below)
On-scene labs You must collect any one of:
  • Payment authorization
  • Patient authorization when patient unable to sign
  • Patient authorization by guarantor
Telemedicine You must collect:
  • Telemedicine consult
...and any one of:
  • Payment authorization
  • Patient authorization when patient unable to sign
  • Patient authorization by guarantor

If the Patient Disposition field (on the Followup page) is set to "Patient treated, released AMA", then the "Patient Discharge Against Medical Advice" form is required if not already signed.


Non-Covered Destination / A.B.N. / Advanced Beneficiary Notification

If performing a stretcher transport that is not emergent, and which has been booked as not covered by insurance, then AngelTrack will require you to collect a signature on the "Non-covered destination / A.B.N." form.

This form gives an estimated price for the trip, and attests that the responsible party does specifically understand that he or she is responsible for the high cost of the service.

The form is specifically intended for use at nursing homes, when a nurse orders transport to a distant hospital or other destination not covered by the patient's insurance, causing the nursing home to get the bill. Usually the nurses are not allowed to be booking such transports, and so the signature form helps to remind them of this restriction.

The form also helps when dealing with adamant family members who demand transport to a distant hospital for the sake of nearness to family. Because that is not an approved justification for insurance coverage, somebody will be getting an unpleasantly large bill for the transport. Family members often back down from these inappropriate demands when handed the form and asked to put their money where their mouth is.


Some Requirements May Be Waived

Your AngelTrack administrator can configure the signature requirements; some required signatures may be waived on account of company policy or local laws.

If a required signature has been waived, then AngelTrack will no longer automatically open the form for that particular signature... nor will the "Signatures" PCR button turn red to indicate that the signature is missing. Of course you can still collect the signature if you deem it necessary.


"Receiving Facility" Signature Form is Sometimes Hidden

AngelTrack hides the "Receiving facility" signature form until you perform the time-punch that indicates arrival at the destination. At that time, the form will reappear.

This is done to prevent nurses at the pickup site from accidentally signing that form. The form should only be signed by the person at the destination who is accepting responsibility for the patient.


Collecting Signatures Without a Wifi Signal

No wifi signal is needed in order to collect signatures. Read the No Signal guide to see how.


Dealing with DaVita Nurses

When a dialysis nurse refuses to sign for transfer of a patient, AngelTrack has a special signature form, which the crew signs in lieu of the nurse.

That's right, you sign the form yourself. Your signature attests that you made the nurse affirmatively aware that you transferred the patient to him or her, and that the nurse gave an unmistakeable verbal acknowledgement that the patient has been transferred. Sign your own name in the box, and then AngelTrack will record the date and time for you.


Collecting Signatures on Paper

You can still collect signatures on paper, and then scan or photograph the signed paper for attachment in Angeltrack.

You can photograph any sheet of paper using your mobile device's built-in camera. Just click the "Select files for attach" button, and your mobile device will prompt you to take a new picture or choose an existing picture. Select one, then click "Attach". The photo will be uploaded right into AngelTrack.

Photograph documents to attach them
Screenshot from an iPhone.

When you attach a "Auth/XFer signatures" document to a dispatch, it counts as both the "Payment authorization" and the "Receiving facility" signature forms. Likewise an "A.M.A." document counts as a "Patient discharge Against Medical Advice" signature, and a "Telemedicine consult" document counts as a "Telemedicine consult" signature.


Using the "Receipt for Patient Belongings" Form

The "Receipt for Patient Belongings" form is used to document the handoff of the patient's personal effects. Use the form whenever you pass any patient belongings to a hospital, to a nursing home, to a family member, to another EMS company, or to law enforcement. It attests that all of the patient's property was present and accounted for at the time of transfer.

Patient personal effects

The form requires a photograph of the property being transferred. The signature attests that the photograph is correct. If you must retake the photograph, then the signature will be discarded and must be collected again. This prevents alteration of the photograph after the form has been attested.

If there is a cellphone among the patient's property, press a button to briefly wake it up so that your picture will prove that the cellphone was working at the time of transfer.



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