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  PCS

112-B Southgate Drive  
Bloomington,  IL  61704  
309-828-8572  
Fax: 309-827-7928  





The information on this page changes often. Please check back frequently.
General Guidelines Regarding Physicians Certification Statement
All non-emergent ambulance transports must have a PCS signed prior to taking the reservation unless otherwise approved by Lifeline Mobile Medics management.
Lifeline Mobile Medics requires the physician's signature on all PCSs prior to transport of the patient.
General Ambulance Guidelines for PCS
Type of Transport PCS Required?
Non-emergent transport to ED for evaluation No
Non-emergent transport to Skilled Nursing Facility or Extended Care Facility Yes
Non-emergent (Roundtrip) to hospital for diagnostic testing (i.e. x-ray, labs, etc.) Yes
(Physician must note roundtrip on PCS)
Non-emergent transport to Hospital for direct admit Yes
(Physician ordering admission must be informed of the need for a PCS)
Non-emergent transport to any destination as a wheelchair trip No
Non-emergent transport from Hospital to Hospital for higher level of care Yes
(Must document reason for transfer and supplemental info such as RN needed, medications, equipment)
Non-emergent transport from Hospital to Cancer Center for treatment No
(Patient is still inpatient at hospital under Medicare Part A. Hospital is billed)









Lifeline Mobile Medics is a non-profit community service owned by BroMenn Regional Medical Center and OSF St. Joseph Medical Center

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