Click links to download policies and forms.  Adobe Acrobat Reader is required (free download).

 

Physician Certification Statement (PCS): Medicare requires a completed PCS for non-emergent ambulance transports.

 

TMHP PAN Request Form: Texas Medicaid requires a PreAuthorization Number (PAN) for non-emergent ambulance transports.

 

TMHP FAX Cover Page: Texas Medicaid FAX cover page.

 

Notice of Protected Health Information:  StarPlus EMS is committed to protecting the privacy of our customers.