First Transit's fax number is (630) 873-1450.
Hospital discharges in an ambulance:
- The ambulance provider enters a single trip request through PassPORT
- The medical provider submits a PCS form to First Transit and gives a copy to the ambulance provider
- The ambulance provider faxes a Run Report to First Transit
Forms and documentation:
- Revised 07/01/19, HFS 2270, Physician Certification Statement (PCS) for Ambulance Transport or Medicar/Service Car Transport (replaces the MCA and CTS forms). If the form does not open in your browser - right-click on the link, select Save Link As, save the file to your computer, then open the saved file.
- HFS 2270 Physician Certification Statement and Transportation Provider Complaint Portal
- July 2019, Transportation PowerPoint Presentation for HFS 2270, Physician Certification Statement
- 07/25/19 Notice to Enrolled Transportation Providers; Hospitals; and Long Term Care Facilities regarding Facility Compliance in Completing the HFS 2270, Physician Certification Statement for Non-Emergency Transportation
- 02/15/19 Notice to Enrolled Transportation Providers; Hospitals; and Nursing Facilities regarding HFS 2270
PassPORTRequirements for Non EmergencyAmbulance Hospital Discharges, Notice to ambulance providers issued 02/21/2014
- New Law Impacting Hospital Discharges of Illinois Medicaid Participants by Ambulance, Notice to providers of transportation and hospital services issued 10/07/2013
- Prior Approval for Non-Emergency Ambulance Services, Notice to participating medical assistance providers issued 07/01/2013
- 89 IL Administrative Code 140.491(c): Requirements for non-emergency ambulance services for discharging patients, medical certifications and orders, for dates of service beginning July 1, 2013.
- 89 IL Administrative Code 140.Table A: Criteria for non-emergency ambulance transportation
- Certificate of Transportation Services (CTS)