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 01/31/19, HFS 2270, Physician Certification Statement (PCS) for Ambulance Transport or
/Service Car Transport (replaces the current 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. Medicar 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)