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Massachusetts Ambulance Trip Record Information System (MATRIX) Data Elements Version 1.5 Effective 12/15/2010 (Supersedes Version 1.4, 3/19/2009, Version 1.3, 5/1/08 and Version 1.2, 9/1/06)per A/R

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How to fill out massachusetts ambulance trip record

01

Step 1: Start by gathering all the necessary information for the Massachusetts ambulance trip record. This includes the date and time of the trip, patient information (name, address, date of birth), the purpose of the trip, and the receiving facility information.

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Step 2: Fill out the 'Ambulance Company Information' section, which includes the name and address of the ambulance company, as well as the company's license number.

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Step 3: Fill out the 'Patient Information' section, providing the patient's full name, address, date of birth, and gender.

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Step 4: Indicate the purpose of the trip in the 'Purpose of Trip' section. This can include options like 'hospital discharge,' 'transport to skilled nursing facility,' or 'doctor's appointment.'

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Step 5: Fill out the 'Receiving Facility' section, providing the name, address, and phone number of the facility where the patient is being transported or received.

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Step 6: Record the date and time of the ambulance's departure and arrival in the corresponding sections.

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Step 7: Document any additional details or special circumstances in the 'Narrative' section, such as any medical interventions performed during the trip or any difficulties encountered.

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Step 8: Ensure that the record is signed and dated by the ambulance crew, as well as any other relevant individuals involved in the trip.

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Step 9: Keep a copy of the completed Massachusetts ambulance trip record for your records.

Who needs massachusetts ambulance trip record?

01

Massachusetts ambulance trip records are needed by ambulance companies, healthcare facilities, and insurance companies for billing and compliance purposes.

02

Medical professionals and transportation providers also require these records to ensure the continuity of care and to document the details of the trip.

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Additionally, government agencies, auditors, and researchers may need access to these records for data analysis and policy evaluation.

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What is massachusetts ambulance trip record?

Massachusetts ambulance trip record is a documentation of each ambulance trip conducted within the state of Massachusetts.

Who is required to file massachusetts ambulance trip record?

Ambulance service providers are required to file the Massachusetts ambulance trip record.

How to fill out massachusetts ambulance trip record?

The Massachusetts ambulance trip record must be filled out accurately with details of each ambulance trip, including date, time, location, patient information, and reason for transport.

What is the purpose of massachusetts ambulance trip record?

The purpose of the Massachusetts ambulance trip record is to track and record all ambulance trips for billing, monitoring services, and quality improvement.

What information must be reported on massachusetts ambulance trip record?

Information such as date, time, location, patient demographics, reason for transport, level of care provided, and personnel involved must be reported on the Massachusetts ambulance trip record.

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