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SERVICES FOR FACILITIES

Facility & Hospital Documents

  • NEW – Physician Certification Statement (PCS)

General Information for Facilities

  • Consent for Treatment & Transport, NPP Acknowledgement
  • Comment/Complaint Form

Medicare & Medicaid Reference Information

  • Ambulance & Related Service Fees 2021-22
  • Ambulance Transportation Estimate
  • Insurance Prior Authorization Contact List
  • Texas Standard Prior Authorization Form and Instructions
  • Texas Medicaid Non-Emergency Ambulance Prior Authorization Request Form
  • Amerigroup Medicaid & Chip Authorization Request Form
  • Amerigroup Medicare Non-Emergency Ambulance Prior Authorization Request Form
  • Medicare Manual for Part A and Part B Ambulance Services
  • Instructions for Physician Certification Statement for Ambulance Transport
  • Texas Medicaid Guidance on Provider Assistance Seeking Prior Authorization
  • Texas Medicaid Information for Hospitals, Nursing Homes, and Physicians on Requesting Client Transport
  • Baylor Scott & White Health Plan Prior Authorization Notice
  • Baylor Scott & White Health Plan Prior Authorization Form

Return signed forms to:

Metropolitan Area EMS Authority

2900 Alta Mere Drive

Fort Worth, Texas 76116

(817) 632-0537 – Business Office Fax

(817) 927-9671 – Communications Center Fax

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Copyright ©2023 MedStar Mobile Healthcare
Serving Fort Worth, TX & Surrounding
Communities. All rights reserved.

SITEMAP

MedStar Mobile Healthcare
2900 Alta Mere Drive
Fort Worth, Texas 76116
No medical services are available at this address.

Phone: 817-923-3700 | Fax: 817-632-0537
Contact Us →

Close Menu
  • About Us
    • Service Area
    • Board of Directors
    • Office of Medical Director
    • Patient Experience Survey Results
    • MedStar Explorer Post 664
    • Ambulance and Standby Medical Services Permitting Process
    • MedStar Foundation
  • Mobile Healthcare Programs
    • MedStar Mobile Flu Vaccine Program
    • Site Visit Requests
    • MIH-CP Outcome Measures Project
    • Referring Agency Satisfaction Survey
  • Services
    • For Facilities
    • For Patients
    • MedStar StarSaver Memberships
    • Special Programs
    • Ambulance Demos and Standby Services
    • Service Fees
  • News and Events
    • News and Press Releases
    • Community Events
  • Education
    • Chest Compression Training
    • Emergency Medical Technician and Responder Course Information
    • Citizen Academy
    • CPR and First Aid Courses
  • Contact
    • Observer Ride Outs
    • Surplus Vehicles and Equipment
    • Request for Proposals
  • Careers

MedStar Mobile Healthcare
2900 Alta Mere Drive
Fort Worth, Texas 76116

No medical services are available at this address.

T: 817-923-3700
F: 817-632-0537
Contact Us

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