Complete an Ambulance Transfer Form and fax to the Transportation Program at 410-996-1020. Please make sure that the form is completely filled out and signed by a licensed physician, certifying that it is medically necessary for this client to be transported by ambulance. Please include a contact name and phone or fax number.Statewide Medical Assistance Provider Certification Form for Ambulance Transports
Contact one of the ambulance companies that have been awarded a contract with the Cecil County Health Department for Medical Assistance Transportation. The authorization number MUST be given to the ambulance company in order to be reimbursed for the transport. The ambulance companies that have been awarded a contract to transport Medical Assistance clients are as follows:
Any facility that must transport a Medical Assistance client by ambulance during weekend or evening hours can fax the completed and signed Physicians Certification for Medical Transportation form to the Transportation Program at 410-996-1020. The transportation program will contact the facility the next business day with authorization. Charges arising from a trip that has not received approval are the responsibility of the requester. Please remember that this program is for non-emergency transportation of Medical Assistance clients.