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ProvidEd, however, that each franchised ambulance service <br />provider shall have ninety (90) days to meet any amended <br />insurance limits as such may be changed from time to time. <br /> <br />SECTION 12. RECORDS: <br /> <br /> Each ambulance provider shall maintain the following <br />records: <br /> <br /> (a) Daily Dispatch Log: This log shall show time call <br /> received, time ambulance dispatched, time arrived on <br /> scene, time departed scene, time arrived destination, <br /> time in service and time returned to base. This leg <br /> shall also include caller's name, address, phone <br /> number, address of point of pick-up, address of <br /> destination, dispatcher's name and whether call was <br /> emergency or non-emergency in nature. This log shall <br /> be kept in chronological order, by call, and shall <br /> provide a specific identifier, for each call, to allow <br /> for correlation with individual ambulance call reports <br /> related to patient information. <br /> <br /> (b) Ambulance Call Report: This form shall include all <br /> t~mes recorded in the preceding section, and address of <br /> polJ,t of pick-up, address of destination, whether call <br /> was emergency or convalescent in nature and the <br /> identifier which correlates the ambulance call report <br /> to the daily dispatch log. This form shall also <br /> include patient name, patient address, patient phone <br /> number, patient condition, type of assistance or <br /> medical care provided the patient prior to arrival at <br /> destination, speedometer readings at beginning and end <br /> of trip, total trip miles, schedule of charges and <br /> signature of driver and attendant. The ambulsnce call <br /> report shall be so designed as to provide the patient <br /> with a copy thereof containing all required <br /> information. A copy of the ambulance call report may <br /> serve as receipt for any charges paid. The North <br /> Carolina State Ambulance Call Report form shall meet <br /> all the requirements set forth herein for an ambulance <br /> call report. <br /> <br /> (c) Ambulance Check List and Inspection Report: This <br /> report shall list contents and description of <br /> operational readiness of each ambulance and shall be <br /> compiled daily and signed by a crew chief or attendant, <br /> <br /> (d) Accounts Receivable Form: This form shall be kept on <br /> all partial and full payments with date of payments and <br /> account number. <br /> <br /> <br />