“Service Not Reasonable and Necessary” Part II Welcome back to Part II of our look at Palmetto GBA’s widespread review of ambulance services in the second quarter of fiscal year 2013. You’ll recall that last week we really focused on Palmetto’s comments concerning signatures and how their presence of lack thereof influenced their decision to […]
Palmetto GBA Releases Results of Second Quarter Review Emergency and Non-Emergency Palmetto GBA, the Medicare Administrative Contractor (MAC) for Railroad Medicare, nationwide, and Part A/B MAC for the States of West Virginia, Virginia, North and South Carolina has released the results of a widespread review of Advanced Life Support ambulance services which was conducted during […]
Coloring Between the Lines—Self-Auditing The Basics Remember those days in grade school when you were so worried about coloring between the lines? Staying in compliance with the many ambulance service billing rules and regulations is a lot like that. We all have to “color between the lines.” One of the best ways to get it […]
HIPAA is Still Here! HIPAA Defined Do you remember HIPAA? HIPAA is the Health Insurance Portability and Accountability Act of 1996. Remember 1996? Bill Clinton was President of the United States, Don Shula retired as the Miami Dolphins head coach, we got socked with a huge blizzard in the eastern United States, and Dolly the […]
Preparing for Dialysis Transport Payment Reductions Last Week In our last blog we provided information regarding the announced 10% payment reduction that is being put in place by the Center for Medicare and Medicaid Services (CMS) on all BLS Non-Emergency transports to and from dialysis treatments for patients diagnosed with End Stage Renal Disease (ESRD). […]
Payment Reductions Loom for Dialysis Transports Section 637 Remember “Section 637.” This is the section of the American Taxpayer Relief Act of 2012 that will require the Center for Medicare and Medicaid Services (CMS) to reduce Medicare payments for BLS Non-Emergency ambulance transports nationwide by 10% beginning on October 1, 2013. Non-Emergency, Basic Life Support […]
Proposed Rule Tightens the Screw for Ambulance Feeling Beat Up? CMS published a proposed rule this week which intends to bolster fraud prevention and also limit certain Medicare privileges we’ve grown accustomed to in the ambulance industry. CMS is inviting comments on the proposal now through June 28, 2013. The American Ambulance Association has committed […]
Office and Operations— A Partnership Who’s Driving the Bus? Why do we have so many “slang” terms for the ambulance vehicle in EMS? Where did they all come from? I’m just as guilty as anyone for referring to an ambulance as a truck, unit, squad, rig, and my all-time favorite, “bus!” Using one of these […]
Uncovering Medicaid—The Other Entitlement Not Just Medicare For as long as we’ve been around the ambulance billing scene, everyone has hung on every word that comes from the Centers for Medicare and Medicaid Services (CMS) pertaining to Medicare. But note the name of the agency . . . it not only contains the word “Medicare” […]
The Crystal Ball— Obamacare and EMS The Beginning of Something Different Over the past year or so, we’ve received questions from our clients about the potential effect of “Obamacare” on the future of Emergency Medical Services in the United States. Frankly, it’s impossible to provide concrete answers to these questions right now, because no one […]
