“Service Not Reasonable and Necessary”

“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 […]

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Palmetto GBA Releases Results of Second Quarter Review

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 […]

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Coloring Between the Lines—Self-Auditing

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 […]

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Office and Operations— A Partnership

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 […]

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Uncovering Medicaid—The Other Entitlement

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” […]

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Railroad Medicare Releases Results of Ambulance Claim Review

Railroad Medicare Releases Results of Ambulance Claim Review The Study A little over a week ago, Palmetto GBA, the Medicare Administrative Contractor (MAC) for the Railroad Medicare program, issued the findings derived from a review of incoming ambulance claims they completed between October and December 2012. Palmetto GBA’s Medical Review (MR) department completed what they […]

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