Medicare Appeals By Kellie Mattos, C.A.C. How to be a WINNER with Medicare appeals. Medicare appeals can be time-consuming and tedious with, frequently, no positive outcome for your effort. Today I am going to talk about the importance of appeals and how to win them! Anatomy of an Appeal- Time Consuming and Tedious When a […]
Guiding -vs- Chasing Reimbursement By Brigit Battaglia Brigit Battaglia, CAC is Director of Process Design and Optimization at Quick Med Claims. Brigit has deep experience in the areas of process development, AI/machine learning, transportation billing and performance improvement gleaned from 12 years in the EMS billing industry. Ever heard someone say that something is “like […]
2018 Ambulance Payment Data Released AAA Capsule Thanks to the American Ambulance Association’s efforts to keep all of us in the ambulance industry informed the Association has compiled and released the ambulance 2018 Medicare Payment Data Report to all AAA members. The report was compiled and posted using payment data derived from the “Early Edition” […]
Medicare Bonus Payments Expire- What’s Next? December 31, 2017, 2359 Hours… When the New Years ball begins its drop in New York City on December 31, 2017 at 2359 hours, so will the Medicare Fee Schedule Bonus Payments drop. Those of you who operate in urban zip codes will see 2% less, rural zip codes […]
SSNRI and What it Means for EMS Agency What is SSNRI SSNRI is the Social Security Number Removal Initiative. The Federal Government is mandating that all Social Security Numbers (SSNs) be removed from Medicare cards by April 2019. A new number called the MBI- Medicare Beneficiary Number will replace the long-standing SSN-based Health Insurance Claim […]
Why the Billing Office Must Train It’s that time of year Next week, our billing office family here at Enhanced Management Services will pause to train. Every single Enhanced staff member is trained as a Certified Ambulance Coder (CAC) using the curriculum supplied by the National Academy of Ambulance Coding (NAAC). This billing office is […]
When Compassion and Compliance Collide New initiatives By now many of you, especially those of you who provide scheduled, routine, non-emergency transports (ie. Dialysis, radiation, etc.) are becoming aware of a new Medicare trial initiative for pre-authorizing approval for claims submitted for these types of transports. The Centers for Medicare and Medicaid Services (CMS) chose […]
Documentation Skills and the Long-Time EMS Provider New Tricks You’ve heard the phrase; “You can’t teach an old dog new tricks.” Well that may be true about canines, but it certainly isn’t the case with us humans. It’s especially not the case with EMS providers. Long-time EMS providers should have learned a long time ago […]
More Medicare Claim Processing Insight- Transporting ESRD Patients for Dialysis Second Week in a Row… Last week we filled this space with information from the Medicare Administrative Contractor (MAC) handling Part B claims in Ohio and Kentucky regarding their Comprehensive Error Rate Testing (CERT) findings. We provided you with a view of how the CERT […]
“Ambulance Service: Incomplete Documentation”- The CERT Perspective It Doesn’t Happen Often… Not often do we ever get a chance to gain a first-hand look into how decisions are made by Medicare compliance auditors. This week we had the chance to do so. CGS- J15 MAC CERT Our e-mail inbox chimed a few days ago, pretty […]
