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” […]
OIG Reports on Overpayments Sparks Discussion This Month The Office of the Inspector General made public the report “Medicare Improperly Paid Providers for Non-Emergency Ambulance Transports to Destinations Not Covered by Medicare” (View the report) this month. The OIG took a look at non-emergency ambulance transport claims paid by Medicare between 2014 and 2016. This time the […]
Why is S. 967 So Important to the Ambulance Industry? Part IV S.967- Part IV Today we land Part IV of our blog posts dedicated to helping us all understand the importance of Senate Bill 967 entitled the “Medicare Ambulance Access, Fraud Prevention and Reform Act of 2017.” In that opening post, we explained that […]
Why is S. 967 So Important to the Ambulance Industry? Part II S.967- Part II Last week, we opened this space with the first of four blog posts dedicated to helping us all understand the importance of Senate Bill 967 entitled the “Medicare Ambulance Access, Fraud Prevention and Reform Act of 2017.” In that opening […]
Origins and Destinations Where am I? We were reminded when adding some new facility locations into our ambulance billing office computer system this week how confusing the types of facilities can become. Today, a single pick-up and/or drop-off location for an ambulance can serve several capacities. Literally one address, one building even, can house several […]
The Bad Apples Ruin the Whole Bunch 1 in 5! Just one week ago, the Department of Health and Human Services Office of the Inspector General (OIG) released a nationwide report citing questionable Medicare billing practices by ambulance suppliers, nationwide. The OIG reports that 1 in 5 ambulance providers has engaged in “questionable billing” practices. […]
The Changing Regulatory EMS Billing Landscape The Landscape Has Changed If you read this space on a regular basis, you know that we frequently discuss the changing regulatory landscape. With Medicare and Medicaid comprising well more than half of all the dollars that flow into many EMS agencies, it’s important that we all understand the […]
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 […]
Understanding the Medicare Prior Authorization Demo Project Repetitive Scheduled Non –Emergent Ambulance Transports The Centers for Medicare and Medicaid Services (CMS) just announced that they will pilot a demonstration project to pre-authorize Repetitive Scheduled Non-Emergent Transports. Repetitive Scheduled Non-Emergent Transports are defined when the same patient is transported three or more times over a ten-day […]
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 […]
