Claim Rejections vs. Claim Denials ─ What’s the Difference? Claims Errors The healthcare billing industry has seen its ups and downs over the years – but one would surely think that advances in billing technology would have made claim errors a rare occurrence. Think again! The industry still experiences an 80% error rate! According to […]
Balance Billing Under the Microscope Growing Concern For some time now, there seems to be a swell of growing concern regarding the practice of balance billing and especially under the microscope is the ambulance industry- air- and ground-ambulance alike. In some cases, there has arisen an almost villainization of the practice that so many ambulance […]
It’s Football Season- Documentation Hints for Sports Injuries Are You Ready for Some Football? Our billing office headquarters is in Pennsylvania. High school football is king in The Commonwealth so many of our clients treat and transport football-induced injuries. Right now, young people everywhere are heading back to school and they are participating in sporting […]
Take Compliance Seriously- Or…It Will Cost You! In the News Recently, some scary EMS articles have been published. Here are some headlines… Fla. Ambulance company to pay 1.2M in federal whistle-blower lawsuit <Company name redacted> settles Medicare fraud suite for 12.7M Ambulance company owner sentenced to prison for fraud Feds crack down on Medicare ambulance […]
Legislative Initiatives Poised to Benefit EMS in Three States PA, NY and MD State lawmakers in Pennsylvania, New York and Maryland have been working on new legislation that has the potential to drastically change the EMS reimbursement landscape. This year has seen a flurry of activity in the chambers of government across these States as […]
Balance Billing and Air Medical Transport Bloggers note- Welcome to Week One of a Two-Part blog series focusing on Balance Billing and Air Medical Transport. This week we’ll look at the issue at hand complete with a brief history lesson on how we arrived at today and where things stand currently with regard to the […]
Other Methods of Transportation are Contraindicated Medical Necessity Defined We talk a lot about Medical Necessity in the ambulance billing office. Medical necessity and Reasonableness are key in determining whether or not an insurance payer is obligated to pay for ambulance transport, especially for Medicare and Medicaid patients. Title XVIII of the Social Security Act […]
Clear. Clinical. Documentation. Bloggers note- we posted this blog almost a year ago to the day. It’s one of those topics that never gets old and the information remains as important as it was the first day we posted it. All of us must keep this important concept in mind when documenting our EMS transports. […]
Medicare vs Medicaid- What’s the Difference? Interchangeable? It seems that often EMS people like to interchange the words Medicare and Medicaid. While similar in scope, the reality is these programs are two uniquely different government offerings. We thought it would be helpful to define the two programs and call attention to their similarities and differences. […]
“NICE” by Default Naughty or Nice? It’s that time of year when we all wonder where we fall on ol’ Saint Nick’s magic list. Where do you stand? Will a big old lump of coal hit your stocking or will Santa hit your chimney with a whole bunch of toys? It’s the stuff we have […]
