“Dear Santa”…a letter from the Billing Office We intercepted… It’s one of those things that happens. A piece of mail floated into our billing office mailbox just this week and behold it was a note to Santa from a billing office far, far away. Good ol’ Uncle Sam’s delivery guys saw billing on it and […]
Transporting SNF Residents: Choosing the Proper Payer This week the industry experts at Page, Wolfberg and Wirth (www.pwwemslaw.com) posted an excellent article in the EMS Legal Update on EMS1.com regarding how to choose the proper insurance payer when transporting Skilled Nursing Facility residents by ambulance. The information is so important that we decided to share with […]
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 […]
Friday Night Lights, EMS and ICD-10 BLOGGER’S COMMENT – Every year, this week in time, we take a minute to review specific documentation tips when treating sports injuries. Let’s hope we never have to use these skills. Have a safe and enjoyable Friday Night Lights! It all Begins Tonight! Our billing office is located in Pennsylvania […]
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 […]
The Power of EMS in Politics- Again! EMS “News” In most areas across the United States, EMS is stressed and much of the stress has to do with reimbursement policy at the government level that fails to recognize what it takes to keep EMS going financially. The largest ambulance service in Lancaster County, Pennsylvania, nonprofit […]
Freestanding Emergency Rooms and Ambulance Billing – Part II Our Thanks! Welcome to Part II of our series “Freestanding Emergency Rooms and Ambulance Billing.” Our blog posts, this week and last week, is presented thanks to timely reminders passed onto us by Doug Wolfberg of Page, Wolfberg and Wirth. Doug spent the day with our […]
Clear. Clinical. Documentation. CMS Three words with impactful meaning anchor our discussion today. The Center for Medicare and Medicaid Services (CMS) sets the definition of medical necessity of an ambulance patient that all of us in the ambulance billing industry strictly adhere to. The definition centers on the clinical requirement “where the use of other methods […]
Facilities and Payment- Medicare Rules Destination Facility Our billing office often receives questions from our clients regarding facilities as an origin yet mostly a destination for transport. For the purpose of this discussion we are going to focus on the destination. A facility or institution is defined as a hospital or skilled nursing home as […]
Resources Where They’re Needed A Mini Rant Lately a lot of people are ranting about something. So we hope you’ll indulge us today as we offer up a bit of a mini rant. Those of us who live in the money game of ambulance reimbursement, be it EMS administrator, billing office or provider, have become […]
