Transported for HIGHER Level of Care By Katie Harrison and Chuck Humphrey, QMC Compliance Team If we had a dollar… Here in our QMC billing office, if we had a dollar for every time we have opened a patient care report (PCR) to read the documentation of an ambulance transport from one facility to another […]
Hurricane Dorian Prompts CMS Emergency Efforts Breaking News Literally, as we contribute to this blog space, our fellow Americans in the Southeast and Mid-Atlantic States are experiencing the dramatic effects of the monster Hurricane Dorian. The Centers for Medicare and Medicaid Services has just issued Medicare Learning Network (MLN) Special Editions (SEs) 19017 (Puerto Rico), […]
On Drop Downs and Written Narratives- Connecting the Data in our PCRs “Paint a Picture” We read a lot of communication that point to expectations. The Centers for Medicare and Medicaid Services (CMS), State agencies and even Commercial Insurance payers bombard our billing office with all kind of communication about what they expect to be […]
Shutdown and ACA- What’s Next and How Will They Affect the EMS Bottom Line? History By now, most likely you have heard that the United States Government is experiencing a partial shutdown. The Trump Administration and Congress reached a stalemate just before the Congressional Christmas break stemming from a disagreement over funding for a southern […]
After the Disaster- What to Do Next? Florence Mayhem Like us, we’re sure you watched in horror as Hurricane Florence smashed into the east coast of the United States dumping trillions of gallons of water on North and South Carolina and Virginia. For days, the heavens opened into a waterfall of torrential rains and flooding […]
Ambulance Industry Legislation Update In this space… Over a few month we reported in this space about legislation in several States that had the potential to impact the ambulance industry in a big way. Since those posts, there have been some positive developments on a few fronts. Pennsylvania Legislation Passes The new State budget passed […]
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 Part Two Welcome to Part Two of our blog series Balance Billing and Air Medical Transport. Last week, we looked at the historical aspect and defined the issue at hand. This week, we peer into the public perception, regulatory consequences, and make some suggestions on how to navigate 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 […]
Medicare vs. Medicaid- What’s the Difference? (Part II) Medicaid Welcome to Part II of our two-week series pointing out the differences between the Medicare and Medicaid programs in the United States and the affect each program has on EMS and how that effect differs. This week we are focusing on Medicaid or in some areas […]
