Movement Barriers and Medical Necessity Outside-the-Norm Questions Our office receives questions from our EMS agency clients, periodically, regarding patients that have some kind of movement barrier connected to the treatment/transport scenario. These are the patients that have some sort of physical or structural challenge that exists between where they reside and the point where they […]
Is Your EMS Agency Experiencing Payer Mix Shuffle? It’s happening now… There’s no doubt healthcare in America is being changed daily. The Affordable Care Act (of you may refer to it as “Obamacare”) is changing the face of the healthcare and the health insurance landscape in America. How is all of this affecting your EMS […]
Effectively Obtaining a Signature in the Field We Get It As EMS providers, we understand that one of the least favorite things you do in the field is to obtain a patient’s signature. From the standpoint of an EMS field provider it often seems like an unnecessary requirement, a burden even. But, to your ambulance […]
Adding EMS Routines? 3 Key Questions to Ask Prior to Taking the Leap Increase volume. Increase cash flow…not so fast! As an EMS billing contractor, we increasingly are contacted by our clients about the pros and cons of adding routine/non-emergency ambulance transports to the daily repertoire. It’s a big decision. It’s a decision that should […]
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 […]
Who’s the New Guy? Really? The new hire… Staffing is tight. You just worked an extra 16 hours this week to fill the holes in the schedule which looks like swiss cheese on paper. In walks someone new that you never met. He (or she) sticks out his hand, shakes firmly and proceeds to explain […]
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 […]
The ABC’s of an Ambulance Billing Company DNA There are many ambulance billing companies out there. These companies come in all sizes and shapes. Some are good; really good. Some are bad; really bad. A really good ambulance billing company has a basic DNA that involves these ABC’s. The same basics may apply to the […]
Non-Emergency Transports- Two Questions to ALWAYS Ask Big Brother’s Watching! Never before has the ambulance industry been so much under the microscope when it comes to billing and receiving payment for ambulance transports- especially non-emergency transports. Federal Government, State Governments, you name it. “Big Brother” is watching what we do. The focus has increased dramatically […]
