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 […]
Railroad Medicare Cites 32.6% Denial Rate in Widespread Review Here we go again… The Railroad Medicare program, administered by government contractor Palmetto Government Benefits Administrators (Palmetto GBA) has published the results of their latest “widespread review” of BLS Non-Emergency Transports. Here we go again… Continually, our industry is turning in dismal audit results with this […]
UPDATE-Properly Executing the Medicare ABN-Part I Misunderstood The Centers for Medicare and Medicaid Services (CMS) has just announced the release of the revised Advance Beneficiary Notice of Noncoverage (ABN). It is important that those of us in the ambulance world who use this form on a regular basis begin to use this version immediately. Just […]
Compliance by Accident…is an Accident Waiting to Happen! Out of Sight…Out of Mind How many of you reading this blog, right now, have a compliance plan located somewhere in your office or somewhere in the station? You know what I mean, that big binder book with a lot of paper, plenty of words that seemingly […]
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 III Three weeks ago, we began the first of four consecutive 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 […]
Why is S. 967 So Important to the Ambulance Industry? Part I April 27, 2017 Certain dates in history stand out as pivotal to the course and direction of the United States of America. April 27, 2017 will almost certainly stand out as one of those dates for the American ambulance industry if Senate Bill […]
Railroad Medicare Cites 32.6% Error Rate for Second Quarter of FY 2017 Review Complete Yesterday, Palmetto GBA, the Medicare Administrative Contractor for the Railroad Medicare program, announced that they have completed their widespread review of BLS Non-Emergency ambulance service claims from January through March of 2017. This comprises their announced review for the Second Quarter […]
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 […]
