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 […]
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 […]
3 Reasons the Billing Office Can’t Bill Your EMS Incident Blogger’s Note… From time to time we pick out some of our most informative and memorable blog posts from the past and breathe new life into them. This is one of those posts. The information comes from a poll we conducted in our billing office […]
New Stuff From Medicare Two Updates Two recent Medicare updates carrying a potential impact on your EMS agency’s cash flow, complete with compliance implications popped up on our radar screen recently. Today’s blog will focus on those two updates. MUEs The Centers for Medicare and Medicaid Services recently updated the list of what they call […]
Documenting Causation for Illnesses V. Our “Documentation as a Habit” series moves on to Part V this week. In it, we’ll discuss causation or the synonym we use a lot in healthcare terminology, etiology. Last week we talked about mechanism of injury which is basically the trauma part of any causation discussion. This week, we […]
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 […]
Of “Ambulance Drivers” and “Emergencies” All of the times… Can you count all of the times that you have been labeled an “ambulance driver”? Nearly half a decade removed from the dawn of modern EMS, to our neighbors that’s what we are…ambulance drivers. Regardless of all of the hours you’ve spent training to attain your […]
Railroad Medicare Pre-Pay Review Upcoming It’s coming… In communication from Railroad Medicare (Palmetto GBA) last week, the ambulance industry was notified that the U.S. Railroad Retirement Board Office of Inspector General (RRB OIG) and the Office of Inspector General U.S. Department of Health and Human Services (HHS OIG) together with internal data analysts had ordered […]
Documenting Non-Emergency Scenarios Post October 1, 2015 Back Again We’re back again in the second part of our look at the guidance provided by Novitas Solutions as published in their future Local Coverage Determination (LCD) slated to begin on October 1, 2015. You’ll recall that we focused on emergency documentation in this space, last week. […]
