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 […]
Be Careful What You Say! The Quick Answer The quick answer will get you every time! You know, the patient asks you a question you quickly answer with an off-the-cuff answer. And then…..you realize…. “Oops…maybe I shouldn’t have said that.” Too late now! Where are we going with this? Invariably, questions fielded about billing in […]
“Trick or Treat” – Documenting Child EMS Scenarios Little Ghouls and Goblins… Tomorrow is the day the little ghouls and goblins make their rounds to collect more sugar than any parent should ever allow their children to have. It’s almost Halloween! So, what better time than to offer some suggestions regarding documenting EMS treatment and […]
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. […]
Closest Appropriate? Explaining Destinations in the PCR Closest Appropriate Facility In the ambulance billing world, this 3-word phrase is discussed more than you’d realize- Closest Appropriate Facility. There are rules that differ in many cases between insurance payers, most notably between Medicare and Medicaid and even some commercial insurance payers regarding payment for transport miles […]
The Puzzle EMS Billing Has Become The missing piece… Have you ever put together a puzzle and found near the end that you are missing a piece or two? It’s frustrating; isn’t it? You have just enough of the pieces put together that you can see the picture you are creating and yet those key […]
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 […]
Insurance Coverage Doesn’t Mean Insurance Payment In the news… The local newspaper that serves the area surrounding the offices featured a story about a large hospital system in this area that is realizing significantly lower insurance payments as the effects of the Affordable Healthcare Act (a.k.a. “Obamacare”) kick in. “Just because there are more insured, […]
Let’s Take a Walk! Walking, Medical Necessity and Billing Join us today as we take a few minutes to explore medical necessity issues surrounding patients who can ambulate and how that fact alone may affect billing for an ambulance transport. Medical Necessity Any claim for payment billed for ambulance transport must meet a medical necessity […]
Hop Aboard the ICD-10 Train! It’s coming… By now, if you’re a regular reader of these blog posts, you are well aware that ICD-10 is coming. As a reminder, ICD-10 is short for the International Classification of Diseases, Tenth Revision. You can certainly look at our blog archives and check in with our full explanation […]
