RSNAT Prior Authorizations and the PCS by Rebecca Illig, QMC Compliance Manager In 2014… In 2014 CMS initiated a Repetitive Scheduled Non-Emergency Ambulance Transportation (RSNAT) prior authorization demonstration program for certain states. These included South Carolina, New Jersey, and Pennsylvania. The program was expanded in December of 2015 by CMS to include Delaware, the District […]
Dissecting the Certificate of Medical Necessity By Chuck Humphrey, B.A., EMT-B, CAC, CADS* The Non-Emergency Transport World If you live in the non-emergency ambulance transport world, then the words “medical necessity form” or the letters “PCS” are most familiar to you. A certificate of medical necessity is required to bill a claim to Medicare for […]
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), […]
4 Important Things EMS Field Practices to Aid Billing Billing is Important! As an EMS provider in the field, if you think you can ignore what goes on in the office- especially the billing part- then you don’t see the bigger picture. Billing is important! Modern EMS is expensive. Most trucks are now a 6-figure […]
Compliance Isn’t Easy Being Deliberate If your EMS agency is going to strive to be 100% compliant with all of the rules and regulations that we all have to navigate in the EMS billing arena, then it means that your organizational culture must be deliberate. Compliance isn’t easy. The problem with what we have just […]
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 […]
The Do’s and Don’t’s of PCS Signatures Signature Focus The Physician Certification Statement (PCS), required by Medicare for all non-emergency transports, can confuse even the seasoned ambulance administrator and billing office. While the document itself can be confusing, determining the person who can properly sign can be an even more confusing scenario. Requirement… The Center […]
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 […]
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 […]
