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 […]
Medicare for All? Feel the Burn After two weeks of the major party political conventions, we can truthfully say we “feel the burn!” Hold on…we’re not taking political sides. Note that it’s “burn” and not “Bern” that we feel, as in “burn out.” Our presidential campaigns in the United States are far too long. After […]
Prepayment Review Shift Triggers Greater Need for EMS Documentation Focus The Report A few months ago the United States Government Accountability Office (GAO) released a report examining audit programs employed by the Centers for Medicare and Medicaid Services (CMS) and the contractors employed by the agency. The study was commissioned by the Senate Finance Committee […]
Properly Executing the Medicare ABN-Part III In today’s blog post, we wrap up the written version of Medicare Advance Beneficiary Notice of Noncoverage blog series with a video demonstration. Below, Chuck presents a brief introduction, followed by walk-through explanation of the ABN form. Introduction Executing the Medicare ABN Form NOTE: You can watch a larger version of each […]
Properly Executing the Medicare ABN-Part II Last Week Thanks for returning to read out two-part series, Properly Executing the Medicare ABN. Last week we introduced the Advance Beneficiary Notice of Noncoverage (ABN) to you and explained the theory behind the use of this government- issued form. You’ll recall that we explained that the ABN is […]
Properly Executing the Medicare ABN-Part I Misunderstood One of the most misunderstood puzzle pieces of ambulance billing is the Medicare Advance Beneficiary Notice of Noncoverage (ABN). As we work together with our contracted EMS agency clients, we find that EMS administrators and providers alike are very confused about the when and how to use this […]
Documenting “Right Now” In the Moment… When assisting in documentation training for EMS providers, a common emphasis is made to continually reinforce the necessity of documenting the patient’s condition right now in the Patient Care Report. We find it especially important to stress this important concept when educating providers who are handling a fairly consistent […]
Billing for Ambulance Scenarios Involving Death Solemn Subject This week we address a rather solemn subject. While none of us care to admit it, there are times when our best life-saving efforts are unable to change the course of events and our patients succumb due to medical emergencies and/or trauma scenarios. It’s sad for both […]
Emergency! – Digging Deeper to Define Lights and Sirens Myth This billing office is often questioned about what constitutes an emergency for the purposes of billing and collecting payment. There’s a myth in EMS that any ambulance incident that necessitates the use of “lights and sirens” is an emergency. It’s not the case. We look […]
Illegal Drugs and EMS Impact- Staying Afloat An Epidemic The Washington Post devoted an entire byline story in 2015 to one Pennsylvania County; The heroin epidemic’s toll: One county, 70 minutes, eight overdoses (The Washington Post, Bernstein, August 23, 2015) By the time that day had ended, 16 overdose calls were dispatched to local emergency medical services […]
