Clear. Clinical. Documentation. CMS Three words with impactful meaning anchor our discussion today. The Center for Medicare and Medicaid Services (CMS) sets the definition of medical necessity of an ambulance patient that all of us in the ambulance billing industry strictly adhere to. The definition centers on the clinical requirement “where...
Facilities and Payment- Medicare Rules Destination Facility Our billing office often receives questions from our clients regarding facilities as an origin yet mostly a destination for transport. For the purpose of this discussion we are going to focus on the destination. A facility or institution is defined as a hospital...
Resources Where They’re Needed A Mini Rant Lately a lot of people are ranting about something. So we hope you’ll indulge us today as we offer up a bit of a mini rant. Those of us who live in the money game of ambulance reimbursement, be it EMS administrator, billing...
Sign-In Please! “Will the next mystery guest sign-in please?” Back in the sixties there was this popular TV show that began with this question. The viewer got to see who the celebrity was based on the person’s signature and the contestants had to guess who the person was by asking questions...
“But we’ve always done it that way!” Don’t walk…run! Probably the most dangerous phrase for an EMS system and especially an ambulance billing program is the phrase… “But we’ve always done it that way!” In today’s world, if your EMS agency is going to be successful and remain insulated from...
To Bill or Not to Bill? Shakespearian EMS? We can only wonder what the documentation would look like if the great bard Shakespeare would have been a member of the EMS community. “Dispatheth via troubadour to yonder hamlet for a person swooning with the vapors.” Okay…enough of that. But we...
Helping Your EMS Billing Program Achieve Success in 2017 Happy New Year! The Holidays are over and it’s back to work. Happy New Year to everyone in EMS land. Before we get too far into the new year, let’s pause for a moment and highlight some relatively easy ways you...
EMS Facing Uncertainty in 2017 Happy New Year! We’re just two weeks from shouting Happy New Year! The year 2017 is just around the corner and the ambulance industry faces unusual uncertainties surrounding funding and reimbursements in the upcoming year. Just before we begin the two-week celebration of Christmas and...
OIG Announces New Ambulance AKS Safe Harbor Breaking News The Office of the Inspector General (OIG) issued a new rule pertaining to government-owned and operated ambulance providers and suppliers this week regarding the waiving of Medicare copayments and deductibles for emergency ambulance services under the Federal Anti-Kickback Statute (AKS). The...
The Power of the “Pre-Auth”! Necessary Evil! The American healthcare picture has increasingly become more complex. The advent of the Affordable Care Act and other changes have ushered in literally thousands of new healthcare insurance coverage options. These options change all the time and each year new plans with new...
