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 […]
Pause and Remember On the anniversary of our most tragic day in history, we take a moment to pause and remember those EMS workers and first-responders who lost their lives on September 11, 2001. Never forget… […]
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 […]
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 […]
When Other Healthcare Disciplines Don’t Know Ambulance “I worked in healthcare.” One recent caller to our billing office started a conversation in this way when he called to question his ambulance bill. The patient called because he had received notice that we had billed Medicare on behalf of one of our EMS agency clients. The […]
Documenting Emergent Scenarios Post October 1 Focus If you’re a regular reader of this space you are aware that we focus A LOT on medical necessity, especially as the definitions contained in the rules pertain to Medicare. With anywhere from 40% to 60% or upward of the average ambulance reimbursements being derived from Medicare Fee-for-Service […]
Adding EMS Routines? 3 Key Questions to Ask Prior to Taking the Leap Increase volume. Increase cash flow…not so fast! As an EMS billing contractor, we increasingly are contacted by our clients about the pros and cons of adding routine/non-emergency ambulance transports to the daily repertoire. It’s a big decision. It’s a decision that should […]
Taking Aim at System Abusers Past History- “Villainizing” the Service Providers If you follow the news regarding entitlements like we do, then you have probably noticed a growing trend toward what we consider to be the “villainizing” of healthcare providers that bill Medicare and Medicaid. Everyone seems to want to blame the ills of the […]
