Shutdown and ACA- What’s Next and How Will They Affect the EMS Bottom Line? History By now, most likely you have heard that the United States Government is experiencing a partial shutdown. The Trump Administration and Congress reached a stalemate just before the Congressional Christmas break stemming from a disagreement over funding for a southern […]
Take Compliance Seriously- Or…It Will Cost You! In the News Recently, some scary EMS articles have been published. Here are some headlines… Fla. Ambulance company to pay 1.2M in federal whistle-blower lawsuit <Company name redacted> settles Medicare fraud suite for 12.7M Ambulance company owner sentenced to prison for fraud Feds crack down on Medicare ambulance […]
Ambulance Industry Legislation Update In this space… Over a few month we reported in this space about legislation in several States that had the potential to impact the ambulance industry in a big way. Since those posts, there have been some positive developments on a few fronts. Pennsylvania Legislation Passes The new State budget passed […]
Balance Billing and Air Medical Transport Part Two Welcome to Part Two of our blog series Balance Billing and Air Medical Transport. Last week, we looked at the historical aspect and defined the issue at hand. This week, we peer into the public perception, regulatory consequences, and make some suggestions on how to navigate the […]
Medicare Prior Authorization- Part II- Impact! Welcome! Thanks for stopping by for Part II of our blog recap of the findings from the recently published interim evaluation report on Medicare Prior Authorization. Last week, we capsulized the findings as published by government contractor Mathematica Policy Research. This week, we will briefly take a look at […]
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 […]
Cost Data Collection on the Horizon for EMS Reality Time When the Philadelphia Eagles won their very first Super Bowl two weeks ago, the City of Brotherly Love went giddy wild. There were light poles to climb, banners to wave and confetti to throw. Then…it was reality time. All that confetti had to be cleaned-up, […]
Medicare vs Medicaid- What’s the Difference? Interchangeable? It seems that often EMS people like to interchange the words Medicare and Medicaid. While similar in scope, the reality is these programs are two uniquely different government offerings. We thought it would be helpful to define the two programs and call attention to their similarities and differences. […]
Winter Flu Season- How to Document? Holidays Behind Us…Enter Flu Season We trust that you had a wonderful holiday season filled with many WARM memories (and we emphasize WARM!) We’re back to our normal routine so let’s dig into a direct documentation topic…. How to document transports that are initiated either directly or indirectly due […]
Medicare Bonus Payments Expire- What’s Next? December 31, 2017, 2359 Hours… When the New Years ball begins its drop in New York City on December 31, 2017 at 2359 hours, so will the Medicare Fee Schedule Bonus Payments drop. Those of you who operate in urban zip codes will see 2% less, rural zip codes […]
