Proven, Expert Partners
EMS & Ambulance Billing and Claims Solutions
Q: The AccuMed Group makes many references to compliance. What are the common mistakes you see from ambulance companies that do their own billing?
- Assignment of incorrect procedure codes (up coding and down coding)
- Improper use of ICD-10 and Condition Codes
- Improper use of Modifiers, including not assigning a GY modifier when the trip does not support medical necessity in the documentation
- Improper mileage use
- Failure to bill properly when processing MVA incidents
- It is a common practice for payors to extrapolate an error rate and apply that to total billable run volume. In the case of a 23% error rate applied to 5,000 annual trips, the payor will likely seek recovery of 1,150 trips, for multiple years plus interest.
Q: What is involved for us to make the switch to The AccuMed Group?
- Initial on-site incident documentation training (how to develop a compliant incident report that maximizes recovery).
- Ongoing incident report documentation review and training.
- Establishment/analysis of:
- Collection Policy
- Incarcerated Patient Policy
- Compliance Plan
- HIPPA Privacy Plan
- Intercept Agreements
- Hardship Policy
- Charge & reimbursement analysis to optimize revenue.
- Compliance reviews (Internal and External).
- Review, analysis and recommendations regarding contractual relationships with third party payers.
- Reasonable cost-free access to the national EMS law firm of Page, Wolfberg and Wirth, LLC.
- Support of the annual budget process.
- Reporting and monitoring tools.
- Technology – electronic data management support.
Q: Does The AccuMed Group only support ESO software?
Q: Does The AccuMed Group include ePCR software or hardware costs within the fee?
Q: Does The AccuMed Group provide assistance with determining the proper amount to bill insurance companies?
Q: Does The AccuMed Group recommend HIPAA policies / plan for clients?
Q: How often will we receive billing / financial reports? How do we receive them?
Q: Is it cheaper for us to outsource billing or do our billing in-house?
Q: Does your company outsource any of your billing process?
Q: Do you use any collection agencies?
Q: How do we send you runs to bill?
Q: Who do our patients call if they have any questions?
Q: Do you bill insurance and patients?
Q: Does The AccuMed Group bill for fire services?
Q: How much do you usually collect, what is your collection percentage?
|EMS System A||EMS System B|
|Annual Gross Charges||$3,000,000.00||$2,500,000.00|
- Incident Report Development and Delivery Method (Manual vs. Electronic Data Capture)
- Incident Report Documentation Quality
- Establishment of Medical Necessity (complete description of all procedures, medications, patient assessments, outcomes regarding what was “seen and done” during the entire incident)
- Complete and accurate demographic and insurance information captured
- Quality assurance procedures completed prior to delivery of the incident for billing (identification and completion of missing, inaccurate or incomplete incident report and supplemental forms data)
- Incident report delivery times
- Complete and accurate supplemental forms (Physician Certification Statement, Advanced Beneficiary Notice)
- Collection Policies
- Overall charge strategy
- Resident vs. non- resident billing strategy
- Hardship criteria – third party debt collection utilization
- Acceptance of credit card payments
- Unique contractual agreements
- Payment obligations conveyed from EMS staff to patient (establishment of expectations / requirements)
- Evolving Community Demographics and Payor Mix
Q: Has The AccuMed Group had any billing violations?
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