Blog Categories  /  Billing Basics

Ambulance Reimbursement & Operational Issues for 2019

Let’s look at a crystal ball to see what 2019 has in store for ambulance operations and reimbursement. Better than a crystal ball, I’m going to use my experience this year to talk about emergency billing issues, rural health transports, CMS cost reporting, catastrophe response, Uber &...

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Insurer Denied? Here's What to Do

Today we offer concrete steps to battle commercial insurance denials. It’s a common occurrence – the billing department carefully verifies who the payer is and sends a properly executed claim to the insurer. Instead of the expected payment, the payer sends an Explanation of Benefi...

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Doesn't Matter - Audits or Regulatory Change - EMS Must Still Run

This piece is about two things – the ambulance industry must be realistic and practical. There is a LOT of scrutiny these days (ALS emergency audits, TPE audits, review of non-emergency transports) and much change on the horizon (non-emergency documentation rules a-coming, a proposed Medica...

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Patients Not Paying Ambulance Bills?

Many transport bills include a patient portion after insurance. As noted in Modern Healthcare on June 27th, a patient’s balance after insurance grew dramatically from 2012 to 2017. Medicare patients also saw an increase. But the increased financial burden and requirement to collect is just ...

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Trip Reports: Narrative NOT the Thing

Recently I conducted a documentation training session. Included in the class were members of the company’s billing department. They were eager to see the crews get their “come-uppance” with training in the areas that billing felt crews were lacking. At break-time, one of the bil...

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The Cost to Bill EMS Trips

Billing ambulance trips is difficult and not always rewarding. Yet reimbursement revenue is the lifeblood of EMS organizations. We already know billing is hard to do, but have you ever thought about how much it costs to collect a bill? Harvard Business School and Duke University got together to f...

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Promise in Recent EMS Bad News

EMS was hit with unsavory press recently – big article in the Washington Post and Kaiser Health News about the detrimental impact on patients of large bills generated by ambulance trips and articles that discuss the use Lyft or Uber over ambulance. While the American Ambulance Association g...

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And Still You Don't Get Paid

I received four calls recently from emergency providers who complained about growing denials, large unpaid accounts receivable and skyrocketing patient balances. Yet I recently read that uninsured rate in U.S. is down dramatically with only 8.8% of population currently without insurance. If so ma...

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Exciting Announcement

We’ve missed you, but we’ve been offline for a good reason – we’re excited to announce that we have expanded into a new office with additional audit and nursing staff. We have you to thank for our continued growth! As fraud oversight strengthens, the need for ambulance...

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Transports Related to Hurricane Harvey Disaster

The devastation in Texas and surrounding states from Hurricane Harvey is horrific. Those of us in other parts of the country ache with concern for the people impacted by this terrible storm. First responders, EMS, police, fire personnel and citizen volunteers have done an incredible job helping t...

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Why It's So Hard to Do Ambulance Billing Right

On Facebook, I read a story about someone’s experience with the billing department. The storyteller complained about problems with insurance and lamented that things would have gone a lot smoother if only she had not been dealing with “a chick with a bad attitude.” Sigh! If only...

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Impact of New HHS & CMS Leaders on EMS

Welcome to 2017 and get ready for the whirlwind! The players have been chosen. We now know more about what to expect from the next era of healthcare. We can start to prepare for the impact on EMS management and revenue. Keep reading for concrete steps you can take now to assure you are ready for ...

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EMS Reimbursement Post Election

The election is over and a new day has dawned. We know there will be changes to healthcare, but we don’t know exactly what those changes will entail. However, there are steps that everyone in the ambulance industry should take to prepare for whatever the new year brings. Regardless of what ...

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Balance Billing Going Away?

I like my surprises to come in small boxes wrapped with ribbon. Unfortunately for many of our patients that's not the way their surprises arrive. Surprise medical bills are getting a lot of attention in the national news.  The Brookings Institution released a study earlier this month not...

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Mental Health Transport Woes Worsen

This situation makes me sad for everyone involved – ambulance companies working with these patients, billing departments trying to figure out how the heck to get paid for these transports, but mostly, my heart is heavy for the patients themselves. Unfortunately, the worlds of both emergency...

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Politicians as a Billing Resource

Unless you have been living in a Wi-fi-free area for the past several months, there is no way you do not know that it’s election season. The time of year got me thinking about what our politicians do for the EMS industry. Don’t worry; I’m not going to talk about anything politic...

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Top EMS Hot Topics

Fall and spring are conference seasons! It’s that time of year when ambulance associations and industry organizations hold their events. Today I will tell you about a couple questions that I get asked repeatedly when I’m speaking. We will outline ideas of what you can do and where you...

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Labor Day EMS VIPs

This Labor Day holiday is a good time to recognize the VIPs of every EMS organization – the dispatch staff, the EMTs and paramedics, and your essential billing team. Look at what they face and how much they do. Dispatch Personnel The call center has become the “special forces&...

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Policies Causing Problems?

I am a big believer in policies and procedures. I preach the importance of having good policies and procedures in my talks and when working with clients. My advice usually goes, “make sure you develop a policy to address the issue.” Yup, I like policies. Well, most of the time. Except...

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Why Don't Providers Get Paid?

Probably the most-requested session I will present during the upcoming fall conference season is “Why Don’t Providers Get Paid?” There are several reasons EMS does not get paid for services. Since I will be seeing so many of you in the coming weeks (can’t wait!), I will ho...

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EMS is NOT on 6 O'Clock News!

The totally most awesome, coolest thing is happening where I live this week! EMS is NOT on the news! We could be, especially this week, but it’s not. You’ll understand when I tell you that I live in the Philadelphia area. It’s a very challenging place to be. It’s hotte...

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Tools to Deal with Repetitive Trips

A fact of life is that people get cancer and need chemotherapy and/or radiation. Others get serious kidney disease and need life-sustaining dialysis. Both types of people often require repeated treatments to respond to their serious health needs. Sadly, many of those patients will become sick eno...

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Why EMS is Lovable

I usually discuss billing or compliance issues, but today in honor of EMS Week I'm going to share a couple of my experiences that explain why I love EMS so much. I've had a glorious career. I'm very lucky -  I’ve traveled the country, met many interesting people and se...

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Gotta Get it Right!

I stepped in it big time this week. I was arranging a healthcare service for a family member. The hospital told me that a prior authorization was needed. I argued strenuously that no authorization was necessary. I went so far as to tell the hospital that I needed them to show me where it was writ...

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Allure of Whisper Policies

Have you noticed the desk that everybody seems to gather around? Or that one person in the department who gets all the emails from the staff wanting to ask a quick question? Why is it that one person appears to be the go-to? Why can't the rest of the staff figure out the answers themselves? M...

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Who Does EMS Cleanup?

Hallelujah! Spring is finally here! The arrival of spring brought new EMS field and billing problems to our door. We quickly realized that it’s time for spring cleanup. The question is, who’s doing the cleanup at your organization? From what I hear, many of you just can’t find t...

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Should You Outsource EMS Billing?

Big question came up from three people this week – should we outsource billing? Or, we outsource now and think we should bring it back in-house. What do you think? I think you need to do a combination of soul-searching and concrete analysis. Below we discuss the benefits of in-house bil...

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Hard to Make Money in EMS

Geez, but the ambulance industry has gotten to be a tough place for some to work! Recent articles talk about providers pulling out of a state because of low reimbursement rates and another article discussed how Philadelphia providers can’t make any money. The really scary stuff is the 37-ye...

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Tension Between Field Crews & Billing

Almost every billing office I enter has the same complaint, “field crews don’t give us enough documentation!”  When I do documentation training, EMTs and paramedics say it feels to them that everything is about billing. I taught a class recently where crew-members told me t...

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