Non-Emergency Transport: Avoiding the Fraud Trap [Sponsored]

By Eric van Doesburg, MP Cloud Technologies This sponsored post is not endorsed by the American Ambulance Association. It reflects the views of the author. Did you know that one of the most common practices in our industry could put your company at financial risk? Transporting patients not qualified for ambulance transportation is a hot topic these days as it has heavily contributed to the rise of Medicare fraud cases. This issue has grown even more relevant recently with a case in Florida, where not only was the EMS company found liable of fraud, but it was the first time several hospitals were held culpable as well.¹ While the burden of proof falls on the government to satisfy the statutes in the Federal False Claims Act, the fact is investigators are becoming more aggressive in fighting these types of billing schemes. “The fact is investigators are becoming more aggressive in fighting these types of billing schemes.” Yes, there are some bad actors in our industry like any other, but more times than not employees simply may be unaware of the qualifications needed when dispatching non-emergency transport. Thankfully, a company can protect its financial future simply by having the necessary protocols (more…)

Financial Hardship Policies: Steps for Your Protection [Sponsored]

By Eric van Doesburg, MP Cloud Technologies In an industry whose sole focus is to help those in need, it’s natural for us to want to assist patients financially when they’re in hardship situations. Waiving deductibles and copays for patients that have either claimed poverty, or simply for bills that seem too small to make a difference has become common practice. Although this is well-intentioned, it can easily put your company in harm’s way. “There is no question of if Medicare will audit you, but when.” The Federal False Claims Act requires businesses to bill patient’s copays and deductibles unless the company puts in place a clearly defined, legally binding policy. Without such a policy, any actions taken in regard to waiving payments would effectively overbill Medicare, leading to Medicare auditing the company for payment as well as instituting additional penalties. And in this day and age, there is no question of if Medicare will audit you, but when. You can still help out the less fortunate while working within the letter of the law, but only with the proper Financial Hardship Policies put into practice. We urge you to seek legal counsel when crafting and adopting a hardship policy, (more…)