Narberth Ambulance Overcomes Major Hurdles In Its Billing System

Pennsylvania EMS Provider Achieves Major Billing Milestones Through Payor Logic Partnership and ESO Integration The Volunteer Medical Service Corps of Narberth was established in 1944 by residents of Narberth Borough, a suburb of Philadelphia, to provide transportation and first aid for soldiers returning from World War II via Philadelphia’s ports. The organization, now known as Narberth Ambulance, has expanded over the past 70 years from a small station with two ambulances to a full-fledged EMS service that makes nearly 10,000 trips annually, employs 33 full-time staff, 44 part time employees, and 80 volunteers. Narberth covers four Philadelphia area communities with two stations, seven ambulances, two responder vehicles and one mass casualty/rehab bus. While Narberth Ambulance has seen tremendous growth and success throughout its history, recent times have brought new challenges. Changing technology in the healthcare industry paired with declining reimbursement over the past several years left Narberth, like many other EMS services, facing issues with its billing system and claims processing. These complications made claims longer to work and payment harder to collect. At the height of this problem, Narberth’s billing team needed from five to ten business days to process a claim. The Issue at Hand According to Meg...

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IRS Proposed Rule on 199A Passthrough Deduction

The 199A passthrough business deduction was created under the Tax Cuts and Jobs Act that was signed into law on December 22, 2017. The creation of the 199A section within this legislation has since created many questions and needed clarifications. On August 8, 2018, the Internal Revenue Service (IRS) issued proposed regulations that provide guidance that further clarifies which passthrough businesses are able to take advantage of this deduction as well as how taxpayers and tax professionals alike can navigate this new deduction. Section 199A allows domestic businesses operated as a sole proprietorship or through a partnership, Limited Liability Company (LLC), S corporation, trust, or estate to deduct up to 20% of qualified business income from tax years between 2018 and 2025. Those who have taxable income of $315,000 or less for joint filers and $157,500 or less for single filers will now be able to take advantage of the deduction. Those who exceed these taxable incomes will be subject to certain limitations. These limitations could include the taxpayer’s taxable income and limitation by 50% of W-2 wages. These regulations clarify that individuals and certain trusts and estates may be able to take a deduction of up to 20 percent (more…)

Preliminary Estimate of 2018 Medicare Rates

A Preliminary Estimate of 2018 Medicare Rates In this blog, I will provide a preliminary estimate of the Ambulance Inflation Factor (AIF) for calendar year 2018.  The AIF is main factor that determines the increase (or decrease) in Medicare’s payment for ambulance services. Calculating the 2018 AIF The AIF is calculated by measuring the increase in the consumer price index for all urban consumers (CPI-U) for the 12-month period ending with June of the previous year. For 2018, this means the 12-month period ending on June 30, 2017. Starting in calendar year 2011, the change in the CPI-U is reduced by a so-called “productivity adjustment”, which is equal to the 10-year moving average of changes in the economy-wide private nonfarm business multi-factor productivity index (MFP). The resulting AIF is then applied to the conversion factor used to calculate Medicare payments under the Ambulance Fee Schedule. The formula used to calculate the change in the CPI-U is limited to positive increases. Therefore, even if the change in the CPI-U was negative over a 12-month period (a rarity in the post-war era), the change in the CPI-U cannot be negative. However, when the MFP reduction is applied, the statute does permit a...

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Time to Automate

Founded in 1964, now nationally recognized, Mohawk Ambulance Service is the largest privately owned ambulance service in upstate New York. Our organization services six emergency centers, makes 56,000 trips annually and employs a team of more than 250 staff members. Eighty percent of our trips are for emergency transports where patients are unknown, in critical condition or have no identifying information. Finding fast, efficient ways to verify demographics and discover insurance coverage for these patients is imperative for our revenue cycle and our bottom line. We’ve always worked closely with our local hospitals and nursing homes to obtain information. Many standard processes have been refined over the years with checks and balances to verify coverage, screen deductibles and reduce eligibility-related rejections before claims are submitted to a payor. But our billing team knew we could do more to eliminate duplicate data entry and processing lag time. This article describes our journey to a more streamlined billing process. It includes lessons learned and best-practice recommendations for other EMS providers looking to improve staff efficiency and reduce receivables. First Stop: Real-Time Insurance Discovery The first area we tackled was insurance discovery where we had three employees stationed. We focused on our self-pay...

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President Postma’s Capital Campaign

At the 2016 AAA Annual Conference & Trade Show, new president Mark Postma announced a visionary capital campaign to build our association’s reserves to $1 million. We invite all members to give as they are able to build a rainy day fund capable of weathering any storm. Thank you in advance for your support and participation. Funds contributed to the Capital Campaign can only be used by the association following a board vote. Pledge Now

CMS Medicare Ambulance Transports Booklet — Revised

CMS has released a revised Medicare Ambulance Transports Booklet. To order a hard copy, visit CMS’ Learning Management and Product Ordering System. Learn about: Ground and air ambulance providers and suppliers, vehicles, and personnel requirements Documentation requirements Coverage, billing, and payments Advance Beneficiary Notice of Noncoverage    

AAA 2016 State Balanced Billing & Direct Pay Survey Results Released

The AAA is providing its members with the results of two important surveys conducted of state laws impacting ambulance services.  The first chart entitled “2016 State Balance Billing Survey” shows whether a state restricts balancing billing of patients.  The second entitled “2016 State Direct Pay Survey” lists whether a state has a law requiring an insurer to send payment directly to a non-contracted ambulance service or a law allowing the insurer do send payment to the patient.  We thank AAA Medicare Consultant Brian Werfel for compiling the data and members of the AAA Medicare Regulatory Committee and the AAA membership to which Brian reached out for their assistance....

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A Preliminary Estimate of 2017 Medicare Rates

 On July 15, 2016, the Bureau of Labor Statistics released its monthly report on inflation.  This release includes the change in the Consumer Price Index for all urban consumers (CPI-U) for June 2016.  As a result, it is now possible to make a preliminary estimate of the Ambulance Inflation Factor (AIF) for calendar year 2017.  The AIF is main factor that determines the increase (or decrease) in Medicare’s payment for ambulance services. Calculating the 2017 AIF  The AIF is calculated by measuring the increase in the consumer price index for all urban consumers (CPI-U) for the 12-month period ending with June of the previous year.  For 2017, this means the 12-month period ending on June 30, 2016.  Starting in calendar year 2011, the change in the CPI-U is reduced by a so-called “productivity adjustment”, which is equal to the 10-year moving average of changes in the economy-wide private nonfarm business multi-factor productivity index (MFP).  The resulting AIF is then applied to the conversion factor used to calculate Medicare payments under the Ambulance Fee Schedule. The formula used to calculate the change in the CPI-U is limited to positive increases.  Therefore, even if the change in the CPI-U was negative over...

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