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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Recovering Loss of Revenue from “not at fault” Accidents

When your units get hit by a third party and the vehicle is out of service, are you getting Loss of Revenue for the downtime while the unit is being repaired? Whether you answered yes or no to that question, reading this article will be the one of the most lucrative uses of your time this year. A call comes in and your dispatcher does a perfect job of answering and scheduling the run. The EMT’s jump into the clean, fueled, and well stocked ambulance responding to the call. Then from out of nowhere, a car turns directly into the ambulance’s path rolling through a stop sign. Now what? You have two paramedics stranded on the side of the road who will be spending the next few hours on paperwork and drug testing. In addition, all the drugs and small equipment need to be removed or secured. Hopefully you have another unit to dispatch or your competitor may have already been called. What happens next is key to getting maximum recovery for your losses caused by the accident. Key items that help maximize your recovery from accidents: Educate and equip fleet drivers with the tools necessary to collect key accident...

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Medicaid Replacement Plans

Medicaid billing in emergency medical services is unavoidable. From trauma trips to non-emergency transports, ambulance providers face a multitude of hurdles when trying to identify, verify and bill the correct payor for Medicaid patients. Guesswork is often used instead of real-time insurance verification. This can be especially true when commercial payors such as United Healthcare and Blue Cross Blue Shield manage the Medicaid plan, commonly termed Medicaid Replacement Plans. This article provides four valuable tips for successfully processing EMS claims when a Medicaid Replacement Plan is involved. The Challenge for EMS Billing: Benefits Verification Just as commercial payers see growth opportunities in managing Medicare Advantage (MA) plans, they are also overseeing hundreds of Medicaid programs. According to the annual CMS-64 Medicaid expenditure report, in federal fiscal year (FFY) 2016, Medicaid expenditures across all 50 states and 6 territories exceeded $548 billion, with nearly half of all spending now flowing through Medicaid managed care programs. On average 54.67% of Medicaid dollars are spent on managed care, whether to manage the transition or fund plans. This ranged from 97.9% in Puerto Rico, down to 12.1% in Colorado. A single trip may have Medicaid benefits, but also managed by United Healthcare or another (more…)

Patient Satisfaction and the Collections Conundrum

Emergency Strikes The year was 2001—seems like a distant memory. Expecting our first child, my wife and I were living in Modesto, California, thinking about cradles and nurseries. We were so excited—the little one we’d been expecting was on his way! Excitement quickly changed to deep concern as we learned there were some major complications with the pregnancy and our baby was in serious jeopardy. Life’s pause button was pushed as everything else in the world came to a screeching halt. An ambulance transport and emergency delivery later, we found ourselves in our new home—the neonatal intensive care unit. For the next four months, we worked with medical teams around the clock to slowly usher our new 1-pound, 4-ounce son, Noah (now 15 years old), into the world. Financial Domino Effects This was an incredibly stressful time in our lives. Of all the things that burdened us, one of the most memorable was the nearly $5,000 invoice we received for a specific service. With no clue how we would pay this, I finally worked up the courage to pick up the phone and call the number on the invoice. The provider was demanding immediate payment before sending the bill to...

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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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Join Us in Fort Worth for a Finances & AR Workshop

MedStar Mobile Healthcare 2900 Alta Mere Dr | Fort Worth, TX 76110 March 16, 2017 | 9:00 am – 4:00 pm $315 for Members | $630 for Non-Members EMS agencies need to make sure all individuals understand how their efforts impact the organization’s ability to care for the patients that they serve. During this workshop, AAA HR & Operations Consultant, Scott Moore, and AAA Medicare Consultant, Brian Werfel, will give patient account personnel and EMS leadership a better understanding of the important role that their function serves within an EMS agency. Attendees will learn about: The finances of an ambulance service, including the Key Performance Indicators of Expenses, Income, Assets, and Liabilities. Cash management’s role in a company’s operation and sustainability. How to tie the financial foundation to the activities and performance of the Patient Accounts Department, discussing the role of patient accounts in the financial strategy of a service, as well as evaluating the performance of your AR department. How to get the most from their billing software to maximize efficiency and ensure the appropriate tracking of claims from time of transport until the account is paid and closed. Attendees will leave with actionable tools from each session they can apply in (more…)