5 Proven Methodologies For Ambulance Billing Services
With
the changing lifestyle of individuals and the rising number of aged populations,
there has been increase in ambulance services and ambulatory care services. But
simultaneously, one of the most affected areas for revenue management is the ambulance
billing services in the healthcare industry.
The
simple reason behind failure to get 100% reimbursement for the rendered
services is the in-house billing team and more focus on saving the life of the
patients (which should be the case) with failure to handle the revenue
processing and collection for the services.
As
a result, the reimbursement decreases significantly from the insurers, both
public and private, while the business cost of medical care is growing. Also,
the increase in the federal government's involvement is impacting the compensation.
Added
to this, the Affordable Care
Act and other monetary limitations will continue to dwindle the
ambulance services if they do not adhere to the time and fee schedules and the
changing guidelines of the payers. Hence, ambulatory care must look into ambulance
billing management and revenue cycle management to tackle the low to no-payment
issues.
Here
are five proven tips for ambulance billing services to ensure the service
provider benefits while serving the community.
Tip 1: Checklist &
Validation
You
need to put in place a system that will ensure mistake-free EMS claim
submission. In addition, it will provide an efficiently managed and smooth
running of the payments. The hassle-free submission system starts with having
the correct details about the dispatch and the ePCR or the patient being
carried to the facility.
The
data entered for every step must be validated so that when the claim is ready
for submission, the data is easily QA'd, so the processing time is minimized.
The
initial setup of the ePCR software must be done in consultation with a
professional biller from the ambulance billing department. They will help the
facility configure the software, input and validate the data, and maintain
adherence to the ambulance billing checklists and regulations. As part of the
process, the staff must be trained in checking to list and validating the
ambulance billing claims.
Tip 2: QA (Quality
Assurance) Check
There
should be a comprehensive cycle of ambulance billing QA for every EMS
operation. For a QA check, you would need a specialist who can ensure a
consistent and clear QA process is followed for the entire workflow of EMS.
The
job of QA cycle management also entails checking denials and rejections, which
can help isolate issues that result in denials. In addition, the process
assists in correcting the reasons for the denials and claim refusals so the
documenting process can be corrected in the future, ensuring the same mistakes
don't happen.
For
this, you need to train your staff, and they need to keep up-to-date with all
the ambulance billing and coding changes of CMS. It will then ensure a quick
and error-free billing submission for the ambulance service.
Tip 3: Documentation
Collection, Implementation, and Sharing
One
of the primary reasons for denials and claim rejections in ambulance billing is
the failure to provide proper supporting documents. Any missing documents from
the medical necessity forms, pre, and post-authorization, and transportation
will lead to claim delay, denial, or rejection. Moreover, each of these
documents must have the necessary signatures, which can be challenging at times
due to the patient's condition.
Additionally,
there can be difficulty in getting the provider's signature, referring, and/or
receiving agency. A single missing signature will result in getting the claim
rejected. Hence, it is essential to integrate the EMS software, which will help
obtain, process, and share the supporting documents across the EMS operation.
Tip 4: Focus On Unpaid
Billing
Ambulance
providers must take special care and focus on unpaid bills. It will help them
break even in operation and keep a check on the security and other regulatory
requirements for providing optimum healthcare. It is vital they learn from the
mistakes that result from incorrect data entry, inaccurate ambulance coding,
and billing. Also, the staff must do a regular follow-up for the submitted
bills. This can help in ensuring prevention from losing thousands of dollars.
Tip 5: Optimizing Revenue
Cycle Management
It
is of utmost importance that the ambulatory practices have an RCM team to take
care of all the timely collections. Also, they must be able to write a
customized report that will include the financial metrics of the practice. The
team must also be responsible for the fee schedules and workflow augmentation.
Furthermore,
it is the team's job to be proactive with the management team to keep all the
updates on the reimbursement changes, so there are no delays in the ARs. It
must be reduced on a continued basis with timely compensation.
How to Manage the Ambulance
Billing Services?
It
is best to bring in a professional service provider such as 24/7 Medical
Billing Services, specializing in the ambulance billing system. While the
practice can take care of the patients, 24/7 Medical Billing Services as an
outsourced medical billing company will take care of the revenue cycle
management. In addition, we help the facility with the latest EMS software that
helps in integrating all the data and documentation to ensure proper claims
while reducing rejections.
About
24/7 Medical Billing Services:
We
are a medical billing company that offers ‘24/7
Medical Billing Services’ and support physicians, hospitals, medical
institutions and group practices with our end to end medical billing solutions.
We help you earn more revenue with our quick and affordable services. Our
customized Revenue Cycle Management (RCM) solutions allow physicians to attract
additional revenue and reduce administrative burden or losses.
Contact:
24/7
Medical Billing Services
Tel:
+1 888-502-0537
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