Friday, August 9, 2013

3 Steps to Make Your EMS Billing Office Love You!

Feel the Love!
Today we’ll provide you with three sure ways that will serve to improve the relationship you have with your billing office, the way we see it; whether you outsource or bill in-house. Do these three things consistently and there’s no way the billing office can’t love you.

Step 1: Write it right away… and turn it in
The first and most important step in getting the billing process started on the right foot is for providers to complete the PCR as quickly as possible following the run.

The best way to kick off the billing cycle is to insure that all PCR’s are billed immediately following the call. A claim that is generated in the shortest amount of time possible following the treatment and transport of the patient has the greatest possibility of finalizing successfully (defined as collecting the most amount of reimbursement in the shortest amount of time with the least amount of effort) when the claim is prepared and shipped off to the billing source with the shortest amount of time elapsed between call and billing.

It just makes sense. If the billing office has to interact with the patient or the patient’s family, facility, whatever… then it’s best to talk with them when the incident is fresh in the memory bank. The best information available from the facility- sending or receiving, will be soon after the run. QA/QI questions and review is certainly answered most effectively when the incident is fresh in the provider’s mind.

Plus from the biller’s perspective, payers process claims most efficiently when they are processing all facets of the patient’s care at the same time. So it is just logical that the ambulance claim will be paid most expeditiously by the payer source when the claim processor is also processing payments for other providers of care- doctors, hospital, diagnostics, etc. We find this to especially be the case with liability payers, such as auto and workers compensation.

In addition, fast conversion time from incident to QA to PCR to billing office to claim insures that the claim is always submitted well within the various filing limitations for tight-window payers like Medical Assistance and participating provider arrangements.

Step 2: Put all the puzzle pieces together…
The second thing you can do to make raving fans of your billing office is to always have all the pieces to the puzzle in place every single time.

Put another way; get it all and get it together.

Nothing is more frustrating to a biller than to obtain only half the necessary information. This means that when the run is completed all the puzzle pieces should be in place to enable the trip to be billed. No biller likes that annoying “to do” pile on the corner of the desk.

For 9-1-1’s, the PCR not only needs to be written and submitted timely but it must be complete. Times, mileage readings, concise medical necessity documentation, chief complaints, origin and destination locations, signature forms… all that stuff needs to be together and turned in.

Plus, the most important piece is to obtain the insurance information. That means at a bare minimum pick-up the ER face sheet complete with patient demographics. If a face sheet isn’t available or it’s a liability scenario, then ask for the information and write those all-important ID numbers down for inclusion when you send the trip sheet package to your billing office.

For non-emergency or routine transports, again the PCR needs to be concise complete with a clear explanation why the patient could not be transported safely by any other means without harming the patient in any way. Along with a well-written trip sheet, the complete package should also include some of the same elements mentioned above… times, mileage readings, origins and destinations, signature forms, Physician Certification Statements, call intake forms, pre-certification documentation (if necessary and obtained), ABN and/or waivers… again all those things that allow for immediate billing.

And… once again… include the insurance information!

Step 3: Paint the Picture
Finally, paint a picture in words about your ambulance run in your PCR.

Know this. Ambulance billers CANNOT read between the lines.

We cannot nor should we make assumptions about your patient’s condition and ultimate treatment and transport (or lack of transport) if your trip sheet doesn’t spell out every single part in the most complete detail possible.

The most frustrating part of the billing office’s duties is when we have to return a trip sheet for clarification. When a biller reads a trip sheet and gains a basic idea of what’s going on but is unable to properly apply a diagnosis code for billing due to the fact that the scenario isn’t concisely documented, it’s extremely frustrating.

Time is money for the billing office. Lost time returning a PCR for review is costly to the entire system and creates extra work and tracking.

Remember, the billing office’s goal is to receive your PCR, review it, apply coding to it (both diagnosis and level of service), get it billed quickly and receive payment in the least amount of time possible. However, the biller is stymied when he/she can’t derive what must be pulled from the trip causing the trip to be returned for review. Returning a trip now delays the billing cycle by days, maybe even weeks. The farther out from the scenario the billing cycle is initiated, the less likely the claim will resolve with successful payment or at least without more unnecessary effort on the part of the billing office.

No one is expecting you to write a best-selling novel for each PCR. However, we offer that you consider your documentation as important a function as the care you provided. When you complete your run sheet, you are making a historical record of the excellent care you have provided to your patient- quite possibly by documenting that you have saved a life.

Put yourself in this frame of mind. Why not consider your PCR a chronicle that celebrates your unique abilities as a healthcare professional? You deserve a pat on the back. The way you get that recognition is by recording the events of the day in the record of the event. Show the pride you bring to your profession by completing a well-documented run sheet.

Pride has a way of perpetuating down the line. You’ve treated your patient well. Your QA office will take note of this. Your success will contribute to the success of the billing office by helping to funnel much-needed monetary resources into your department which in turn pays for the life-saving equipment that can now be purchased to save yet another life… and the cycle repeats itself again and again.

The ball’s in your court!
So now you have the 3 steps you need to take to make us billers happy.

The ball’s in your court.

Need help?

Your billing office will probably bend over backwards to give you a hand. Most of us are pretty good guys and gals and we like cooperation. Our day depends on it.

But we also know that there are those billing offices that aren’t as easy to work with as we would hope. At Enhanced we strive to provide our clients with the necessary tools to make you successful.

Be it our friendly staff, cutting-edge tools such as Enhanced PulsePoint™ and PulsePoint™ Mobile, education opportunities such as our this blog, e-mail blasts, news from our website or even on-site documentation training; we provide the kind of necessary support to field providers that today’s EMS systems demand.

If you’re not receiving that kind of everyday support from your billing company then it’s time to talk to our Business Development Manager, Chuck Humphrey to learn how your department can become a client today! Chuck can be reached by e-mail at chumphrey@enhancedms.com or you can call him toll-free at (800) 369-7544, Extension 108.
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