Friday, May 30, 2014

The ABC’s of an Ambulance Billing Company

DNA
There are many ambulance billing companies out there. These companies come in all sizes and shapes. Some are good; really good. Some are bad; really bad.

A really good ambulance billing company has a basic DNA that involves these ABC’s.

The same basics may apply to the in-house billing operation; if that’s the model your company chooses to follow.
The ABC’s of an Ambulance Billing Company
Analytical
No matter what the size of the company measured in either the number of employees, the number of clients or even the number of annual claims; a really good billing is analytical.

A really good billing company provides the tools for an ambulance department to adequately analyze the billing program. Because every ambulance company is different, whatever reporting and tracking tool is available must have the ability for the ambulance company, as the client, to manipulate certain data sets in order to analyze the program’s results.

In addition, billing company staff must be experienced and possess the knowledge-set to assist ambulance department administrators in reviewing the data when necessary. A well-rounded billing company can easily look at billing reports and help administrators make sense of them without delay. This analysis can include, reviewing trends in the industry, monitoring and predicting Medicare and Medicaid reimbursements and other associated trends just to name a few.

The billing company staff also must examine and determine the adequacy of medical necessity and the reasonableness of the claim as supported by documentation in staff-written Patient Care Reports. 

Basics
Really good ambulance billing companies do the basics really well.

They almost always use a very robust billing software program. The really good billing company uses electronic claim submission technology whenever possible and to every third-party payer source possible. They interact with their clients electronically, connecting to the ePCR software of the client’s choice.

The really good billing company’s staff reads subjective narratives; they take note of chief complaints. They know how to read the Patient Care Report and how to apply the correct procedure and diagnosis codes.

The really good billing company practices really good customer service, practices habitual follow-up and never accepts a payment as final until they know that the claim has been paid according to applicable fee schedules and payment models.

Plus the really good billing company knows how to play by the rules and respects the gravity of the role they play in the success of the overall EMS systems they serve.

Certification
The “C” in our ABC analogy represents certifications.

The really good ambulance billing company insures that every staff member holds all necessary certifications. Because ambulance billing is so unique and unlike any other healthcare discipline when it comes to billing, the industry requires a certification for billing staff that is unique to the ambulance industry.

The Certified Ambulance Coder (CAC) certification via the National Academy of Ambulance Coding (NAAC) is the one certification that is specific to the ambulance billing discipline. The CAC training provides ambulance billers across the United States with training and continuing education opportunities to insure that those certified are up-to-date with the latest rules and regulations surrounding all facets of ambulance billing.

Know that your ambulance billing company has completely certified individuals before engaging or continuing to engage that company’s service.

Choose Wisely
Today, more than ever, it’s important to choose an ambulance billing company wisely.

Enhanced Management Services has its DNA and ABC’s in order. If your company isn’t using Enhanced, contact us today. Business Development Manager, Chuck Humphrey is ready to help you via e-mail at chumphrey@enhancedms.com or by voice by calling toll-free to (800) 369-7544, Extension 108.
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