Friday, October 24, 2014

Why so much personal information?

So you say you’ve just been elected to the Board of Directors or you’ve become an Officer or both for your local EMS Agency.


We applaud your willingness to step up to lend your wisdom and leadership capabilities to make a difference in the lives of those in your community when they are in need of Emergency Medical Services. But with the title comes responsibility.

We’re often asked…
Now that you’ve become a Board member or you’ve been elected to an office you’ve been requested to provide some very personal information.

We’re often asked, because Enhanced is an EMS outsourcing ambulance billing company that assist our clients with all matters concerning credentialing, why Medicare, Medicaid and even some commercial insurances request so much information on the provider applications.

We’ll attempt to explain.

"Personal" Personnel InformationName, rank and serial number please!
There is a process that Congress now mandates called Revalidation. Medicare and Medicaid providers and suppliers of services, ambulances included, are required to report vital information about your agency and included in that information is the identifying information for each person who holds a position of leadership- however that is defined for your organization.

It is required of both for-profit and non-profit organizations to report vital information and the most vital of information is the reporting of those persons who “run the show.” Basically it’s a “name, rank and serial number please” approach.

So for each person who sits your agency’s board and holds an office as it pertains to EMS is required to tell Medicare and Medicaid the following information…
  • Legal Name (First, Middle, Last)
  • Home Address (Medicare does not require but most State’s Medicaid programs do)
  • Social Security Number (and not just the last four digits either)
  • Date of Birth
  • State of Birth
  • Country of Birth (if born outside the United State of America)
  • For managers, the date the person took office
  • Position Held within the Organization
  • For-Profits must report ownership and also in some cases for States’ Medicaid family relationship to other owners
Ever heard of identity theft and privacy?
We’ve had some directors and principal officials flat out refuse to provide so much personal information. They typically ask something like; “Have you ever heard of identity theft and privacy?”

Well, yes we have but Uncle Sam requires the information and we are just the messenger. Don’t shoot us!

We get it. We’re all hesitant to provide information. Some Directors and Officers balk because they feel that the IRS or Big Brother is watching them. Okay…probably but providing information for your EMS Agency to use for credentialing isn’t going to stop them if they really want to peer into one’s life.

Certainly, everyone is worried about identity theft. We understand.

It’s why, here at Enhanced, the persons involved in credentialing are long-term employees who have a track record of safe handling of personal and private information. The Medicare Administration Contractor’s (MACs) or your State’s Medicaid Provider Enrollment/Credentialing Staff have been proven to be extremely discreet as required within the contractual relationship with the Federal Government.

What will Medicare/Medicaid do with my information?
Medicare and Medicaid will do the following with your information…
  1. Verify you are who you say you are
  2. Verify that you were never convicted of some financial crime or deception that cost the Medicare and Medicaid program dollars paid out inappropriately
  • This is accomplished by comparing your personal information against a database called the “Exclusion List.” It is a list of those persons who have defrauded the Medicare and Medicaid programs out of billing of dollars. The intent is for history to not repeat itself and more money is lost to fraud and abuse.
Once you have been vetted and found not to be misrepresenting yourself, your EMS Agency will be returned to fully active status and your information will be nicely tucked away in a very secure place until your information or your Agency’s profile changes and an update must be made.

That’s it!
That’s pretty much it!

So why is it that some Directors and Officers kick up a major dust storm when they are requested to provide the information? You tell me. I don’t get it.

So help out your administration or the billing office, if credentialing is their responsibility, by providing the information without delay. Holding onto your information and being stubborn about sharing could result in your Agency losing their Medicare and/or Medicaid billing privileges which could be devastating.

Remember, your organization will only shine as you represent it to shine. It comes with the title and the inherent responsibility. Live up to the office you have accepted and be willing to be transparent. You’ll be happy you did!

The Ambulance Billing Services blog is offered as an EMS billing-related educational tool for clients and friends of Enhanced Management Services, Inc. Enhanced is an all-EMS outsource billing company serving EMS Agency clients located across the United States. Our website is located at To learn more about Enhanced click on the “Get Started” button on the site.
Post a Comment