Friday, July 24, 2015

Changes? Include Your Billing Office!

What’s New?
What’s new in EMS? There are plenty of new things happening in EMS.

The very nature of EMS is change. We are learning and learning fast about the outcomes from what we do in the field so there is a lot happening in the world of pre-hospital care, treatment and transport.

Changes? Include Your Billing Office!
While all of these clinical and operational changes are taking place, we’re sure that you’re continually training your provider staff to update them about these changes.

The question is; are you also including your billing office staff in the update and training process?

Billing Needs to Know!
When changes take place on the street side of the equation, the billing office needs to know about them. Any changes affecting patient care, especially major ones like protocol changes- treatment protocols, dispatch protocols- can affect how the billing office translates information into claims submitted for payment.

Consider when there is any type of changes in the way your provider community does their job how important it is to share those changes with the billing office, whether your billing office is down the hallway or in the next State. Don’t forget to include them in the update process.

Recent Example…
One recent example that easily comes to mind is the change allowing first responders of all types to administer the drug Naloxone (Narcan).

Because we have found that this drug so quickly and effectively reverses the effects of narcotic opioid drug overdoses most States and/or EMS regions are widely distributing the drug for administration by first responders of all types and levels, including by trained members of law enforcement outside of the direct EMS provider population.

While heretofore Naloxone was administered as primarily an ALS skill, intravenously or intramuscularly using subcutaneous injection; the drug is now being distributed to be administered nasally via nasal atomizer.

In many States and EMS regions, protocols have been adopted changing the administration of the drug as a BLS skill.

If you fail to notify your billing office of this type of change, it is very possible that you have billers in place that will continue to see that a drug was administered possibly billing the trip as an ALS level which would be a billing error in the final analysis.

Important Dialogue
The example above is just one of the more recent changes that come to mind. However, we all know that while we are learning about the outcomes of EMS all the time, many changes are happening right before our eyes. Your billing office staff, unless they are active EMS providers, won’t know about them unless there is a culture within your organization of having important dialogue.

While a good billing office keeps abreast of these types of changes, it certainly is healthy to promote discussion at all levels to be certain that everyone is in the loop, so to speak. If your billing office is an in-house operation, you may wish to include a key member(s) of your billing office staff in regular meetings, even if only once per month.

Outsourcing and Reporting Change
As you know, we write this blog space from a stand-alone outsourcing resource company perspective. Third-party billing contractors work on behalf of Fire/EMS agencies that typically range across many regions, multiple dispatch and operational protocols and even across many State boundaries.

Even with active EMS providers on staff, if a change is initiated to another State’s EMS protocols, it may be likely that the billing office several States away may not be made immediately aware of the changes as fast as you are right there in your back yard.

Consider it a gift you will be providing to your third-party biller when you share protocol change releases as they happen.  Periodically, share protocol documents and bulletins from State and Regional EMS governing bodies with your billing office to be sure they are made aware of changes that can potentially affect the billing arena.

In many cases, providers are made aware of imminent operational/clinical changes via e-mail or listservs. Be sure to forward those communications on to the billing office as they happen so the billing office can be prepared for what’s coming down the pipe.

The result will be an efficient exchange of information that is vital to the integrity, efficiency and key to your billing program’s overall compliance.

The Enhanced Ambulance Billing Services blog is brought to you as an educational tool by Enhanced Management Services, Inc. Enhanced Management Services, Inc. is an all-EMS third-party billing company serving Fire/EMS clients located across the United States. For more information about the cutting-edge features offered to benefit your EMS agency, please visit our website at www.enhancedms.com and click on the “Get Started” button on any landing page.

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