Friday, January 6, 2017

Helping Your EMS Billing Program Achieve Success in 2017

Happy New Year!

The Holidays are over and it’s back to work. Happy New Year to everyone in EMS land.

Before we get too far into the new year, let’s pause for a moment and highlight some relatively easy ways you can help your EMS Billing Program achieve success in 2017.

Focus on Signatures

While signatures aren’t a new phenomenon, there is more focus than ever being placed on the accuracy and presentation of signatures than ever before, especially by the Centers for Medicare and Medicaid Services (CMS) and Medicare.
  • Patient
Patient signatures are critical. You’ve known that for a long time. Your billing office cannot bill to Medicare without a signature and preferably the patient’s signature.
Here are a few bullet points to remember when obtaining a signature…

  • Have the patient print his/her name near the signature (especially if the signature is illegible)
  • Be sure that all signatures are dated (the date the actual signature took place)
  • If anyone other than the patient is signing, be sure that there is a precise explanation provided as to why the patient was unable to sign the authorization statement
  • Healthcare Provider
For those of you who are involved in completing non-emergency, routine transports and obtain Physician Certification Statements (PCSs) containing the signature of a healthcare provider be aware of the following…
  • Get in the habit of asking and obtaining not only the signature but also the printed first and last name of the healthcare provider signing the PCS
  • Be certain that the healthcare provider printed his/her credentials (D.O., M.D., R.N., etc.) when printing his/her full name
  • Remember, the actual signature must be dated to represent when the healthcare provider signed the form and that date must be immediately in proximity to the signature on the PCS document that he/she is signing
  • EMS Provider
It is important that all persons involved in your ambulance run sign-off on the Patient Care Report (PCR). At a minimum the author absolutely must sign, but more and more we are finding that payers are looking for the full crew to sign-off on the PCR.
Even if not required, it’s good practice to get into the habit of all crew members signing off on PCRs once completed. Of course, in this case the is signature can be digital or actual depending on the PCR software (if you are using software) you have in place.

Documentation Detail

There’s never been a time in our EMS industry when there has been such a focus and demand on the information contained in the PCR. It is so important in today’s reimbursement climate to capture every single detail of your EMS incident and be certain that those details are ALL included in the PCR.
Allow us to remind you of a few hot items…

  • Be sure to always document by what means and how you were dispatched. Be explicit about this fact. To capture every single dollar and capture that dollar in compliance with the rules and regulations, there must be a clear accounting in the PCR of the method of dispatch and the nature of the incident at that point.
  • Describe your patient’s condition at all points in the scenario. Especially describe in great detail the patient’s condition…
    1. At the point of initial encounter at the scene or point of origin of the scenario
    2. During treatment and transport of the patient when the patient is in your ambulance and in your care
    3. Upon arrival at the destination facility and/or point of drop-off

  • Paint a Picture using words to describe your EMS incident in great detail using clear clinical documentation. No detail should be left out!
  • Review your PCR before finalizing it and ask yourself this question each and every time…
    • “Have I sufficiently described in detail why transportation by any other means other than an ambulance was contraindicated for this patient at this moment in time?”
      • Of course, maybe the answer is that the patient did not require an ambulance and then be sure that you have explained that fact too. This will insure that your billing office will not be stuck trying to read between the lines when reviewing your PCR for proper billing
    • Know without a doubt that you have done your best to properly document…
      • Your patient’s medical necessity
      • The reasonableness of your treatment/transport incident
The 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 contractor serving Fire/EMS agencies across the United States. To learn more about who we are and what we do, please visit our website at www.enhancedms.com and click on the “Get Started” button on any landing page.

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