As a crucial part of the EMS claim lifecycle, the Billing Department follows the completion of Pre-Billing tasks. Their primary responsibility is finalizing and sending claims to the designated payers, ensuring that clean claims are promptly processed.
Each Biller embodies EMERGICON’s Texan Touch®, providing personalized and meticulous service. Each Biller’s task depends on a what-who-how context. They evaluate what happened, who the identified payer is, and how the specific EMS agency has set up its billing structure. They go above and beyond while assessing each claim and gathering information to bill it appropriately, embracing our mission of supporting first responders and dedicating their best to accomplish it.
As Billers display their efforts to assist our EMS partners, they share valuable information and additional steps providers could take to smooth the reimbursement process. Here are the top six insights from our Billers:
Top 6 EMS Claim Billing Insights:
- Chart Corrections: Ensuring the Patient Care Report (PCR) is accurate and complete is the best way to avoid chart corrections. Meeting PCR standards for compliant claims speeds up the billing process and, consequently, the reimbursement timeline. Review our series of blogs for PCR recommendations: Best Practices | Patient Data | Signatures Guide | Writing a Narrative.
- Contractual Allowance: Contractual Allowance is a type of write-off that refers to the difference between the amount EMS agencies bill for services rendered and the agreed-upon payment negotiated with payers. Governmental payers such as Medicare and Medicaid reimburse providers at fixed rates.
- Level of Service: Emergency and Non-Emergency Transportation are categories of the Level of Service rendered by EMS providers. Their main difference is the need for immediate treatment, which determines the required equipment and personnel. Reimbursement processes for these transports strongly rely on detailed documentation.
- ABN: ABN stands for Advance Beneficiary Notice of Non-coverage. EMS providers must issue an ABN when an item or service doesn’t meet Medicare’s standards for reimbursement. Providers should have the patient sign an ABN at each transport. ABNs protect providers, allowing them to bill patients for services Medicare doesn’t cover.
- EMD Codes: EMD stands for Emergency Medical Dispatch. It’s a number-letter-number format code that describes the type of incident. Including the EMD code in the documentation of an EMS call simplifies the billing process and accelerates the reimbursement outcomes.
- Internal PCR Audits: Conducting periodical internal PCR audits promotes best practices and compliance. This practice ensures the maintenance of high-quality documentation, facilitating reimbursement processes. EMERGICON’s partners can request assistance from their Client Team to perform a PCR audit or documentation training.
For more information about EMERGICON’s services, contact our EMS & Client Hotline: 866-839-3671 | support@emergicon.com.
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