Tag Archive: Billing

Last week, the U.S. Centers for Medicare and Medicaid Services (CMS) announced proposed changes to how it reimburses home health agencies. Specifically, CMS will now allow home health providers to report the costs of remote monitoring. Like many initiatives happening at the local, state and national levels, this move by CMS appears to recognize and support…

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We’ve heard it for several years now: Value-based purchasing is coming. But some of you, I know, are beginning to wonder if that future will ever arrive. After years of hearing about these changes, we still largely get reimbursed the same way we have for decades. A recent report out of Maryland shows that the…

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City and county officials, EMS agency directors and fire chiefs who struggle to balance budgets may want to analyze the efficacy of their EMS billing operations to recover additional revenue.

It’s time for EMS leaders and educators to take compliance training as seriously as clinical training – caregivers’ careers and patients’ lives depend on it By Anthony Minge It seems like you can’t go a day lately without seeing a report or article related to compliance issues in health care. The statutes, guidelines, regulations and…

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Many municipalities are pressured by shrinking budgets, how can leaders do more with less for EMS? Learn about the issues and how to proceed with expert intel.

As the EMS adage goes, “If you’ve seen one EMS system, you’ve seen one EMS system.” While that statement reflects the diversity of EMS systems across the United States, it also creates the false sense that every EMS system is entirely different and that EMS leaders can’t learn from each other. Clearly that is not the case. As we see in the premiere edition of the EMS Trend Report, EMS systems across the country share many traits. On the other hand, significant differences do exist in everything from clinical care to salaries to operational benchmarks to hiring requirements.

Rarely does a week go by without another news report about an ambulance service or hospital under investigation by the federal government for fraud or abuse related to billing for transport services. Whether willful or unintentional, negligence that results in the billing of transport services at inappropriate levels is leaving many hospital-operated ambulance services at risk. And the scrutiny is only increasing.

Increased attention on ambulance use demonstrates the need for compliance plans to include emergency and non-emergency ambulance operations. The HHS OIG has published voluntary compliance program guidance for ambulance suppliers. Ambulance billing should reflect the care provided by the EMS personnel, not the hospital diagnosis of the patient. Training for billing personnel and EMS providers on documentation and billing for ambulance services is often inadequate. Ambulance suppliers should conduct regular claims reviews to ensure problems are identified and corrected prior to an audit.