Blog

January 11, 2022

How the crew documentation drives medical necessity?

In this post, we will define medical necessity and how the determination of medical necessity is driven by the crew documentation. CMS (Centers for Medicare & Medicaid Services) defines medical…

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December 19, 2021

Good practices that ambulance service providers can adopt to help ensure EMS billing is effective and successful

There are several good practices that ambulance service providers can adopt to help ensure EMS billing is effective and successful. Effective EMS billing is defined as billing that produces timely…

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Hospital to Hospital transports from an RCM perspective

December 13, 2021

Hospital to Hospital transports from an RCM perspective

Revenue Cycle Management(RCM) in the ambulance industry has a lot of moving parts to monitor to ensure the bottom line is met.  Lower DSO, maintain a steady cash flow, keep…

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Factors that contribute towards patient centric billing approach

December 05, 2021

Factors that contribute towards patient centric billing approach

As recent as ten years ago, healthcare expense was straightforward from the patient perspective.  You paid your employer a premium, then paid the physician $25 for an office visit, the…

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Compliance from a health care perspective – Are you covered?

November 20, 2021

Compliance from a health care perspective – Are you covered?

Are you aware that payer enrollment is the Gatekeeper of your revenue cycle? Enrollment, along with credentialing, prevents fraud by validating all your company information. The CMS program utilizes the…

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Know your rights – The 5 levels of Medicare Appeals

November 14, 2021

How to handle Medicare Appeals (The Process of Appeals)

Every provider’s goal is to submit a claim to Medicare and receive payment for medical services provided. If Medicare denies the claim, do you know your appeal rights as a…

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CARES Act Provider Relief Fund amidst the Covid crisis

November 08, 2021

Impact of the CARES Act Provider Relief Fund amidst the Covid crisis

Recently the CARES Act Provider Relief Fund allowed for a bonus of $50 billion to be allotted to healthcare providers.  This was to help to counteract the loss of revenue…

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What is Billing for Inter-facility trips - do's and don'ts

October 10, 2021

What is Billing for Inter-facility trips – do’s and don’ts

When a Medicare beneficiary is transported by ambulance from one facility to another, it is very important to understand how to determine who is responsible for that Inter-facility transport. This…

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5 things you need to know to survive a Medicare audit

October 04, 2021

5 things you need to know to survive a Medicare audit

Important facts to help prepare and successfully navigate the auditing process. It is not uncommon that ambulance providers are faced with Medicare audits. There are several types of audits performed…

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January 29, 2020

Authorizations, the problem child in healthcare

Prior authorizations, or Pre-Certifications are a formal permission that allows the provider to see and verify the following; member is active and eligible for services, guarantees to the insurance that…

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