Ambulance billing reimbursement is just like clinic or hospital medical billing: it requires specific knowledge of relevant codes, processes, and regulations. However, these services have their own nuances to consider for optimal revenue results, which all ambulance service billers should comply with.
Upgrade your software.
Ill-equipped or improperly setup software will slow down the note taking process and could also store information inaccurately that is required for medical records and billing purposes. If a claim has the wrong info due to an ineffective software, or their customized reports are not set up correctly, then the ambulance company may start losing revenue due to denied claims. Enhancing collections begins with the right software and staff that have been properly trained on how to use it, the correct codes to know, and any updates on billing regulations.
Begin recording at dispatch.
Depending on the call EMS are responding to, the information needs will vary. To start off on the right foot, the ambulance team should begin setting up the case as soon as the call comes in so that filling in the necessary info will be easier. There are a couple different incident profiles that it will most likely be considered: emergency, non-emergency, and canceled. An efficient RCM software will be essential in taking accurate notes to help streamline the process.
Be thorough in the report.
No matter the type of situation, the ambulance team should be taking detailed notes of the condition of the patient in the Patient Care Report (PCR)—especially if the call is considered non-emergency. Many ambulance services are covered by Medicare, which already complicates the process, and the billers will need a sufficient amount of supporting documentation that states why the ambulance ride was necessary. If the claim isn’t properly supported, then the insurance or Medicare will not cover it, which can result in lost revenue and potentially larger amounts due to the patient.
Follow-up on late or unpaid claims.
If a claim has been rejected for whatever reason, that puts more pressure on the billers to ensure they follow-up while keeping on top of recent claims. Additionally, billers should be checking up on any unpaid bills to ensure it’s not a claim error. The more time they have to spend on incorrect claims, the more delays in revenue will occur. It can be easy to dig themselves into a hole if they can’t keep up with the work and billing regulations.
If your ambulance billing services or software are not up to par, it may be time to look into outsourced billing help. Outsource Receivables has a team of experts ready to help improve your ambulance billing revenue and streamline the process for enhanced results.