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Computer Security Risks

Computer Security Risks

As ambulance billing is conducted on computer software, the typical ambulance and fire department is now home to a handful of laptop or desktop computers and most are likely to be connected to the internet for as long as the computer is on. Of course a lot of managers and fire chiefs have in place a number of rules and/or regulations regarding Internet use by employees on the working premises and rightly so, but these are not normally put in place for security reason, they normally arise to prevent users spending time online instead of fulfilling their employment terms and conditions.  This is perfectly normal behavior from the employer but it does not prevent the risk of Malware and viruses entering an individual computer or network, where an internal network exists.

Computer viruses have existed for nearly as long as computers have and for whatever reason there are people in the world who just love to create havoc with other peoples computer systems and there are many famous instances over the years to demonstrate that the bigger the network they can hack, the more news worthy it is and the bigger the ego becomes.  Why then, would they bother disrupting an ambulance or fire department? The answer is they do not typically select a specific target in their day to day activities, more a scatter-gun approach that harms and disrupts as many computer systems as possible.

How do ambulance and fire departments combat this? The worrying answer is that most do not and tend to rely on the user to adopt some common sense when using internet sites. Providing the end user knows what to look out for and can identify a potential threat then this may be enough but in most cases it is not enough of a preventative measure, a measure that could ultimately cost thousands of dollars. ABS Inc. is going to expand on this subject next week, highlighting what happens when a virus strikes and what the potential knock-on effects are.

Poor procedures lead to fraud investigations

Poor procedures lead to fraud investigations

Having touched on the matter of fee schedules and coding errors, this week ABS Inc. will discuss the procedural errors that also create problems for Emergency Medical Services.

Procedural errors are the most common error for fire departments and are caused mostly due not being familiar with insurance and Medicare regulations with regards to Ambulance transport but as always, Medicare will not accept regulation ignorance as a defense. Medicare also considers information published in the Federal Register, newsletters and carrier billing manuals as adequate billing and charges procedures so the onus is very much on the ambulance services to ensure and up to date copy of their carrier’s manual is in place and further ensure a careful review of the section updates in newsletters.

Fire departments are also somewhat negligent when it comes to submitting claims that are not supported with signature authorization documents, HCFA 1500 & 1491 claim forms. Not only are these claims considered as fraudulent by Medicare and insurance companies, it may also be considered as mail fraud.

If an insurance company or Medicare carrier request a signature authorization form and the fire department cannot produce it, monies made for that claim will almost certainly need to be refunded. If a fire department is audited by a Medicare carrier and it is discovered that it is routine to not provide the forms the carrier is likely to request further investigation at the Office of Inspector General. Medicare has authority to recover monies paid out for each Medicare transport for a period of three years prior to the date of the investigation.

ABS Inc. will continue of the procedural errors next week to highlight further common practices that rebounding on departments create problems, fines and reimbursements that should never have been necessary in the first instance.