Common Billing Errors

In the majority of cases where fraud charges have been filed against emergency medical services and fire departments, the problems are normally traced back to their billing process. Unfortunately in these cases, ignorance of the regulations is not valid in defending a prosecution. In order to avoid the possibility of a fraud investigation, EMS managers need to have a clear and thorough understanding of current regulations. A number of common errors have been identified, these common errors are:-

  • Fee schedules
  • Coding
  • Internal Procedures

Fee schedules – In the case of fire departments, this typically relates to the adoption of the fee schedules and structures set out by ambulance services. Billing methods and inappropriate charges are the most common errors.

Coding errors – Insurance companies and Medicare reimburse transportation by ambulance once it has been confirmed the transport was “medically necessary”, based on the condition of the patient when transport was provided. A code system has been introduced to aid the billing process and Medicare requires claims are submitted with at least one diagnosis code (ICD Code) as outlined in the International Classification of Disease manual. Since the development of the ICD codes used as the final diagnoses, the use of them in ambulance transport coding is complex at its best, and at its worst, an opportunity for fraudulent claims by departments, knowingly or unknowingly. Unless billing staff members are sufficiently trained in the interpretation of the information and able to select the correct codes, it becomes possible for an incorrect code to be submitted unwittingly.

Procedural errors – In fire departments, this is the most frequent type of error, typically due to lack of knowledge or understanding of insurance and Medicare regulations with regards to the services of ambulance transport. As far as Medicare are concerned, ignorance is no defense.

Next week ABS Inc. will continue this theme by going a little deeper in to the issues and highlight the importance of their business when it comes to helping you in preventing any potential fraud investigation against your business.

The cost of billing fraud

The cost of billing fraud

ABS Inc. are going to run a series of blogs starting this week to highlight the importance of getting your billing right – first time, every time. Businesses like ABS Inc specialize in billing services and are in the best position to help you avoid the pit-falls they lay in wait.

Millions of EMS journeys are billed to health insurance companies and Medicare every year across the United States. For larger organizations they are likely employ specialized staff to undertake the work, however for smaller organizations where perhaps a minimal number of staff may be assigned billing duties as not much more than an additional duty to their routine.

In either case, the requirements are exactly the same. Billing is to be in accordance with strict requirements from a number of different agencies with Medicare being the most notable of them. If an organization fails to process their EMS claims, in accordance to the regulations, they become open to the possibility of fraud charges, significant penalty payments and even reimbursement of monies collected.

Healthcare is the currently the federal budgets largest expenditure. The huge number of claims submitted every year by an equally huge number of providers means the field of healthcare is wide open for fraud. It is estimated that the annual cost, due to healthcare fraud, to the United States government is in excess of $100bn! With the size of healthcare expenditure and estimated fraud figures, the United States government is ramping up their investigations in to fraud, looking at all types of providers.

In recent times, it was announced by the Justice Department that Columbia/HCA, the hospital giant, agreed to pay a fine of $745 million for systematically defrauding, over a period of several years, the Medicare program. Although it is not believed likely that an ambulance provider or fire department would be penalized to such a significant extent, it does indicate the government is getting serious in their drive to investigate fraud and eliminating it.

Next week, ABS Inc will highlight the common errors made by billing staff and you then begin to understand better why ABS Inc. are the sensible choice to undertake your EMS billing duties. Contact us to discuss any issues you may have and see what we have to offer to help you avoid breaching any of the many regulations in place today..

Need to improve your Ambulance Billing Service?

Need to improve your Ambulance Billing Service?

More and more people are becoming increasingly aware of just how much value an EMS Billing Service can offer to their organization.

A recent news article (10th October, 2012) described how city officials in Glenn Heights, Dallas has taken on board an external billing service as they looked for ways to increase revenue without increasing taxes. So why was this decision made?

Quite simply an independent Ambulance Billing Service can provide a better and more efficient service to both their clients and the general public. At ABS Inc. we employ dedicated individuals to perform specific tasks to ensure the smooth running of all operations.

It mostly comes down to the management issue of billing services within the emergency medical services. It can be time consuming and expensive, more so when it comes to debt recovery. There is of course the added burden and cost of keeping up with current policies and regulations from organizations such as HIPAA.

ABS specialists, such as ABS Inc. provide a service that brings everything together and generates growth in revenue, substantial increases in many cases. Any EMS company that is struggling to break even or making small gains in their billing services really need to have serious consideration in to out-sourcing this business activity to a dedicated and expert billing service provider, such as ourselves.

Another aspect that should be considered is the customer service relationship. Our members of staff are trained to deal with all people in a highly professional manner, remaining courteous at all times in dealing with their affairs.

ABS Inc use the industry’s leading ambulance billing software to ensure maximum revenue potential and provide the best possible solutions and service.

Talk to us for an informal discussion on how ABS Inc. can help you realize the revenue potential of your EMS business.

Don’t take our word for it!

Don’t take our word for it!

In recent weeks, ABS Inc. have been telling you why we believe we are the best option to undertake your Ambulance Billing requirements and perhaps you are sitting there thinking along the lines of “Why should I believe you?” If that is the case then perhaps you need to know what our current clients are saying about us.

From an EMS Director, Tennessee – Client for life

I had to start an EMS agency for my county, whose private provider quit operating overnight. I told the city council that I needed to outsource the billing and collections. I chose ABS, after asking colleagues opinions. The board was skeptical, but today, three years later, my dept. is in the black!! Not just cost neutral, but positive cash flow. Needless to say the board is now convinced, with no reason to change!!

From a Fire Chief, Oregon – Reliable!

We did our billing in house since day one. We have a small Fire Department, so everyone felt that was no big deal. Our billing person left and we had to make a choice. I can’t believe it but ABS almost doubled our cash. They said it was all about follow up on denials. Who knew!! Apparently ABS did. I always wondered what the zero pays were all about. Now I know, and now eventually many get paid. Thank you ABS!!

From a Fire Chief, Colorado – Great company to work with!

ABS has been my billing partner for 9 years.  They were my fourth billing company after I had done my own billing.   Obviously, I have no intention of separating from them.  Yes I may pay a percentage point or two more, but they deliver, and I don’t have to worry.  I constantly recommend them to other departments around the country.

A Private EMS Owner in New Mexico – The right company!

ABS has helped us in ways I don’t believe we could have helped ourselves.  Yes we could learn all of this billing stuff, but the cost would have been too great, and I don’t think I would have survived, financially or mentally!!  They are a great company to work with.  You call, they answer the phone, and someone can help you!

A Private EMS Owner in Texas

When I started my EMS Company, I used a billing company.  Then I took it in house, because I felt I was paying too much. As I grew I could not do it anymore, then I went through two billing companies before I found ABS. They were personable and pleasant to deal with even after I did not choose them the third time. After multiple issues, I found Steve’s card, and four years have now passed without any other incident or issues.  No need to look any further!!  You have found the right company!!

Just a handful of testimonials and praise we receive for our efforts to making your business more profitable and as you can see our net has been cast all of the country. We have made their lives easier and their businesses profitable and we can do the same for you!

Contact us to discuss exactly how we can help you make your billing performance improve. It does not matter who you are or where you are from providing your in the United States and need an Ambulance Billing solution.

Sky High Costs

Sky High Costs

At ABS Inc, our billing services also cover air transport services that are provided by the emergency medical services, a costly service in anyone’s books and even more costly to the provider if they are not able to recover those costs from the patient or insurance provider of the patient.

Air ambulance services operate in the most humane way of course by performing the air lift, rescue and delivery to the nearest hospital but do not take in to account the ability of the patient to pay for the service. We are not saying it is wrong to take this course of action as the importance saving of just one person cannot be understated but it can mean a good slice of income is lost and never recovered in some cases as the cost of recovery can make it less viable to pursue.

In the United States, it is believed that some 550,000 people are flown by helicopter or small aircraft to hospitals following serious car crashes, heart attacks and hiking accidents but very few of them realize the cost of transportation is going to be anything in excess of $9,000 depending on the distance of the journey. In some cases, the patient has adequate insurance cover to meet the cost but in many cases, that seems to be on the increase, they are not.

Can you afford to lose out on this kind of revenue each time a patient cannot find the funds for the service? Perhaps the answer is yes (though highly unlikely) but how about if you could find an outside party that is capable of recovering this money, or at least a good portion of it, on your behalf, would you be interested

Come and talk with us, we are experts in the billing service industry and work closely with insurance companies and the courts to recover costs that have not been made by patients.

What ABS Inc is all about

What ABS Inc is all about?  ABS Inc – The company

We concentrate our professional billing efforts to maximize your collections. We allow for electronic run form submission via scanner or field data capture device. We submit runs daily (rather than weekly) to all payors so you will receive checks more frequently. We electronically image and index all client-submitted documentation to expedite document retrieval and appeals processing. ABS allows clients to run reports and query data online with data as current as the prior business day’s transactions.

ABS staff is current on upcoming ambulance program regulation changes as a member of the American Ambulance Association (AAA), many State Ambulance Associations and many other organizations listed on our Links portion of this web site.

Software used

We use the industry’s leading ambulance billing software, Sweetsoft® Amazon program, on a secure Oracle SQL 2000 Server in conjunction with SentryFile™ file/image processing software. Every program electronically tracks document access for Health Information Portability and Accountability Act (HIPAA) Privacy Standards compliance. HIPAA compliant code sets for all electronic file transmissions. Our software servers utilize RAID-5 software and hardware ensuring data is maintained on redundant drives, in conjunction with a rigorous file back-up and recovery system. ABS conducts Electronic Archival of all customer data onto Digital Video discs daily, and onto tape weekly.

Proven process

We are an air, ground, and water ambulance billing service provider. We have an active compliance program in place to uphold the most continual patient security, confidentiality and accurate billing practices. Professionally staffed with ambulance billing and appeals specialists, EMTs, and medical professionals, to assist ambulance services just like yours, for, in some cases, much less cost than you are currently paying to do the job in-house. All based on a percentage of net collected revenue. In other words, if you don’t get paid, we don’t get paid: Period.

We are credited with “saving” companies on the verge of bankruptcy through sound billing practices, attention to detail and persistence. View our client testimonials on the client tab of this web site. We will endeavor to collect on every dollar that is owed to your service, based on your collection protocol.

Contact us and see how we can help you.

Another joins the fold

Another joins the fold

In February this year the Barren-Metcalfe Emergency Medical Services made the decision to go ahead with outsourcing their ambulance billing on a 12 month contract. The service had been considering the possibility of outsourcing for some time and during their discussions with other Emergency Medical Service providers it became evident that most others had already adopted outsourcing as their way forward for the billing side of the service.

It was also confirmed, in all cases, that there was an immediate increase in monies collected, highlighting that providers such as ABS make a difference. An Emergency Medical Services director stated that the company awarded with the contract would be able to collect enough revenue to offset costs. Certain guarantees formed part of the contract, so no revenue was actually lost by Barren-Metcalfe, as a safety net, though it is firmly believed that they would not need to fall back on such a clause.

The decision to outsource was following the departure of one of their employees about 9 months earlier. The loss of just one employee, for whatever reason indicates the fine balancing act the Emergency Medical Services go through to ensure a smooth and efficient running service in conjunction with employee issues.

Companies like ABS will erase any such concerns so the services can get on with their primary role of attending call outs. This aspect of outsourcing cannot be stressed enough. Human resources can be a costly exercise in both time and finances, remove that burden and it becomes instantly noticeable who much more time and effort can be put in to the activities that “really” matter.

If you are one of the EMS providers that still have in-house billing, contact ABS today to discover what the benefits of outsourcing are, this will be a decision you will not regret as ABS are here to make your life easier and allowing you to free up time to do what you do best.

Ambulance Billing Services – The best solution

Ambulance Billing Services – The best solution

These days it has become a tough challenge to deal with regulatory requirements in the fast and ever changing Healthcare Industry. Outsourcing has become a common practice for many ambulance services across the United States as the time required to manage Medicare changes and HIPAA mandates usually creates a loss of revenue. Some services have kept in-house billing but are normally faced with having to use more than one system and have higher costs to operate and manage.

Many Ambulance services and Fire Services now agree there is a cost effective solution that works for them, by outsourcing, and allows them to focus on their core activities – getting ambulances and fire engines to the people and places that need them, treatment for patients, fleet management and regulation compliancy etc.

If outsourcing of your Ambulance Billing or Fire Service Billing is something you are considering then look no further. Ambulance Billing Systems, Inc. is the right choice for your air/ground ambulance service.

ABS use the industry’s leading ambulance billing software, Sweetsoft® Amazon program, on a secure Oracle SQL 2000 Server in conjunction with SentryFile™ file/image processing software. Every program electronically tracks document access for Health Information Portability and Accountability Act (HIPAA) Privacy Standards compliance. HIPAA compliant code sets for all electronic file transmissions. Our software servers utilize RAID-5 software and hardware ensuring data is maintained on redundant drives, in conjunction with a rigorous file back-up and recovery system. ABS conducts Electronic Archival of all customer data onto Digital Video discs daily, and onto tape weekly.

For further details, click here