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We have over 24 years of experience in providing EMS billing services to hospitals, ambulance service providers, emergency medical service agencies, urgent care centers etc. Our billing process is driven by a team of medical billers/coders, insurance specialists, billing supervisors, quality analysts, etc. They have extensive knowledge of CPT-10/ICD codes, HIPAA, EOB, HCPCS Level II Codes, etc. They leverage their combined knowledge to verify patient insurance coverage, obtain necessary authorizations, document patient demographics, ensure compliance with HIPAA regulations and review EMS bills (basic life support (BLS), advanced life support (ALS), mileage documentation) before submitting them for medical claims. We streamline your requirements in the following ways:
- Implement an EHR (electronic health record) system, an EDI system (Electronic data integration system), and electronic submissions to digitize various touchpoints in the EMS billing workflow, such as electronic claims processing and payment posting.
- Validate patient demographics, medical history, physician referral information, and payer details such as coverage type, effective date, expiration date, and claims address, among others.
- Support pre-authorization documentation from insurance payers for non-emergency medical transportation.
- Stay updated with the EMS billing requirements for Medicare & Medicaid and other private insurers (Athena Health, Humana, United Health, etc.).
- Follow a dedicated billing approach for every type of EMS billing requirement - ambulance billing, urgent care billing, etc.
- Maintain regulatory compliance while handling diverse EMS billing models, from value-based care and telemedicine to capitation and episode-of-care billing.
- Assigning specific codes (CPT, ICD-10, HCPCS Level II, revenue codes, modifiers, NEMSIS, place of service codes) to procedures, services, and supplies provided during emergency medical care.
- Analyze EOBs, identify claims rejections, and initiate the appeals process accordingly.
- Study EOBs to provide patients with a breakdown of proper out-of-pocket expenses (co-insurance, co-payments, deductibles).
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