Our billing office is often asked the question by EMS agency administrators; “What do we need to do to collect the most dollars?”
Simple question, not-so-easy answer.
However, you can put forth a plan that we refer to as L.A.T.T.D.and you’ll find that your ambulance billing program and some other things flow involving your organization are just as successful.
As EMS providers we tend to get caught-up in the “stuff” we have to do when on an EMS incident and sometimes we forget to listen.
From the very first moment that you encounter the patient, take time to listen. While there are times we must jump right in and begin life-saving interventions we still must listen and observe what’s going on with relation to the patient.
What is the patient telling you about his symptoms? When did the incident begin? What caused the patient to activate the EMS system?
Maybe it’s not the patient you should be listening to. Quite possibly, it’s a parent, guardian, next-of-kin, a neighbor, a co-worker….someone else that has knowledge of the patient’s current condition complete with contributing factors and mechanism. This is especially true when the patient cannot verbalize or is in an altered state of consciousness or mental capacity.
All the while you’re listening, hopefully you’re making mental notes or better yet, physically writing notes for recollection later.
A thorough assessment is critical to the practice of EMS.
As EMS providers we must be totally aware of the patient’s condition and the only way we’re going to be one hundred percent sure of the patient’s condition and how to properly attend to the patient’s needs, it means we conduct a complete head-to-toe assessment.
Here’s where the results of that assessment not only dictate treatment but also contribute to the bulk of what you’ll be documenting in your final Patient Care Report about this incident.
Plus, don’t forget to document assessments when either the patient refuses treatment and/or transport but also when you are handing off to another provider such as in an ALS Intercept incident.
You’ve assessed and now it’s time to treat.
As you’re treating your patient, you’ll be recording treatments and interventions plus you’ll be recording if the patient responded to your treatments- all of this is very important when painting a picture in words regarding the patient’s overall medical necessity and need for EMS.
Ultimately, this will tell the story and include vital information which will allow your billing office to properly code and bill out the claim to the correct source for payment.
Transporting the patient is an essential element, obviously.
This pertains not only to moving the patient to a location where he/she can be properly treated for his/her illness or injury, but the backside of the transport is it enables us to bill for the service.
The Medicare and Medicaid programs pay for transportation. Most insurance payers follow suit and so the lion’s share of the dollars we collect to keep our EMS agencies going come from the fact that we transport.
It’s important to record the origin and destination locations, or where we picked-up the patient and dropped them off. Additionally, don’t forget to record the number of miles traveled the transport the patient from Point A to Point B and remember to record the tenths of miles as well.
When your EMS incident is completed, now it’s time to document.
Don’t discount the importance of this step. It not only records your incident for legal purposes, allows your billing office to bill and collect reimbursement for the services rendered but it also proves that the billing was in line with the many compliance rules and regulations.
Document every single detail. Paint a picture in words both by applying numbers and values to explain the patient’s condition and your ultimate treatment and transport but also use the written narrative to describe your scenario using clear clinical documentation.
Tell the story about your incident so there is no doubt that the patient required your services and to prove that you provided care within the boundaries of your scope of practice.
Success will follow if you do!
The Ambulance Billing Services blog is brought to you as an educational tool by Enhanced Management Services, Inc. Enhanced Management Services, Inc. is an all-EMS third-party billing contractor serving Fire/EMS agencies across the United States. For more information about our services, please visit our website at www.enhancedms.com and click on the “Get Started” link on any landing page.