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Billing

Our Solutions

We offer billing services to EMS and ambulance services throughout the nation. We have vast experience in managing the revenue for all types of ambulance providers, from government operated, volunteer services, hospital owned, and private companies; in all sizes ranging from a couple transports a month to thousands of monthly transports. With the experience gained from working with all types of services within the industry we are able to provide knowledge, insight, and reporting from many aspects.

As a billing client, you will be assigned a dedicated Billing Account Specialist, or a team of Specialists depending on transport volume. The Specialist(s) assigned to your account processes all of the day to day tasks of your revenue cycle management. They code the claims, process payments, correct denials, follow-up on unpaid claims, and assist with your report needs. Having a dedicated biller, or team of billers, allows you to work and set up processes and timelines for your optimal account performance. Your account is also monitored by the compliance team, quality assurance team, review team, and provider enrollment team. These additional team members ensure your account is processed in accordance with your set guidelines, our internal controls, and the regulations set forth by CMS guidelines and HIPAA laws. Our billing department is highly qualified to successfully manage your ambulance billing needs. Our employees enjoy what they do; to put that into perspective, the average length of employment for our billers currently is eight years. That is expertise that cannot be picked up and taught quickly.

One practice that sets EMS Consultants apart within the billing service field, is our in-house development and support of our proprietary billing system, Prestige Billing. Like our billing service, Prestige Billing was, and still is, created solely for the EMS industry. The benefit of having Prestige Billing created in our office is that when a regulation or claim submission format changes our development team can make the change at the same time as the industry changes. We also are not slowed down by updates and system maintenance while billing processes are being conducted. Also, when using our billing services you can use our Prestige ePCR free! That will eliminate your costs for field reporting software while contracted with us for billing services. We do not require the use of our PCR system to be utilized with billing service, you are able to use any NEMSIS 3.4 compliant field reporting software. Call or email to find out the field reporting software systems we are already integrated to work with.

To increase revenue for your department, claims requiring an appeal of denied claims are processed by our internal review department. All claims that are denied get placed in a review queue. Daily, all new claims are placed in the review team’s work flow. The claim is initially assessed by one of the review specialist. If the claim meets coverage requirements an appeal is started; however, if the claim denial is accurate the account is notated with reasoning of support of the payer’s decision. Our review department will continue the appeals process through all levels of appeal. Most appeals are successful within the initial appeal level. Our appeals department will fight for your claims for any payer, to include Medicare, Medicaid, commercial insurance, worker’s comp, auto insurance, etc.

The EMS industry has many challenges to overcome on a daily basis. As a leader in your organization, you are having to manage the ever changing requirements, regulation, and financial needs of your EMS service. While we cannot eliminate the stresses and requirements of these regulations and laws for you we want to assist you in the highly regulated portion that is EMS billing. We have a team that ensures your billing processes are completed in accordance with all regulations and laws. Our Compliance Officer is constantly ensuring CMS guidelines are followed to ensure all reimbursement is legal and due to your service. As a billing service client, you will see regular feedback from our Compliance Officer. On a quarterly basis, your account will be audited internally and the results provided for your review. The next time your county officials or board members ask if the billing is conducted in accordance with the laws regulating medical billing you will have a report showing detailed audit notes and remarks. A condensed list of items being checked for by our Compliance Officer is: patient signatures, medic signatures, PCS/CMN form (when applicable), correct coding, applied discounts/write-offs, proper documentation to prove medical necessity and that of levels of service, and much more.

In addition to our commitment to compliance, our quality assurance (QA) team assesses accounts to ensure procedures are completed timely, correctly, and by the best practices. As a billing service client, you will receive, at minimum, a quarterly report outlining improvement areas for your account. While the QA team checks on the work completed internally, they are a second set of eyes assisting with the quality of what your team is submitting.

Our billing service comes with complementary statistical and analytical reporting. With the use of Microsoft’s Power BI, we provide our clients with real-time Business Intelligence (BI) reporting. The reports are already formatted to include a visualization for quick reference and professional presentation for your meetings. Our BI Reporting allows you to quickly and easily add additional fields and filters to narrow the data you are evaluating. The customizations on reports can be saved to your profile for quicker access next time.

Call or email our office to get more details and discuss the many other additional services available.