New Year's Resolutions
By J.R. Henry Consulting, Inc

Did you make any New Year’s resolutions this year?  Personal resolutions often include eating healthier, exercising more, saving money, spending more time with our family and friends, etc. Professional resolutions may include making your ambulance service more efficient, reducing expenses, generating more revenue or implementing a comprehensive compliance plan.

If you are like me, many of the best intended resolutions may go unfulfilled. The problem seems to be that many of our resolutions are not thought out or realistic, so they may be difficult, even impossible, to achieve. This leads many to simply not make any resolutions or set any future goals. 

So, this year, why not try to make some realistic professional resolutions which are achievable?

Here are a few suggestions which may help both you and your ambulance service be more successful this year:

1)   Resolve to perform a Billing and Coding Review to assure that your service is billing properly and receiving all of the revenue that it deserves.  Since billing revenue is typically the primary source of cash flow for an EMS or ambulance organization, this resolution can have a profound effect on your organization’s bottom line.

Here are a few examples of key issues that you might wish to examine: Are we properly coding emergency and non-emergency transports?; Do we have the documentation to support the use of a particular HCPCS code?; Are we eligible to use the Q3019 / Q3020 codes for billing Medicare beneficiaries when we send an ALS unit when a BLS units is not available to take the call? Does our billing staff have access to emergency dispatch information which demonstrates the patient condition at the time of dispatch? How can  we improve our non-emergency call intake process to assure that we send the right vehicle and reduce the frequency of claim denials?

This resolution can be achieved rather quickly and can have a tremendous impact on cash flow and revenue production. In my consulting practice, clients are often quite surprised to learn that they had been missing out on months, even years of legitimate billing revenue. The clients are often upset with themselves for not previously committing to  conducting a simple billing and coding review.

2)    Resolve to enhance Compliance Activities to assure that your service is in compliance with federal and state laws and regulations. Compliance monitoring and education is another area in which many ambulance services do not spend enough time or resources. Even if your organization does not yet have a comprehensive compliance plan in effect, resolve this year to take steps to enhance informal compliance activities. 

In addition to conducting the billing and coding review mentioned earlier, other suggestions may include: Perform background checks on all current staff members, vendors and other applicable associates. This is a relatively easy task that can be performed by accessing the OIG web site at http://exclusions.oig.hhs.gov/search.html  Be sure to maintain a record of the background check in the employees personnel file or compliance folder.

 While you are at the OIG website, be sure to download a copy of the OIG Compliance  Guidance for Ambulance Services or click on the following link: 

      http://www.oig.hhs.gov/fraud/docs/complianceguidance/032403ambulancecpgfr.pdf

      This document contains information which can help guide your organization in taking the       necessary steps to minimize compliance risks and avoid the nightmares associated with          mandated pre-payment reviews and mandatory overpayments.

3)   Resolve to better monitor and evaluate performance of your organization’s accounts receivable process.  In order to make your resolution successful, simply take a few minutes to ask yourself a few basic questions: Do we know what our collection percentage is? Should we change our statement frequency to improve our collections? How many days does an outstanding invoice remain in our system?  Who are our most difficult payers?

At first glance, this resolution sounds complicated and possibly unachievable. However, you have the ability to better monitor and evaluate activities and performance simply by using the power of the Ortivus NA software that is already installed at your office. There are literally hundreds of standard and optional reports which are available to you as a  Sweet user.

4)   Resolve to better appreciate and recognize the staff.  As we enter the New Year, take a moment, no, better yet take some quality time, to recognize the efforts of your billing staff and all of the other team members who make your organization successful. Billing staff often do not feel appreciated for all of their hard work and dedication which is paramount to keeping the organization financially solvent. Keep in mind that their efforts are just as important to the organization’s cash flow as the front line operational folks who provide the patient care.

Good Luck with your resolutions and Happy New Year!

For more information on reimbursement, compliance or other EMS management issues, please feel free to visit our website www.emsconsult.org; send email inquires to: jrhenry@emsconsult.org or call (412) 736-4163.