Essential functions of EMS must converge in order to avoid serious consequences and to optimize revenue recovery

Richard Keller is a top EMS system expert and creative designer. As a partner of Fitch & Associates, LLC for 25 years, he has been a driver behind understanding the production efficiency and design of EMS systems. His areas of expertise include operations, fiscal systems development, and reimbursement. He leads the health-care finance component of the firm’s practice.

The Dilemma:

-Definitions of ALS and emergency are different in dispatch, the field, and for filing for reimbursement.

-Conflicting documentation results in the necessity to file for reimbursement at the lower level.

-The Department of Justice, Federal Bureau of Investigation, the Office of the Inspector General, and the State Attorneys General are pursuing ambulance services that file claims for ALS or emergency transports inappropriately. ($1 of investigation expense results in $17 of recovery)

-Few fully understand the rules and regulations applicable for ambulance reimbursement.

-Most ambulance providers (private, fire, hospital, volunteer, etc.) inadequately monitor their billing department or outside billing agency, yet the provider is ultimately held accountable and subject to repayment, damages, fines, penalties, and interest for filing claims inappropriately. Ignorance is not a viable defense

-Actions occurring and documentation in Dispatch is essential for complying with the rules and regulations for filing for ambulance reimbursement.

 

Discussion:

-Most EMS systems respond ALS to all 9-1-1 calls, but payers (especially Medicare) will not reimburse at the higher ALS level unless certain criteria are met.

-Advanced Life Support (ALS) is the appropriate level for reimbursement when ALS interventions are provided OR when an ALS assessment is required with or without ALS treatment.

-Being reimbursed at the ALS level for assessment only is entirely dependent upon the defined protocols implemented, activities accomplished and documentation provided by the EMS Dispatch Center.

 

Presentation Objectives:

-Introduce and understand the definitions.

-Recognize causes of conflicting documentation and identify elements that often contradict each other.

-Define the necessary steps and documentation requirements for dispatch and operations in order to comply with payer rules and regulations and ensure appropriate reimbursement.

-Identify key indicators to monitor compliance of an in-house billing program or an outside billing service

 

Who will benefit from participating?

The presentation is designed for a broad based audience including those who dispatch, field, and billing services and those who are ultimately supervise and responsible for compliance and performance. Suggested participants include:

-EMS Chiefs and Administrators

-Finance Officers

-Supervisors

-Dispatch Administration

-Dispatchers

-Field Personnel

-Billing Managers and Account Representatives

-Quality Management Personnel

-Medical Directors

-Compliance Officers

-Ambulance Service Owners/Directors, Administrators

-Municipal and County Auditors

-City Managers

-Billing Service Managers

Complimentary (no cost)
Tuesday, June 15, 2010
2 pm Eastern / 1 pm Central / Noon Mountain / 11 am Pacific times / 60 minutes

Approved for 1.0 NAAC CEU

Discover first-hand how TriTech's ePCR has achieved ROI across KCEAA's organization.

If your thoughts about an ePCR solution have stopped at implementation costs and state requirements, it’s time to broaden your thinking.  There are many other aspects of an organization that electronic patient care reporting affects besides the medic’s side.

What if this electronic PCR solution could process your paper PCRs 46% faster?

What if this ePCR solution helped enable you to achieve zero day billing – thereby gaining the best time-value of money possible?

What if this ePCR solution resulted in more complete records and better QA data to turn around higher AR percentages and leverage better relationships and results from hospitals and facilities that you work with?

It’s not only about this ePCR solution – it takes good management and vision to use the ePCR tool to accomplish results like these. Join us in this panel discussion with Kanawha County Emergency Ambulance Authority’s Director of Finance, Larry Cole, to learn how his service has accomplished these results. Pick up tips for your own operations - and possibly - even rethink how this ePCR solution can affect your service in a way that earns money instead of costing money.

2 pm Eastern / 1 pm Central / Noon Mountain / 11 am Pacific times / 60 minutes

Panel Speakers:
Larry Cole, Director of Finance for KCEAA
Kelly Rothlisberger, TriTech Product Lead and Analyst
Karla Hageman, TriTech Account Manager

The goal of a compliant ambulance billing system is to help providers obtain and keep their legitimate reimbursement. Join us for this fast-paced, multi-part webinar series which will outline the ways the Sweet-billing system can help you safeguard your compliance.


Part 2 / April 20th  / 1 hour / Approved for 1.0 NAAC® CEU
2 pm Eastern / 1 pm Central / Noon Mountain / 11 am Pacific times / 60 minutes

co-presented by Maggie Adams, National Academy of Ambulance Coding (NAAC) Executive Director, and Kathy Ransom, TriTech Industry Education Coordinator and Support Services

This session addresses what your software can do to:
-Verify accurate mileage billing
-Confirm necessary elements of how a clean claim is prepared
-Using the system to assist you to perform internal audits

Charlie Barry, Sr. Product Manager at Ortivus, will discuss the Decision Support features of Fusion ePCR in this live webinar on Thursday, March 25. Register now to join live or receive the recording and and learn about:

•    What Decision Support is
•    How it works
•    The benefits it provides

The goal of a compliant ambulance billing system is to help providers obtain and keep their legitimate reimbursement. Join us for this fast-paced, multi-part webinar series which will outline the ways the Sweet-billing system can help you safeguard your compliance.

Part 1 / March 23rd / 1 hour / Approved for 1.0 NAAC® CEU
2 pm Eastern / 1 pm Central / Noon Mountain / 11 am Pacific times / 60 minutes

co-presented by Maggie Adams, National Academy of Ambulance Coding (NAAC) Executive Director, and Kathy Ransom, TriTech Industry Education Coordinator and Support Services

During the first session of this series, we will look at ways your billing system will:
- Assist you in reviewing the medical necessity of ambulance transports
-Track Physician Certifications Statements
-Manage Repetitive Transports

This webinar addresses some of the specific challenges associated with transporting dialysis and other repetitive patients. These transports are subjected to additional scrutiny by Medicare contractors, including both prepayment and post-payment reviews. Therefore, the quality of your documentation not only impacts your ability to get paid for these transports, but also the potential liability in the event of an audit. For this reason, you want your documentation for these patients to be as comprehensive as possible.

The webinar will review Medicare guidelines associated with the transport of repetitive patients, including the rules related to the Physician Certification Statement (PCS). The webinar will also provide practical suggestions for:

• Improving crew documentation
• Obtaining PCS forms from physicians, and improving the quality of the information listed on these PCS forms
• Ensuring consistency in how bills are submitted to Medicare, and
• Establishing an effective QA Process

Originally presented on Dec. 2, 2009 at the American Ambulance Association Annual Conference in Las Vegas

Speaker Biography
Brian S. Werfel, Esq. is a partner in Werfel & Werfel, PLLC, a New York based law firm specializing in Medicare issues related to the ambulance industry. Brian is a Medicare Consultant to the American Ambulance Association, and has authored numerous articles on Medicare reimbursement. He is a frequent lecturer on issues of ambulance coverage and reimbursement. Brian is a graduate of the University of Pennsylvania and the Columbia School of Law. Prior to joining the firm in 2005, he specialized in mergers and acquisitions and commercial real estate at a prominent New York law firm.

In this webinar, participants will learn how Lean Six Sigma provides a process for prioritizing, selecting, supporting and managing improvement initiatives in all parts of your organization. It doesn't matter if those processes are clinical, financial, or administrative - Lean Six Sigma can help make your organization perform more effectively and efficiently. This webinar offers examples of how Lean Six Sigma projects can operate within an EMS organization.

Todd Hatley, Founder and CEO of IPS, an international consulting, leadership development and information services firm (www.onlineips.com)

Please join us in this FREE webinar hosted by Ortivus and presented by Tim Holman, national speaker on Business, Fire and EMS Management and Leadership issues. Check out Tim's impressive credentials on the Holman Training and Development website at: www.holmantraining.com.

In this free 90 minute presentation that you can join via the internet, we will discuss the following:

1. The challenges of today's leader
2. How does the leader engage the employee
3. Identify four types of employees and how they challenge the leader
4. Explore the five levels of leadership and how to attain each level
5. Understand the #1 goal of the leader
6. Understand how trust impacts performance
7. Leadership mistakes to avoid
8. The firm but fair leader

Join from the comfort of your office or home through a phone line and an internet connection.

This webinar  covers the reasons providers get audited by Medicare, the most common areas audited, suggestions for avoiding audits, and more! (sound begins at 2:45 minutes into the presentation)

This course has been approved by the National Academy of Ambulance Coding (NAAC) for one (1) continuing education unit. Email info@TriTechEMS.com for your CEU certificate after watching this recording.

The countdown has started to the replacement of ICD-9's by ICD-10's. This webinar identifies the important dates in this transition, provides a broad comparison of ICD-10 to ICD-9, and discusses the implications of the change for the ambulance industry without being boring!

Target Audience:
Billing Saff and Managers.

This course has been approved by the National Academy of Ambulance Coding (NAAC) for one (1) continuing education unit. Email info@TriTechEMS.com for your CEU certificate after watching this recording.