Reimbursement Solutions for the Mobile Healthcare Industry

Transcription

1 Reimbursement Solutions for the Mobile Healthcare Industry

2 The Problem... The environment of healthcare reimbursement continues to be unstable. The cost of providing air and ground medical transportation services continues to increase. Intangible benefits that once motivated hospitals and health systems to invest millions in medical transport services are becoming insignificant in today s new healthcare delivery market. Hospitals often do not know how much direct net revenue their medical transport services are generating. Hospital-based medical transport services are often subject to insurance payer discounts of up to 50%. Many payers immediately reject all medical transport claims. Many hospital billing services immediately write off all rejected claims or place patients in collections. Many volunteer EMS agencies don t have the personnel or the time to follow up on complex reimbursement claims with Medicare or private insurance claims. Many billing offices simply do not have the complex expertise to ensure compliance; adapt to dynamic regulatory environment; or provide complicated, customized feedback for operations and marketing efforts. Are you confident that you are getting the financial results that are increasingly vital to your success? Can you depend on your current billing, collections, accounts receivable management, and compliance efforts to deliver what you need today and in the future?

3 The Solution... Air Methods Complete Billing Solutions... shared experience with an industry leader We are a full service reimbursement and accounts receivable management service. We have a staff with extensive experience in the air and ground medical transport trade, and we are entrusted with billing thousands of transports each year. We are confident in our ability to provide maximized results for: Professional Billing Services Hospital-based air and ground medical transport services Volunteer and municipal EMS agencies Private ambulance services (for-profit/non-profit) Now, it is possible to have a strategic billing partner that will help you generate some of the highest collection percentages in the air and ground medical transport industry; a partner with as much experience in our field as our clients have in clinical and operational leadership. We serve our clients in their name, as an extension of their office. We do not use the Complete Billing Solutions name on invoices or in verbal communication with our client s patients. We become a part of your team! At Complete Billing Solutions, we pay attention to detail and follow up much more thoroughly than a generic or medical billing agency. We have a multi-disciplinary team of specialists empowered with the most sophisticated resources and tools available. Our specialists work with coding, billing, collections, legal issues and reimbursements to optimally bill and collect for medical transport services. Other services to enhance results include: Complete reimbursement and compliance audits. Educate crews as to how their documentation contributes to the financial success of their service. Education is provided to ensure regulatory compliance.

4 Insurance Receivables Management Complete Billing Solutions has developed a complete transport document package for our customers that significantly enhances the speed of reimbursement and the acceptance of claims. These forms were designed with the assistance of some of the nation s most respected legal and reimbursement experts in our industry. Complete/clean claims Faster payment Reduced denials Increased cash flow Complete Billing Solutions integrated reimbursement and collections software system automates billing, speeds up the collection and entry of information and determines claims deficiencies BEFORE claims are electronically or manually submitted to your payers. Each claim is tracked through the billing process to assure all necessary events take place to get your claim paid. Self-Pay Collections Effectively managing self-pay portfolios is becoming more important, especially with increasing managed-care accounts. Complete Billing Solutions specializes in early treatment of self-pay receivables. Prior to sending our first self-pay bill, our objective is to ensure that all third-party sources of payment are identified and pursued. CBS utilizes a variety of resources to accomplish these objectives: Web-based skip trace service Contact the patient and guarantor Contact sending/receiving facilities where patient has been treated Web-based insurance eligibility access to hundreds of payer databases

5 At the proper point of intervention, Complete Billing Solutions will: Recover debt by utilizing your patient as our advocate to assist with insurance denials and claims rejections. Individually work with your patients in a manner that preserves a healthy relationship by maintaining your professional standards. Work diligently to avoid patient alienation by creating a rapport that is positive and helpful. Determine if patient qualifies for special consideration review (SCA Program), base on ability to pay criteria. Recovering self-pay balances once the patient has passed away is difficult. Our expertise helps generate greater and more expedient recoveries through estate and probate resources. These fragile accounts receive compassionate, yet efficient, customer care in a timely and sensitive manner that increases the prompt recovery of self-pay balances while maintaining a compassionate image. Complete Billing Solutions will guide hospital programs in carving out your medical transport service from other hospital services in payer contracts, eliminating discounts that jeopardize your program s financial health.

6 Policy and Procedure Compliance Complete Billing Solutions is experienced with the application of the complex laws, regulations and policies that affect medical transportation billing reimbursement. We have a comprehensive medical transportation billing reimbursement compliance program that is specific to our industry. This program assures that both our clients and our operations remain in strict adherence to all laws, regulations and policies specific to the air and ground ambulance industry. Our compliance team is dedicated to assisting you and your medical crews in assessing your documentation compliance. They will also help you develop training and auditing programs geared toward enhancing the accurate communications of patient care and services while achieving the highest caliber of claim integrity possible. Reporting Complete Billing Solutions has the data management resources and flexible reporting capabilities to generate dozens of standard reports configured specifically to each of our customer s needs. Graphic and statistical analysis, accounting reports, statistical change comparison reports, payer analysis reports and any other type of reports can be generated utilizing any specific data entered into our reimbursement management software application. Reports can be printed, ed or accessed via customized Client web-access.

7 Your Customer Service Team At Complete Billing Solutions, we provide optimum service to both your organization and your customers. Unlike most billing agencies that manage multiple specialties, we re exclusively dedicated to the medical transport industry and able to provide seamless personalized service throughout the entire claims process. Each Complete Billing Solutions client is supported by the following reimbursement team: Billing Manager Serves as the primary client contact and team leader and reviews audits, manages work flow and oversees team functions and performance. Medical Coder Nationally certified and responsible for verification, coding, data entry, demographic reporting, QA and missing documentation. Insurance Account Manager Responsible for insurance payer notification and qualification, final claims reviews, HCFA management, denials, and timely appeals. Patient Account Manager Responsible for incoming patient calls, patient correspondence and patient follow-up projects. Insurance Claim Expeditor Follows your claim throughout the process with the insurance payer to ensure timely and accurate payment. Paralegal Manages collection activities including estates, bankruptcies and, with your directives, engages in negotiations with third-party payers and attorneys. Cash Management Coordinator Posts payments and adjustments, and researches payments, credits, overpayments and refunds. Records Manager Manages the protected health information of your customers, as well as payment and correspondence files in compliance with HIPAA. At Complete Billing Solutions we have invested in our team of professionals, supported by every possible tool necessary to enhance your organization s revenue.

8 AirMethods.com 625 East Carnegie, Suite 200 San Bernardino, CA rev. 09/09