Get Your Billing and Coding wrong can not only delay payments to you but could constitute fraud!
billing the correct type of transport
determines if and when you get paid
Medically Necessary Transport
Medical transportation services are necessary when other modes of transportation may pose a risk to a patient’s health. These services are specifically designed to transport patients to and from medical facilities such as hospitals, critical access hospitals, or skilled nursing facilities. A written order from a doctor confirming the medical necessity of transportation may also be required.
Non-Emergency Medical Transportation
Transportation services in a non-emergency medical situation where patients and healthcare consumers who face medical and transportation barriers in getting to medical appointments such as having a physical, cognitive, mental or developmental limitation.
why medical transportation management is challenging
Patient Needs At The Time Of Transport
The patient’s needs and not the capabilities of the transport company determine the appropriate level of reimbursement. It is crucial that billing and coding are performed for the correct level of reimbursement so as not be considered fraud.
Paramedic Scope Of Practice
Although the definition of the type of transport is federally mandated, EMT-P licensing requirements are state specific. So, if billing is incorrectly applied by the scope of practice of the transportation company alone, the claim can be denied.
why medical transportation management is challenging
Knowledeable Staff
Using an experienced billing company whose staff understands how to accurately bill and code for your type of service and submit your information to insurance companies, Medicare and Medicaid will ensure that you receive the revenue that your are due in a timely fashion.
Consistent Billing
In-house billing staff comes with the worry of unexpected absences or downtime from your own employees, as well as mistakes from untrained staff. An experienced billing company has a large well-trained staff to ensure your billing is consistently performed.
Avoid Costly Mistakes
If the type of transport service is billed incorrectly to insurance companies, Medicare or Medicaid, it could be considered fraud. Medical transport billings are regularly scrutinized because some companies purposely bill at the emergency level to receive higher payments. These mistakes, even if accidental, can ve very costly and negatively affect your revenue cycle and bottom line.