(2 min read) In April 2020, the National Association of Emergency Medical Technicians (NAEMT) conducted a survey to assess the early impact of COVID-19 on emergency medical services (EMS) agencies. Almost 900 agencies responded, and 61% reported an average one-third decrease in volume. The associated decrease in revenue, along with an increase in COVID-related costs, led nearly three-quarters of agencies to report a strain on finances. In a recent webinar, Maggie Adams, president of EMS Financial Services, shared her recommendations for improving billing and reimbursement to counteract revenue loss.
For many communities, treatment in place (TIP) is becoming more common. Especially during COVID-19, some patients are fearful of going to the hospital. Unfortunately, the Centers for Medicare & Medicaid Services (CMS) doesn’t currently reimburse for TIP, adding yet another financial burden. Maggie recommends that agencies try billing COVID-related TIP to private payers, and in some states, to Medicaid. That said, CMS’ reasonable collection requirement rule means that agencies should bill the same amount for TIP to every payer, whether private or public.
Maggie offers other suggestions for agencies to recoup some of their unreimbursed work. She underscores the need for good reporting across the entire agency to capture the data necessary for better decision-making. For example, good reporting can identify any dispatches that have not been reconciled or that remain undocumented. Billing all viable trips and mileage promptly is more important than ever. Incomplete patient care reports (PCRs) cannot be billed; therefore, they cannot be reimbursed.
Another tip Maggie shares is for agencies to closely monitor denial reports and accounts receivable (AR) aging reports. Understanding where the biggest of buckets of AR, by payer, are “stuck” will help prioritize resources to correct errors and resubmit claims. Better awareness of the rules and timely filing requirements for covered ambulance services also help agencies optimize reimbursements. For many agencies, eligibility or coordination of care issues contribute significantly to denials. Verifying eligibility and managing deductibles on the frontend, save time and reduce denials on the backend.
Internal audits are also valuable when it comes to identifying opportunities to increase reimbursements. At the beginning of the pandemic, many agencies changed or added billing steps. An internal audit will ensure that policies and procedures that have changed are being implemented and applied correctly.
Finally, with more people unemployed during the pandemic, most agencies will have more Medicaid and self-pay claims. Conducting an internal audit will confirm whether financial assistance policies are being followed consistently and compliantly.
Maggie offers much more valuable advice on keeping EMS agencies as financially sound as possible in the webinar, “EMS Billing in the COVID-19 Environment”. Don’t miss the opportunity to capture the revenue you have earned. 
Watch More from Maggie Adams on EMS Billing Best Practices During the Pandemic.
