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Strategies and Tips for Capturing Optimal EMS Reimbursement

ZOLL Data Systems | Mar 31, 2023

When EMS agencies maximize reimbursement revenue from patient transports, they help keep their organization financially strong so that they can continue to provide top-notch emergency medical services.

However, when claims for transport are submitted to payers with incomplete, inaccurate, or conflicting information, reimbursement may be delayed or denied, resulting in a plethora of financial woes for EMS agencies. If cash flow is compromised, agencies may forego purchasing needed equipment and supplies, struggle to cover daily operational costs and payroll, or risk financial insolvency.

The good news for EMS leadership and billing professionals is that there are specific actions, strategies, and technology tools that can render the revenue cycle process significantly more efficient and help agencies capture the reimbursement revenue they need to maintain financial strength.

Specific Actions That Can Improve EMS Reimbursements

There are key areas in which operational improvements can have a big, positive impact on the bottom line. Highlights include:

  • Patient Care Report (PCR) Documentation Quality — There are multiple, specific ways that PCRs and processes can be improved, resulting in higher reimbursement rates.
  • Billing Staff Evaluation — An evaluation of the billing staff and billing department operations can yield powerful insights on productivity, accountability, and training (or lack thereof). Those insights can help identify which operational improvements will be most impactful.
  • Signature Capture — New procedural requirements require signature capture from patients, particularly for Medicare. There can be significant financial ramifications when crews fail to obtain a patient signature authorizing EMS services.
  • Deployment of Software Updates — Best-in-class billing software vendors regularly release software updates that can improve productivity. Agencies should monitor those updates and put new functionality to good use.
  • Automation of Billing Processes — Shifting from manual to automated billing processes can streamline the claims process and accelerate time to cash.
EMS Billing Technology Handles the Heavy Lifting To Improve Reimbursement

EMS billing technology can help reduce the time it takes to prepare, submit, and monitor claims. Key automated billing tools that make the claims process more efficient and effective include:

  • Demographic verification
  • Insurance discovery
  • Insurance verification (determination of emergency services coverage)
  • Deductible monitoring
  • Claims status (monitoring and managing claims that require attention)

Watch the webinar, “5 Tips for Optimizing EMS Reimbursement Revenue,” to learn more about how to prevent denials, get a better handle on payments and cash flow, and improve transport reimbursement revenue. You’ll take away game-changing insights and actionable strategies that you can put in play in your own organization.

Read More About EMS Billing Strategies:

Should Your Agency Bring EMS Billing In-house?

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