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Case Study

Narberth Ambulance

Ardmore, PA

Proven Results

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Insurance coverage found
80% of the time


Billing team 66%
more efficient

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100% integration
with ESO

Pennsylvania EMS provider achieves major billing milestones through AR Boost partnership and ESO integration

Time to work claims drops from 7 days to 7 minutes with AR Boost

Narberth Ambulance is a small community volunteer ambulance service doing large EMS work. The organization was established in 1944 as a community volunteer ambulance service for Narberth Borough, a suburb of Philadelphia. Over the past 70 years Narberth Ambulance has expanded to cover four Philadelphia area communities, make nearly 10,000 trips annually, employ 30 full-time staff, and partner with more than 80 volunteers.

Amid declining reimbursement and rising technology challenges, Narberth tapped AR Boost in 2017 to increase efficiency in claims processing, insurance discovery and payor reimbursement. Dollars were getting harder to collect and claims longer to work. Narberth’s billing team typically needed five to ten business days to process claims.


Difficulty obtaining correct demographic and insurance information on the front end, requiring time-consuming searches and multiple follow-up calls to the hospital.


Integrates AR Boost insurance verification and discovery into front-end workflow for real-time searches versus batch processing.


Hundred of steps to hunt down a correct address resulted in long claim processing times. 


Uses AR Boost demographic verifier to validate patient data and fill in the blanks for emergency transports.


Multiple piles of returned mail. Extra postage to resend invoices and general administrative aggravation. 


Greatly reduces the number of patient statements by effectively finding and billing insurance coverage first.

Billing Barriers Removed with AR Boost 

“The first barrier encountered by our billing staff was simply trying to obtain correct demographic and insurance information for our patients,” says Meg Nelson, billing lead for Narberth. Receiving up-to-date information and face sheets from local hospitals was a struggle despite their access to the hospitals’ EHRs. Repeated follow-up calls were a necessity and a nuisance for everyone involved.

“Because our data was often incorrect, we experienced a high volume of return mail,” adds John Roussis, executive director, Narberth Ambulance. “There were hundreds of steps to hunt down a correct address, multiple piles of return mail, extra postage to resend invoices, and administrative aggravation. AR Boost has relieved these billing burdens and effectively reduced time to process claims by 66 percent. We are now performing only one third of the paperwork, calls and claims-related tasks we did before. Our team calls AR Boost the magic button for EMS billing.”


Insurance Discovery Milestones
Met in Real Time

Like most EMS providers, Narberth needs correct, valid and billable insurance information to process claims and collect payment. With commercial and government payors ratcheting down coverage, this task has become increasingly difficult.

Narberth turned to AR Boost and its integration with the provider’s billing system, ESO, for relief. The combined solution takes away all the billing stress and insurance coverage nuances of having bad information,” adds Nelson. “The AR Boost technology automatically finds insurance coverage for 80 percent of our trips with only one or two clicks, and all on a single screen.”

One-Screen Workflow Saves Billing Time

Once a trip is complete, the Narberth crew enters information into ESO’s EHR and data is automatically uploaded in the vendor’s billing module. From there, a part-time staff member verifies the chart for accurate data, enters charges and preps the case for billing.

If demographics, face sheet, insurance information or any other pertinent details are missing, the billing team clicks on the AR Boost icon within the ESO Billing screen. The system sends an immediate query to find correct demographics and billable insurance coverage using AR Boost’s real-time solutions.

Within seconds, the ESO Billing screen is populated with any results from AR Boost. If no information is available—which occurs in about 20 percent of cases—the billing team proceeds with their manual process, pursues medical assistance using Medicaid numbers provided by AR Boost, or considers the account for write-off.


Next Steps for Narberth

The next hurdles for Roussis and AR Boost to tackle include communication with commercial payors, payment likelihood for self-pay accounts and deductible management. With staff efficiency in the crosshairs, Roussis is confident these three final challenges can be overcome by working together with AR Boost.


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