The medical billing process can be quite frustrating for agencies and the people they serve — but with the right partner, it doesn’t have to.
How to Improve the EMS Billing Process for Your Agency and Community
EMS agencies have been dealing with financial challenges due to the pandemic. When hospitals were at capacity, first responders often were left with no other choice than to treat patients on-site. This decision, though necessary, put reimbursements in jeopardy because Medicare and other payers required the transport of patients to approved sites for reimbursement.
Even when this was possible, Medicare and Medicaid generally limit reimbursements for such services. Many times, payers reimburse at rates lower than the actual costs. Patients then find themselves with unexpected medical bills for services they thought would be covered by insurance. That burden is shifted to EMS agencies if patients are unable to pay their bills, which is leading to lost revenue for many agencies.
Complicating matters further is the rising cost of healthcare. In 2018, more than $3.5 trillion was spent in the U.S. healthcare system — and those costs are expected to reach more than $6 trillion by 2028. All in all, healthcare costs continue to rise, and an increasing number of patients will struggle to pay their medical bills.
Improving EMS Billing for Patients
The medical billing process can be uniquely frustrating for patients. Few people understand their financial responsibility and might be confused by their bills and what their insurance covers. When they reach out to an EMS agency with questions about billing, they might already be worried or upset.
Some billing issues might require contacting insurance companies. These steps take significant time, and your team is busy. However, if your organization does not have time to meticulously examine billing issues to reach solutions and explain those to patients, the EMS billing process suffers.
A positive medical billing interaction is critical, so how do you improve the EMS medical billing process for patients while maintaining revenue integrity for your agency?
A third-party EMS billing service — such as Mobile Health Resources — is the answer.
In-House EMS Billing Versus an Outside Billing Service: Which Is Better?
Outsourcing has become commonplace for almost every industry. It is often an efficient means for reducing costs and allowing organizations to focus on their core operational goals. However, EMS billing is not always first on the list for outsourcing, as this business function is so closely tied to an organization’s profit and revenue.
Taking a closer look at the process, though, shows that outsourcing EMS billing services to a third party makes fiscal sense. In-house billing requires a significant investment not only for purchasing billing software that can communicate with ePCR systems, but also for hiring the staff necessary to code and bill for services.
Billing requires an in-depth knowledge of Medicare and Medicaid as it relates to EMS. An in-house billing team also needs the experience and background to comprehend obscure rules and policies and follow frequent federal regulation changes. Should any of those responsibilities get missed, EMS agencies might experience delays in payment or not get the revenue they are due for services performed.
Moving to a third-party EMS medical billing partner such as MHR relieves the burden of missing updates and changes and can cut down on operational costs — all while offering myriad other benefits. These include:
- Improved revenue.
EMS revenue cycle management is a critical component of EMS agencies’ financial viability. Should something go wrong or be missed during the billing process, you could face claim delays, denials, and rejections. Each one could mean a loss in revenue.
An efficient EMS revenue cycle management process can correct many problems, but it takes time, money, and resources — all of which are often in short supply. Instead, expedite the process by working with MHR. We have the expert background, experience, and technology to catch issues, minimize delays, and increase the amount collected.
- Skills gaps.
The healthcare industry is facing a declining labor force. In this small talent pool, it might be difficult to hire and retain an in-house EMS billing expert. Working with a third-party EMS billing service can bridge that skills gap. Outsourcing your EMS billing to MHR offers access to certified ambulance coders. Coders regularly take part in continuing education about updates and changes in EMS billing.
Rest assured that our team members are experts in the field, so there are no concerns about compliance or whether the billing process is being conducted in a timely manner. If an issue were to occur, MHR has the experience and resources to act quickly and correct the problem to minimize delays.
- Improved patient care and experience.
EMS agencies often are the smallest operational units in the healthcare system, which means they frequently work with limited resources. By moving to a third-party EMS billing service such as MHR, you no longer have to allocate funds to billing infrastructure. Therefore, you can devote more time and resources to patient care, improving the overall patient experience.
The Benefits of Choosing MHR as Your EMS Billing Partner
When outsourcing to a third-party EMS billing service, you want to find a reliable partner with the experience, chops, and proven track record to avoid any claims issues and ensure you get the revenue you are owed. Compliance problems alone can quickly result in significant issues when you make the wrong choice in an EMS billing partner.
The question, then, is this: How do you know when you are working with a trustworthy EMS billing service that will provide excellent support and maximize your revenue? Look for a partner that fulfills its promises with real action.
At MHR, we do just that. Our experience and expertise are unmatched, which is why our goal is to be more than just another EMS billing service. We strive to be an EMS billing partner. We take this relationship seriously to ensure you and your patients feel truly supported throughout the billing process. Below are just a few of the services MHR offers:
Revenue integrity: We handle all of your claims with great care. That means each claim is accurate, timely, and compliant with CMS regulations. Should a claim be rejected, we follow up on it as soon as possible so you get what you are owed.
Customer service: MHR serves as an extension of your organization. When MHR speaks with patients, we help them navigate every step of the EMS billing process. If patients do not understand their insurance, we offer guidance — and even contact insurance companies — to ensure they get the assistance they need.
Commitment: Our team is committed to providing the best service. As such, we are always ready to review policies and fee schedules with you and go the extra mile by providing training for your staff on how to best optimize your revenue.
When working with MHR, you also can expect:
- Certified ambulance coders that are well-versed in billing procedures.
- A thorough review of each claim before it is submitted to ensure the documentation matches the diagnosis.
- Great attention to detail, as our team looks out for any hidden issues, rejection trends, and other problems that might delay reimbursement.
- Hands-on service so you and your patients always speak with a live MHR team member who is knowledgeable, courteous, and prompt.
- Immediate follow-ups on any delays or rejections during the claims process and payment reviews to ensure all reimbursements and payments match the total of submitted claims.
- Extensive industry experience, as MHR has processed thousands of EMS claims for agencies of all types and sizes.
- Knowledge of CMS rules and guidelines.
- Claim review to make certain all claims are assessed thoroughly before being sent out and can be supported should an audit take place, helping you avoid costly fines that could reach back multiple years.
- Advocacy, as our team advocates for your agency, your patients, and your patients’ families.
We understand how important it is to trust your EMS billing service. At MHR, we take each partnership seriously, providing service and support tailored to your specific needs and the community you serve. Because we are often the last interaction patients, payers, and providers have with your agency, we carry out our work with intention. That is the difference between a service provider and a true partner.
To learn more about how Mobile Health Resources can improve the EMS billing process for your agency and your community, contact us today.
Connie Cleary serves as the director of operations at Mobile Health Resources. Connie has spent her entire career in revenue cycle management in a variety of healthcare settings. Additionally, she serves on several reimbursement committees and works closely with legislative bodies and major insurance companies to resolve EMS reimbursement issues and develop new strategies for dealing with EMS reimbursement problems.