11-09-20 Regular Meeting of the La Porte City Council

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EMS Billing Services City of La Porte RFP #20510 2. Describe how you currently submit claims electronically to Medicare, Medicaid, and major private insurance companies. Ambulance Billing At EMERGICON, we believe in compliant and effective EMS billing that maximizes cash collections. Through our tried-and-true processes, EMERGICON has increased reimbursements for every one of our Texas clients. Our efficient services are the result of ongoing training, education, and closed-loop, continuous quality improvement, both external and internal. We follow a proprietary Quality Assurance and Improvement Plan that emphasizes rigorous cross-referencing (with ESO Billing Software Services and manual review), unique EMS and emergency responder training, and continuous professional development of EMERGICON staff. Our billing process is a team approach consisting of two pre-billers who perform payer research, a commercial billing specialist, and a governmental billing specialist. This team approach leverages specific knowledge while allowing for shared accountability. The billing process begins with the pre- status. As described above, EMERGICON does not rely on automated payer-matching databases for payer research as those databases frequently miss the correct payer (e.g., identifying dental insurance as a payer rather than a health plan). Our billing software maintains data on all insurance carriers, previous claims, and patient information in case they need transport in more than one instance. Our Match Patient technology provides a smoother billing process as it allows research to be reused for repeat patients, including those who erritory. Furthermore, EMERGICON uses several tools to ensure that we have correct and current insurance information for each patient, and we work with local hospitals to identify patients who are transported as John or Jane Doe. By reviewing the insuranceinformation for accuracy, we can better reduce the risk of human error during a time of crisis. The difference between good billing and great billing, assuming everything else is equal, is consistent follow-up. EMERGICON never accepts a denial or partial payment without reaching out to the payer for clarification. Whereas many of our competitors attempt to automate this process for cost savings, we ensure that a staff member pursues resolution and refiles the claim as needed to maximize the reimbursement amount. Billing and Collection Procedure -step approach to billing claims focuses on accuracy the first time the bill is sent with targeted follow-up. Accuracy is a key component of greatbilling, from documentation in the field to capturing the correct Medicare number, to coding and billing. Based on our experience and ongoing analysis, we believe we have the best billing process that focuses on maximizing collections. We bill all known payers, including Medicare, Medicaid, commercial insurance, auto insurance, workerscompensation, and attorney pays. Step One:The EMERGICON billing process begins the day after the transports occur. Runs Billing Software timestampsany record and then imports the claim. We ensure the dates areverified and compare the claim to any available patient log for the day. 11 Confidential & Proprietary