Tenth of a Mile Billing - the Sequel

Got a free moment? You still have a few days to comment on the proposed rules published by CMS last month that will likely negatively impact ambulance service revenues in coming years.

In short, last month, CMS resurrected the idea of requiring tenth of a mile billing for ambulance transports. About a year ago, CMS issued a transmittal to that would have required tenth of a mile billing, but that transmittal was later rescinded after there were objections that this change should go through a rulemaking process. Last month, CMS started that rulemaking process by publishing this proposed change along with a couple others that will impact ambulance services. Some estimate that this change will save from $45 million to $80 million per year. This savings comes at the expense of the ambulance industry, but isn't that the only way to save money – not spend it?

The second proposal would allow the Ambulance Fee Schedule (AFS) to reduce reimbursement rates from one year to the next. Currently, the AFS increases annually through the Ambulance Inflation Factor (AIF) calculated with the consumer price index. However, the current formula does not allow for a negative AIF. However, the Healthcare Reform legislation calls for a "MultiFactor Productivity" (MPF) adjustment. The MPF assumes that new technology makes provision of healthcare more efficient – so it should cost less. The proposed rule would subtract the MPF from the AIF to derive a final update percentage for the fee schedule, and the update could be a negative percentage – thereby reducing reimbursement levels.

You have until midnight August 24 to submit comments to CMS regarding the proposed rules. Our friends at Page, Wolfberg, and Wirth have developed a number of materials regarding this matter. Click here to access the PWW page on how to submit comments.

Pick up more NAAC CEUs, and Keep Up-To-Date

Make sure to sign up for the two latest opportunities for free education and CEUs on EMS billing topics:

The Latest Medicare News on Signature Verification, Documentation and More

9/8/2010 2:00 PM ET | 60 minutes | 1 hour |Approved for 1.0 NAAC CEU

Presented by Doug Wolfberg, of Page, Wolfberg and Wirth

This webinar will cover:

-The latest Medicare news on signature verification, documentation and more
-Proper use of ABNs
-Critical HIPAA changes coming soon
-The new Medicare audit crackdown
-Ask a Lawyer Q&A session


How Your Billing System Helps Maintain Compliance - Part 3

9/23/2010 2:00 PM ET | 60 minutes | 1 hour |Approved for 1.0 NAAC CEU

co-presented by Maggie Adams, National Academy of Ambulance Coding (NAAC) Executive Director, and Kelly Rothlisberger, TriTech Team Lead/ Product Analyst.

The goal of a compliant ambulance billing system is to help providers obtain and keep their legitimate reimbursement. Join us for this fast-paced, multi-part webinar series which will outline the ways the Sweet-billing system can help you safeguard your compliance. This session addresses

This webinar will cover: Working with Procedure Codes and Modifiers

VisiCon Justification Toolkit

In these tough economic times, it is only natural for a manager to ask, “How can we justify spending money to participate in a conference when we are facing budget reductions?” The answer lies in the value of the conference’s content and the focused interaction it provides. Sometimes learning one new piece of information or gaining better understanding about only one process can justify the entire cost of attending VisiCon (Oct. 13-15, 2010 in San Diego). And making one professional contact can be worth much more.

We've developed some helpful documents to assist you in justifying your attendance and receiving approval to attend VisiCon 2010: TriTech’s Annual User Conference. The first and foremost communication should be your company’s standard request form or a formal memo directed to your manager requesting attendance and why (Click here for VisiCon Justification Letter). It would be helpful to include the return on investment and cost savings for attending.(Click here for VisiCon Justification toolkit which can help provide ROI). Schedule a follow-up meeting with your manager to discuss the request. In your letter and follow up meeting focus on how attending the conference is relevant to your company and/or your team goals and future projects.

Here are some talking points to help you make a case for attending:
• I am going to look for a solution for “this” problem.
• I believe “this new technology” could benefit the company and I would like to learn more about it.
• I want to plan effectively for upgrade or incorporating new technology
• I plan on meeting with “x” vendors to discuss these issues
• I am going to talk with several users for ideas on how they working around “x” issue
By offering a hands-on lab, peer-to-peer discussions and various general industry and training sessions, VisiCon 2010 offers you the knowledge of multiple TriTech staff, fellow users, and third party vendors that are focused on the effective use of your TriTech system to increase your ability to meet the challenges facing your agency.

REGISTER

Merge EMS Call-Intake, Dispatch, Operations and Billing…or Else

What is the dilemma?
-Definitions of ALS and emergency are different in dispatch, the field, and for filing for reimbursement.
-Conflicting documentation results in the necessity to file for reimbursement at the lower level.
-The Department of Justice, Federal Bureau of Investigation, the Office of the Inspector General, and the State Attorneys General are pursuing ambulance services that file claims for ALS or emergency transports inappropriately. ($1 of investigation expense results in $17 of recovery)
-Few fully understand the rules and regulations applicable for ambulance reimbursement.
-Most ambulance providers (private, fire, hospital, volunteer, etc.) inadequately monitor their billing department or outside billing agency, yet the provider is ultimately held accountable and subject to repayment, damages, fines, penalties, and interest for filing claims inappropriately. Ignorance is not a viable defense
-Actions occurring and documentation in Dispatch is essential for complying with the rules and regulations for filing for ambulance reimbursement.

What is the discussion?
-Most EMS systems respond ALS to all 9-1-1 calls, but payers (especially Medicare) will not reimburse at the higher ALS level unless certain criteria are met.
-Advanced Life Support (ALS) is the appropriate level for reimbursement when ALS interventions are provided OR when an ALS assessment is required with or without ALS treatment.
-Being reimbursed at the ALS level for assessment only is entirely dependent upon the defined protocols implemented, activities accomplished and documentation provided by the EMS Dispatch Center.

Join the presentation on June 15 at 2 pm ET to get in on these objectives of the complimentary, online webinar:
-Introduce and understand the definitions.
-Recognize causes of conflicting documentation and identify elements that often contradict each other.
-Define the necessary steps and documentation requirements for dispatch and operations in order to comply with payer rules and regulations and ensure appropriate reimbursement.
-Identify key indicators to monitor compliance of an in-house billing program or an outside billing service

The presentation is designed for a broad based audience including those who dispatch, field, and billing services and those who are ultimately supervise and responsible for compliance and performance.

Richard Keller will be presenting this 60-minute webinar, who is a top EMS system expert and creative designer. As a partner of Fitch & Associates, LLC for 25 years, he has been a driver behind understanding the production efficiency and design of EMS systems. His areas of expertise include operations, fiscal systems development, and reimbursement. He leads the health-care finance component of the firm’s practice.

Register Here

Face Time. It Matters.

In response to economic pressures on many of our clients, we instituted TriTech University to provide more remote options for learning, including new classes, ranging from the beginning user to the advanced user, as well as educational and informative webinar offerings. While remote education opportunities continue to provide tremendous value, we would like to encourage TriTech customers to attend VisiCon - TriTech's national user conference in San Diego on October 13-15. VisiCon offers important sessions on TriTech products as well as informative presentations from industry experts. Most importantly the value of VisiCon lies in the networking with fellow clients and face to face meetings with TriTech executive management and staff.

According to research by the Convention Industry Council, unique benefits associated with meeting face-to-face include:
• Face-to-face meetings build trust and relationships;
• Education and training are more effective in a live setting;
• Live meetings actually save time and money;
• Live meetings result in a more effective exchange of ideas;
• Face-to-face meetings provide the human connection that powers business;
• Face-to-face meetings create jobs and powers the economy.

Come for the ‘Face Time.’ It Matters.

• Come to VisiCon to get ‘face time’ with Chris Maloney, TriTech president and CEO, to get his thoughts on the industry and roadmap for TriTech.
• Schedule meetings with an Account Manager to move forward on projects to improve operations.
• Spend some time in hands-on labs with our trainers to refresh skills and learn new functionality.
• Network with other users to share insight and lessons learned from their operations.

We would love to opportunity to spend some ‘face time’ with you at VisiCon. For information about VisiCon, please visit www.tritech.com/visicon.

New Threat to Privacy

A hidden threat to privacy has recently been given national attention, and I'm not talking about the latest 'enhancements' to Facebook. This threat -- your copier.

When you dispose of your digital copier, you are potentially sending digital images of thousands of copied documents out the door with the machine. These digital images can be recovered off the copier hard drive much like recovering deleted files off your computer hard drive.

The details of this security risk were publicized in a recent CBS News report. I recommend that if you haven't seen this report -- take 5 minutes to watch it and then think about how disposing of your copier could potentially result in a HIPAA Privacy violation.

http://www.cbsnews.com/video/watch/?id=6412572n

How can an ePCR solution provide value beyond the medic?

If your thoughts about an ePCR solution have stopped at implementation costs and state requirements, it's time to broaden your thinking. There are many other aspects of an organization that electronic patient care reporting affects besides the medic's side.

What if this electronic PCR solution could process your paper PCRs 46% faster?

What if this ePCR solution helped enable you to achieve zero day billing - thereby gaining the best time-value of money possible?

What if this ePCR solution resulted in more complete records and better QA data to turn around higher AR percentages and leverage better relationships and results from hospitals and facilities that you work with?

Of course, it's not only about this ePCR solution - it takes good management and vision to use the ePCR tool to accomplish results like these. Join us in this panel discussion with Kanawha County Emergency Ambulance Authority's Director of Finance, Larry Cole, to learn how his service has accomplished these results. Pick up tips for your own operations - and possibly - even rethink how this ePCR solution can affect your service in a way that earns money instead of costing money.

Join in on this panel discussion by registering here: http://www.ortivusna.com/TriTech-University/Webinars.asp


The value of ePCR beyond the Medic: Discover first-hand how TriTech's ePCR has achieved ROI across KCEAA's organization.

May 20, 2010
2 pm Eastern / 1 pm Central / Noon Mountain / 11 am Pacific times / 60 minutes

Panel Speakers:
Larry Cole, Director of Finance for KCEAA
Kelly Rothlisberger, TriTech Product Lead and Analyst
Karla Hageman, TriTech Account Manager