In today’s EMS world revenue is critical. We’re all stuck on a constant loop of trying to find ways to generate more. Always. All the time.
The issue that we’re faced with as ambulance coders is making sure this revenue is compliant. Compliance is of the utmost importance to medical billing companies, at least it should be. We need to make sure that we’re compliant with all regulatory entities. This way we (and in turn you) can avoid some serious repercussions. Sounds simple enough right? Not necessarily.
- You probably won’t always like us when we require you to be fully compliant.
Remember when we established that money was a critical part of our industry? Unfortunately, sometimes being fully compliant can cost you. For example, if you’re currently billing a high number of ALS runs when many of them should actually be billed BLS, you won’t be getting as much in revenue. However, if this is your current method, much of that revenue could be fraudulent, and needs to be refunded, so while a quick pay day always seems nice, future consequences won’t be. As is the case with many things in life, often times doing something the easy way and doing something the correct way don’t always go hand-in-hand.
- Your billing company (and you) need to have a compliance plan in place already.
The “already” aspect of this is the really important part. If you’re in the situation where you’re being audited by the Office of Inspector’s General (OIG) or other regulatory entity, it’s too late to come up with a plan at that point. Unfortunately, if there is an audit and you’re non-compliant at that time, you’re going to have to deal with the consequences (which are often times very pricey).
- You should be engaged in internal annual security risk assessments.
Is your current biller helping you participate in these security risk assessments? They should be. Per HIPAA regulations, you need to be getting annual security risk assessments. These risk assessments help to ensure that you’re both compliant with all regulations and make sure none of your agency’s PHI has been compromised.
- Documentation is extremely important.
Documentation is a critical part of overall compliance. What is documented is largely how we, as a billing company, figure out how to properly code and bill our clients’ incidents. So if the runs are documented incorrectly it’s a huge problem.
Here at AccuMed we offer documentation training for all new clients. So you know everything is being done properly and you don’t have to worry about the issues that could result from improper documentation.
At The AccuMed Group, our dedication to compliance could save you from having to pay back a lot of money to the various regulatory entities, as well as other serious consequences (such as possible imprisonment). In FY 2015 alone $1.6 billion was returned to the Medicare Trust Fund. We are committed to full compliance with all regulatory entities and strictly comply with a comprehensive Corporate Compliance and Integrity Plan that is modeled after the OIG Provider Integrity Agreement. AccuMed employs the national EMS law firm of Page, Wolfberg and Wirth, LLC to audit our compliance efforts and test the aptitude of our billing and management staff.
At the end of the day, AccuMed invests time and resources to help ensure that we, and all of our clients, are compliant. It’s something we take very seriously (as should you). If you’re not sure how seriously your current vendor is taking this or if you’re not certain your in-house billing team has all the appropriate resources to keep you compliant, then we would welcome the opportunity to conduct a cost free analysis of your current billing, compliance and reporting effectiveness. Either you pass the test or you don’t. Better safe than sorry, wouldn’t you say?
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