Ambulance and EMS billing and reimbursement is not a simple and straightforward process. In a simple world, patients would pay for emergency medical services soon after they receive their service bill. Unfortunately, that is not the case, and why EMS billing continues to be a painful process to this day. In this PPT deck, we’ve outlined billing challenges, and how a robust EMS Billing Software should alleviate you of those problems. 1. Lost Revenue and Increased Costs from Incomplete Patient Care Report 2. Not Knowing Why Accounts Receivable is Growing 3. Not Getting Paid On-Time 4. Not Knowing Who to Bill 5. Denied Claims When Patient’s Deductible is Not Met 6. Not Getting Paid by Self-Paying Patients 7. Spending Too Much Time Learning about  “Medical Necessity” 8. Encountering Fraudulent or Erroneous Medicare Claims 9. Not Knowing Which Areas Need Most Attention View the original article: https://traumasoft.com/ems-software/9-problems-your-ems-billing-software-shouldve-solved-yesterday/ See how Traumasoft can help with EMS Billing: https://traumasoft.com/product-features/billing/

1. 9 Problems
Your EMS
Billing
Software
Should’ve
Solved
Yesterday
9 Problems Your EMS Billing Software Should’ve Solved Yesterday 1

2. Lost Revenue in EMS
Organizations
of all Medicare claims filed by EMS organizations were denied.
9 Problems Your EMS Billing Software Should’ve Solved Yesterday 2
10%
That 10% translates to approximately
123 million claims.
Of those claims, only 3%, or
3.69 million claims were appealed.
Source: Page, Wolfberg & Wirth, LLC

3. 9 Problems Your EMS Billing Software Should’ve Solved Yesterday
01.
Lost Revenue
and Increased
Costs from
Incomplete
Patient Care
Report
Definition of “Medical Necessity” is not clear and
can differ by payment type.
Burdensome to train crews on how to establish
“Medical Necessity” payment type.
Solution:
Your EMS billing software should require your
crew members to report sufficient information to
establish “Medical Necessity”
3

4. 9 Problems Your EMS Billing Software Should’ve Solved Yesterday
02.
Not Knowing
Why Accounts
Receivable
is Growing
Most prioritize sending new invoices over
following up on overdue reimbursements.
Invoices become harder to collect as the overdue
date extends.
Solution:
Your EMS billing software should provide a real-
time accounts receivable report to help your staff
focus on invoices between 45-90 days overdue.
4

5. 9 Problems Your EMS Billing Software Should’ve Solved Yesterday
03.
Not Getting
Paid
On-Time
Not knowing which payer account has the highest
number of accounts receivables.
Not knowing which payer account is
paying on-time.
Solution:
Your EMS billing software should break down
your receivables by account so you can easily
investigate which accounts are getting paid faster
than others.
5

6. 9 Problems Your EMS Billing Software Should’ve Solved Yesterday
04.
Not Knowing
Who to Bill
Depending on situation, you may need to bill
Medicare, patient, hospital, or others.
Complex billing process creates rejected
reimbursements and delayed cash flow.
Solution:
Your EMS billing software needs to be
customizable so you can set rules on whom to
properly bill in certain situations
6

7. 9 Problems Your EMS Billing Software Should’ve Solved Yesterday
05.
Denied
Claims When
Patient’s
Deductible
is Not Met
Your submitted claims are denied because
patient’s deductible has not been met.
This claim turns into accounts receivable
where your only course of action is to invoice
the patient directly.
Solution:
Your EMS billing software needs to be
customizable so you can set rules on whom to
properly bill in certain situations
7

8. 9 Problems Your EMS Billing Software Should’ve Solved Yesterday
06.
Not Getting
Paid by Self-
Paying
Patients
Sending the bill to an incorrect address or faulty
contact information.
Transporting patients who carry on insurance
or has no ability to pay.
Solution:
Your EMS billing software should automatically check
and compare the patient’s information with other
institutions to detect whether you have the most up-
to-date data.
8

9. 9 Problems Your EMS Billing Software Should’ve Solved Yesterday
07.
Spending Too
Much Time
Learning
about
“Medical
Necessity”
Definition of “Medical Necessity” is not clear and
can differ by payment type.
Burdensome to train crews on how to establish
“Medical Necessity” payment type.
Solution:
Your EMS billing software should require your crew
members to report sufficient information to
establish “medical necessity”.
9

10. 9 Problems Your EMS Billing Software Should’ve Solved Yesterday
08.
Encountering
Fraudulent or
Erroneous
Medicare
Claims
Employee submit erroneous claims just to
complete ePCR reports.
Employee may falsify Physical Certification
Statements to expedite Medicare reimbursement.
Solution:
Your EMS billing software should have rule-based
configuration settings that ensure proper
documentation.
10

11. 9 Problems Your EMS Billing Software Should’ve Solved Yesterday
09.
Not Knowing
Which Areas
Need Most
Attention
EMS billing has many moving parts: cashflow,
accounts receivable, refunds, write-offs, etc
Getting an overview of the moving parts is difficult.
Solution:
Your EMS billing software should have a dashboard
with real-time information on all the moving parts.
11

12. Conclusion
EMS companies are tasked to save lives, not operate as
collection agencies. If, however, providers cannot get
reimbursed for their services, their ability to save lives is
negatively impacted. Most providers require a steady
stream of revenue to continue operations. A
comprehensive and highly customizable EMS billing
software can help achieve just that.
If you are experiencing any of these issues, schedule a
30-minute demo with Traumasoft to see how we can
help.
What other Billing and collections problems are you
experiencing? Contact us now to see whether we can
help you solve those problems!
9 Problems Your EMS Billing Software Should’ve Solved Yesterday 12