December 29, 2015
Ambulance billing and coding is a specialty unto itself. It has a unique set of codes which are not used by physicians’ or hospitals’ services. One must understand that the difference between medical and ambulance coding is vast. It goes without saying that the coding and documentation requirement for ambulance billing are unique, and facts that physician and hospital coders take for granted are not applicable to the world of emergency medical services coding. For instance, condition codes need to be used because it is beyond the scope of an EMS license to diagnose as only a physician can give a diagnosis. Add to that, the actual condition of the patient can be very different than it was actually at the time the ambulance is dispatched and there are rules that make it necessary to mention the condition that must be entered on the claim, or in case of death of the patient between dispatch and arrival of the ambulance. These and many more factors need to be considered by the ambulance coder in order to produce an accurate claim.
The Ambulance services industry is pegged at $15 billion and is estimated to grow at just over 1 percent. It employs over 200,000 people. The importance of ambulance services in the healthcare system has made the revenue growth for the Ambulance Services industry grow in the last five years. Demand accelerated during recession period when a number of people lost their private insurance coverage and waited until health issues escalated in to emergency situations. Additionally, it is estimated that a number of individuals aged 65 and above will increase which will sustain the industry’s growth.
Steps to simplify ambulance billing and coding services
One of the most vital steps is to hire experienced ambulance coders. As discussed above ambulance coding is complicated hence, to simplify this process one must hire a qualified and experienced individual who has clarity of role and job and can simplify the process
Secondly conduct persistent training for the coders so that they are abreast with the changing environment
Effective and efficient utilization of EHR. Automation is one of the best ways to simplify a process. However, automation needs to be used smartly. It is also important that the emergency medical services make it a point to choose an EHR which suits their needs
To sum it up we can say that ambulance billing though tough is not unmanageable. One just needs a smart and experienced hand that can simplify the process so that it does not become overwhelming.
Best Billing and Coding Practices