ambulance billing Archives

Keep the Wheels Turning: Best Practices for Ambulance Billing Efficiency

Ambulance billing can often feel like navigating a traffic jam—just one small misstep can cause a major backlog. But what if there was a way to ensure the billing process runs smoothly, every time? Have you ever wondered how improving ambulance billing efficiency could help your service recover thousands in lost revenue? With demand for […]

Covered Destinations for Ambulance Transportation

Basics of Destinations for Ambulance Transportation Ambulance transport is covered to the nearest appropriate facility to obtain necessary diagnostic and/or therapeutic services such as a CT scan or cobalt therapy as well as the return transport. In addition to all other coverage requirements, this transport situation is covered only to the extent of the payment […]

Medicare Ambulance Transports and ABNs

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A physician or supplier often has a lot of doubts when it comes to ambulance transports and ABNs. Most suppliers consider ABNs a way to avoid Medicare’s medical necessity denials. So let’s dive deeper into a detailed understanding of ABNs, and their appropriate use. ABNs are only rarely appropriate for ambulance services. A physician or […]

Guidelines for Billing Medicare for Ambulance Transportation

Medicare Coverage for Ambulance Transportation Medicare Part B covers emergency ambulance services and, in limited cases, non-emergency ambulance services. Part B covers medically necessary emergency and non-emergency ambulance services at 80% of the Medicare-approved amount. In most cases, you pay a 20% coinsurance after you meet your Part B deductible ($233 in 2022). All ambulance […]

Role of States in Exclusion of Ground Ambulances from NSA

Exclusion of Ground Ambulances from No Surprises Act The No Surprises Act (NSA) will prohibit most surprise bills, reducing out-of-pocket costs for emergency services and non-emergency services where the patient unintentionally sees an out-of-network provider. The recently enacted No Surprises Act (NSA) provides landmark protections against surprise billing in a wide range of settings but […]

Medicare requirements for ambulance transport medical billing

Today various private and public ambulance transport services are operating in a huge number for servicing critical patients at crucial moments. These players are getting reimbursed under Medicare Part B which covers ambulance transport medical billing with certain limitations. Let’s understand Medicare Part B in more detail: Medicare Part B Medicare Part B covers emergency […]

Extension of Prior Authorization for Repetitive, Scheduled Non-Emergent Ambulance Transports

Federal Register announced in their notice that a 1-year extension of the Medicare Prior Authorization Model for Repetitive Scheduled Non-Emergent Ambulance Transport. The extension of this model is applicable in certain states only. Earlier in those states, ambulance suppliers must obtain prior authorization from Medicare before providing scheduled, non-emergency ambulance transportation. These states are: Delaware […]

Avoid Common Errors in Ambulance Transportation Billing

An ambulance is a part of Emergency Medical Services (EMS), which is a billable event and most of the insurance companies such as Medicaid and Medicare compensate for it. Billing and coding for ambulance services may be complex owing to different modes of transportation like air, water, and ground. Apart from this, reimbursement of ambulance […]

Ambulatory Surgical Center Terminated Procedures

Ambulatory Surgical Center Terminated Procedures The following guidance determines the appropriate ambulatory surgical center (ASC) facility payment for a scheduled surgical procedure that is terminated due to medical complications, which increase the surgical risk to the patient. Payment is denied when an ASC submits a claim for a procedure that is terminated before the patient […]

Top 5 Compliance Issues for Ambulance Biller

Ambulance service billing involves a host of unique compliance challenges. The ambulance industry has seen a significant number of false claim cases, fraud investigations, Medicare audit activity, and other types of billing-related cases. It is imperative that billers fully understand the nuances of ambulance reimbursement to be able to successfully sidestep these landmines. The following […]

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