5 Takeaways from the abc360 Conferences

Tracy Holmes, Lauren Junker, Ailyn Risch & Sherry Willingham

Logis Billing Team
Based in Fort Worth, Texas, the experts on the Logis Billing team work to create, improve and implement solutions that make our billing software for emergency and patient transport as automated, customized and easy-to-use as possible.

For the first time in almost two years, EMS leaders, practitioners, executives, managers and privacy officers gathered in person for the abc360 National Conference on Ambulance Revenue Cycle and Compliance. The Logis Solutions Billing team attended the Las Vegas,  San Antonio and Clearwater, Florida, events, where we heard from invigorating speakers and joined informative breakout sessions about our industry.

Our team came away with several highlights from the conferences:

1. New ideas for improving the documentation process

Documentation was a key topic at abc360, with a particular focus on how more effective training can improve reimbursement. We all know that accurate clinical and billing documentation is critical, but many users are EMTs and paramedics who prioritize running the call but not so much the paperwork that follows. This is understandable, but these busy professionals need to know how important documentation is.

Suggestions we heard for helping to improve documentation included offering incentives to users who transmit their PCRs by the end of the shift and making sure your entire organization understands the financial impact of poor documentation. Another idea: Have paramedics and EMTs do a billing “sit-along”—just like billing people often do in the ambulance—so they get a first-hand look at the importance of accurate and timely documentation.

2. How the “No Surprises” Act will affect reimbursement

The “No Surprises” Act protects people covered by group and individual health plans from getting surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers. Right now, the act applies only to air ambulance but it’s only a matter of time before it will include ground ambulance as well.

One significant change still to come: The bill will require that ambulance services contract with insurance companies to be paid, something that doesn’t happen today. This will mean that agencies need to come to an agreement with insurers on what is fair compensation for their services—always a difficult discussion. This will be a big adjustment for both industries when the time comes.

The speakers we heard at abc360 emphasized that ambulance companies will need to focus on optimizing their billing and collection departments when it comes to balance billing. If your company doesn’t have a contract with an insurance company, there’s no real incentive for the insurer to pay an outstanding bill. Their members won’t be billed for any remaining balance outside of their co-pay deductible, so the burden falls on the ambulance companies to collect. That will require an increased focus on managing and processing those claims quickly and accurately to collect on them if you want to keep your revenue stream flowing. At Logis, we’re already working on ways to include contracts into the system to make the process of connecting ambulance services and insurance companies much easier.

3. The best way to achieve a clean claim

There was also a lot of lively discussion around the importance of getting clean claims out the door the first time around. We’re big believers in automation and most of those we talked to agreed that the best way to ensure clean claims from the outset is to automate as much of your billing operation—invoicing, auditing, report generation—as possible. Automating the flow of data in and out and being able to report on what matters to your organization’s executives are critical.

After all, reimbursement hinges not only on making sure you’re taking care of the patient but streamlining the entire process so that it’s fast as well as accurate. When you do this well, you’ll have enough money to keep ambulances on the streets.

Automated billing software is a good first step toward producing claims without error. Every chance you have to auto-populate fields like level of service and other data entry inputs removes the chance for human error and prevents undercoding and overcoding.

These are tough times for recruiting, and automation can also help with staffing. With so many new employees in many billing departments, automating routine processes helps them get up to speed quickly and prevents a number of mistakes new employees are likelier to make. It also helps free up staff from mundane tasks to focus on more value-added work on the back end, especially collecting payment.

Also important: Staff time spent verifying information in the prebill process is an inefficient use of resources. An automated software billing solution that transfers information directly from the CAD and patient care reports makes it simple to match them up—one less thing your staff has to look at.

4. Getting actionable insights to key decision-makers

A recurring theme at abc360 involved reporting. Executives ask for reports on total billing dollars, unreimbursed claims, continuous Quality Improvement (QI) data, productivity, denials, and time from claim submittal to payment receipt. This is the essential information needed to run an organization efficiently.

Our Logis Clarity (more details coming soon) solution is a report-builder that provides dashboards and the ability to drill down into specifics like payers and cost reporting. Reports can be tailored to your specific needs, unlike the typical canned reports. In the current environment, ambulance agencies have to find a way to cut costs, and running these kinds of detailed reports is essential to achieving that goal.

5. Where EMS is headed

One of the most exciting aspects of the conferences were the conversations we heard around the need to reclassify ambulance as a healthcare provider as opposed to a transportation service. After all, it’s not always going to be about going to the ED; more and more, patients are being taken to alternate destinations, like an urgent care facility or a clinic when these are the best options to deliver the care they need, as well being treated in place when appropriate.

As our CEO Gil Glass has said, it’s time to put more emphasis on the Centers for Medicare & Medicaid Services’ (CMS)  ET3 model (Emergency Triage, Treat, and Transport) and other new and innovative approaches to ensure fair reimbursement and appropriate care. Right now, ambulance is considered just a transport provider, not a healthcare provider. While CMS and others are working to change that, there’s plenty of room for great ideas to be heard.

As with any industry, getting together in person to discuss important ideas is critical to the future of emergency medical services. The final message coming out of the abc360 conferences was that we all must be thinking ahead in ambulance billing because with the ever-changing insurance industry, if you don’t, you’ll be left behind. A sobering thought perhaps, but one that should be seen as a call to action. Innovation and automation are the ways to stay ahead.

If you’d like to learn more about how Logis Billing can help streamline your billing operation and accelerate your revenue cycle, we’d love to start a conversation.

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