• Implementation and transition support: o Review current procedures and documentation and collaborate with current billing vendor to ensure a smooth transition o Provide and execute an implementation and transition plan (e.g., initiating data and insurance carrier connections, establishing fund transfer process) o Review current state of Accounts Receivable and provide recommendations for transition • Automated integration with our electronic patient care report system (EMS Charts). Automatically receive required demographic, condition and billing information for patients that are transported to the hospital. Note that Monroe EMS does not bill for on-scene assessments that do not result in transport to the hospital • Pre-billing quality and documentation review. Prior to submission of claims for billing, review documentation and patient insurance information to attempt correction of any deficiencies. For example, this may involve utilizing vendor connections with the hospital to obtain insurance information. Note that Monroe EMS intends to implement the ESO Health Data Exchange module that will provide access to insurance information for patients transported to certain hospitals. • Revenue Cycle Management. Proactive management of the entire revenue cycle – from initial notification of patient transport to insurance verification, billing (including all patient communications and statements), coding, payment posting and follow-up on unpaid claims. • Insurance carrier, Medicare and Medicaid claim submission • Self-payment support (e.g., credit card, check and debit) • Proactively monitor claims adjudication outcomes (e.g., insurance denials) and attempt to resolve or move to self-pay approach. Conduct phone outreach to patients to assist with resolution of issues.
