Our old Silverdale phone numbers have now been disconnected.
All of the toll free numbers the patients use remain unchanged.
Administration
Please use our new numbers for all future contact.
Toll Free: 800-585-5242
Phone: 360-394-7020
Fax: 360-394-7099
Department Contact List |
 
Credit Cards ProcessingSystems Design announced in August and September a deal with Official Payments to enable patients to make payments of their EMS transport with major credit cards. Accepted credit cards include Visa, Master Card, American Express, Discover, and debit cards. Many of our Fire & Rescue clients are already taking advantage of this service. We believe that offering this convenience will encourage more private payments from patients and improve the uncollectable amounts owed to our clients. Based on the amount of patient inquiries regarding credit card acceptance, we believe this option will be worthwhile to our clients.
Web Server Project We are near completion on setting up a new web server that will provide Systems Design's clients real-time access to financial reports. Security is our priority in this endeavor and the web server will enable us to provide online access to important information in a secure environment. Systems Design will provide and maintain login IDs and passwords in order to protect your patients' health information. Ultimately, this service will be expanded to provide access to patient accounts. We expect the financial reports portion of this project to be completed by mid-December. |
Billing News...
What is Accurint?
If you have ever received a patient's account history from us, you may have noticed an account note mention something called "Accurint." Accurint is a service provided by LexisNexis which allows Systems Design to search for and obtain a person's address history, any phone numbers, whether or not they are deceased, etc. This service is often used by law enforcement, legal professionals, health care providers/billers, insurance companies, various government organizations and others. You can find more information at www.accurint.com.
If we ever attempt to send someone an invoice for services rendered by your organization and that invoice is returned back to us because we didn't have the patient's correct address, Accurint is the tool we use to find a correct address or phone number and get that invoice back to where it needs to go. Our custom billing application even has built-in access to Accurint results, which allows us to automatically look up patient addresses quickly and efficiently and get those invoices out the door. |
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Previous Newsletters?
Maybe you missed a earlier newsletter, or want to refer back. Just click on the link below to view our Newsletter Archive page.
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 Medicare Rule Changes
A recent newsletter from PWW confirms that the proposed rules from CMS are now finalized and will be issued in the national register on November 29, 2010.
Ambulance providers need to be aware of three issues that will affect them once the final rule becomes law:
- Beginning January 1, 2011, ambulance providers are to document mileage to the tenth of a mile per the CMS rule. Unfortunately, this means no more rounding up your loaded miles. If your ambulance is not equipped with an odometer that reads tenths of miles, it is suggested that you install a GPS or another device to document mileage in tenths. By implementing this rule, Medicare expects to reduce costs by $80 million annually.
- Beginning January 1, 2011, an efficiency adjustment will be applied to the fee schedule, lowering Medicare's allowable payments. This adjustment is projected to affect the ambulance provider industry by $30 million annually.
- The rule will also identify the procedures regarding the retroactive rural bonus reimbursement that was promised to rural ambulance providers for 2010.
Please see Systems Design's July newsletter for more information on these issues. |
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ProviderOne Automated Validation
The Washington Administrative Code (WAC) 388-502-0160 does not allow the billing of a DSHS eligible patient for a covered service, if it is known that the patient has/had coverage for that date of service.
When we receive a PCR, sometimes there is no insurance information available. In many cases the patient has DSHS but we are unaware. An invoice is sent to the patient requesting insurance information and a response usually comes back in a few weeks.
Since DSHS's ProviderOne software is now capable of batch processing eligibility requests, we will begin checking for DSHS eligibility on every claim where no insurance information is available. We will also verify DSHS eligibility prior to submitting a claim. This process will occur automatically from within our billing software by submitting batches electronically to ProviderOne. The results of this eligibility inquiry will be returned to us electronically where we will then proceed with the billing process based on this information.
It is also fairly common that patients who did not have DSHS eligibility at the time of transport subsequently apply for medical assistance. If it is granted, it may be retroactive for a period that could include the transport date of service. To cover this scenario, we have been manually checking for eligibility before sending the account to bad debt, collections or levy. With batch processing, this step will be automated.
The net result of this software automation and process improvement should decrease some DSHS:
- Rejected claims for unidentified insured
- Write-offs, collections and pass to levy expenditures
- Reimbursement times
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Medicare & Medical Necessity
You might think that Medicare will always pay for ambulance transports, especially when it's an emergency response. In reality, there are certain criteria that must be met before payment can be made. The most common reason used by Medicare to deny a claim is that the ambulance was not medically necessary.
What makes an ambulance transport medically necessary? An ambulance is justified when transportation by any other means would endanger the patient's health.
The following list contains 10 patient conditions that fulfill medical necessity:
Patient transport is due to an accident, injury or acute illness
Patient needed restraints for their own safety or the protection of others
Patient was unconscious or in shock
Patient required oxygen or other emergency treatment en-route
Symptoms of respiratory distress or cardiac distress
Symptoms of acute stroke
Patient has a fracture or possible fracture that is not set
Patient with severe hemorrhage
Patient could only be moved by stretcher
Patient was bed-confined per Medicare's 3-part definition:
Unable to get up from bed, unable to ambulate and unable to sit in a chair or wheelchair
Thorough documentation goes a long way in justifying the medical necessity of every transport to help ensure that payment will be made. There will be times when you must transport the patient, but the circumstances may not fit Medicare's definition of medical necessity. If the documentation does not support medical necessity, then the patient may be responsible for the bill.
For more information from Chapter 10 of the Medicare Benefit Policy Manual, CLICK HERE.
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Sharing Information on Federal & State Standards
Signatures on Patient Care Reports
When Medicare requests a copy of a patient care report (PCR) for medical review, the signature of the primary EMT must be on the PCR. The purpose of a signature is to authenticate that the services were provided and that everything in the PCR is true and correct.
Handwritten signatures are acceptable but they are required to be legible. For those whose signature is not legible, their name should be clearly printed directly below the signature along with their credentials. You can also keep a signature log on file to validate signatures that are not legible. The log should include each EMT's printed name and credentials with their hand-written signature and initials.
Electronically signed PCRs are also acceptable. Many electronic systems are password protected and the EMT's name is automatically attached to the PCR. In a recent appeals seminar, several questions were raised regarding the proper use of electronic signatures. It is not necessary to print the PCR and be physically signed by the EMT. The electronic signature is acceptable if it includes a statement next to the EMT's name, such as "This report has been reviewed and electronically signed by (EMT name)". |
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Pickup Location - Zip Codes
The point of pickup (POP) for any transport is a critical piece of information when billing a Medicare patient. Medicare uses the POP zip code to determine whether to use the urban, rural or super-rural bonus to pay the claim. If you document the wrong zip code you could be under-paid for the transport and lose revenue. The wrong zip code could also cause the claim to be overpaid, which might prompt Medicare to audit a larger portion of your claims.
When your transports arrive at Systems Design, we include the POP zip code on all claims. If it is missing or unclear, we contact you to get the information. Having good documentation will speed your claims through the billing process and ensure you receive the correct payment. |
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