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Ambulance Transportation Billing 101

Ambulance Transportation Billing 101

Ambulance transportation also has bills that one needs to cover. Even the big insurance companies like Medicaid and Medicare pay or cover the costs of ambulance transportation. However, billing and coding for ambulance transportation are complex and unlike typical medical billing and coding processes due to comprehensive and unique modifiers.

There are various modes or types of ambulance transport such as water, ground, and emergency air ambulances. Third-party medical billing and coding companies usually have certified and experienced ambulance transportation billers and coders to streamline these billing processes.

As discussed earlier, ambulance transportation billing and coding is quite difficult for the providers as documentation required to file an ambulance transportation claim is different. Other than that, appropriate coding for billing is required as the claim is the only source to determine whether the ambulance service will be reimbursed or not.

Ambulance transportation cost and reimbursement rates might vary because it depends on the service provided to the patient. All ambulance transportation claims are based on strong documentation, and EMR systems help all the ambulance transportation providers to organize the necessary clinical documentation. To optimize the ambulance transportation reimbursement, you need to ensure that you have the right documentation filed and attached to support your claims.

Due to the complexity of the claims, you need a professional third-party coding and billing company like Avosina Medical Technologies to ensure a low rate of claim denials. We have the right knowledge and expertise in ambulance transportation billing and coding. We assure error-free billing and coding to increase the cash flow and improve the overall revenue cycle.

Definitions in Ambulance Services

We have listed a few of the most common definitions that pertain to ambulance payment and claim processing. This may help in clarifying billing terms necessary for ambulance transportation billing.

A/B MAC A Definition

This term refers to all the contractors responsible for processing claims associated with institutionally based ambulance providers. They are billed following the CMS-1450 form or ASC X12 837 institutional claim transaction.

A/B MAC B Definition

This term refers to all those contractors that are responsible for processing claims for the ambulance suppliers. They are billed in accordance to the ASC X12 837 institutional claim transaction or Form CMS-1450.

Date of service

The date at which the loaded ambulance vehicle departed from the point of pickup is known as the date of service.

In case the patient is declared deceased after the vehicle arrived, the DOS will be the day when the vehicle was dispatched.

In case the patient had called for air ambulance transport but he was declared after the airplane takes-off to pick up the deceased body, the DOS will be the day when the airplane took off.

Definition of a provider

This term is used to refer to a facility-based ambulance provider that is owned and managed by a skilled nursing facility, a hospital, a clinic, an outpatient rehabilitation facility hospice program, or a home health agency.

Definition of a supplier

This term refers to any ambulance service that is not institution-based. A supplier can be any company that owns operational ambulances.

Ambulance transportation bills are only separable under part B. Once the patient gets admitted into a hospital, the service is then known as ‘patient transportation’.

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