MightyMee

SPAM REMOVED. IF YOU WISH TO ADVERTISE HERE, PLEASE PM ME. - ADMIN :homework: [-o< There! Now I can say I did my marketing for today and move on to other things ! Thank you for time! But, if your interested in our services which we are exellent doing don't hesitate to contact me! MightyMee

HI! I am in Tx, I have over 20 yrs specializing in EMS billing. I have several certifications and have went one on one with the heads of Medicare, and BCBS for not paying as they should. I have also gotten claims paid that others would have written off as lost. My word of advice is simple: Don't let them (insurance companies) scare you into thinking you are wrong and they don't have to pay! Know how to code properly is the key to getting claims paid, as well as knowing you are right from the time you receive the patient information to the point where it is paid PROPERLY. Do not take any deals with insurance companies, such as we'll pay within 10 days if you agree to this amount! Always follow-up and appeal as needed any unpaid claims. DO NOT make a telephone call to the insurance company without ALL information in front of you --document, document document all calls and work you do on a claim! Marilyn Specialist in EMS Billing

Hello! Just a fast note here: It has been my knowledge you should be collecting on the average for 400 runs $160,000.00. You should not have to spend out for expensive software for your billing. This saves you money. You should not have to hire and train people in house and cover the expense of doing this twice a year as help turns around. Sick days and personal days also cost you money. If you are sending to a billing company, with this few runs a year, there should be no setup fee, no software to purchase or pay to access. You should be getting paid for every run! If it is a no insurance and patient responsibility the billing company should be working with the patient to insure they pay (no hard core collections required), after insurance pays the patient should have to pay what the insurance advises is patient responsibility. You cannot just FORGIVE co-pays and deductibles, that is fraud. Their by the ever popular subscriptions are walking a fine line if they are forgiving co-pays and deductibles for the subscription amount. If insurance is NOT paying the correct amount the billing company should be catching it and asking for proper reimbursement. Denials should be appealed in all cases! MVA insurance should be billed and if in the hands of the atty's it should be followed up. ALL accounts should be sent to insurance within a 3 day time period of receiving the information. If the billing company does not have all the required information they should be contacting the patient and or your company or even the hospital to get the information. They should be working to get you the money not just saying "oh well we don't have the information so we aren't billing it" It can and should be obtained. The billing company should be doing PROPER coding! All this said and followed you should be getting the highest possible reimbursement and something on each and every run! The average payment per run is $400.00 some higher and medicaid lower! But the rule of thumb is $400 per EACH run. Hope this helps! Marilyn Specialist EMS Billing

[/font:d3b7e6109a] :shock: Thank you! This is how I read it and practice it , this is what I was told by Medicare and OIG. BUT, when I asked out right of one of the companies doing this I was told, we have done this for 10 yrs and 5 counties and never had a problem! If there is a second or third insurance yes of course it gets billed, but to promote it by telling the public (residents) they do not have to pay out of pocket anything if they join membership seemed wrong to me. Medicare has always said no waiving of co-pays etc. Other insurances, say they are in a contract legal and binding with the insured advising the insurance company pays their portion and the insured then by policy contract must pay their portion. I was thinking maybe I missed something and there was a written exception somewhere for EMS providers. But I really didn't think so. I appreciate your help. I do not want to jeapordize my company by taking on a client that has this procedure. May I add a note to all EMS people! May you all stay safe and be under the wings of Gods Special Guardian Angels. You people do fantastic work, and I for one could never do what you do, thank God you are available!!

[/font:ecaf5ea561] Hello! I am going to say first I am the owner of an insurance billing company, specializing in EMS for well over 20 yrs. BUT, even the best of us can get confused at times. Thought maybe someone here could enlighten my brain waves and relax the hair on the back of my neck so they can lay down. My concern is all these counties in TX having "membership fee's for the public, so there is no out of pocket money paid if insurance does not cover the whole bill. The way I understand it, if Medicare does not pay the whole allowed amount Mr. Whoever, has paid his $35.00 for the year to the county plan, so he isn't charged for co-pay, co-insurance or deductible. Am I understanding this correctly? When I called the City office who uses this plan and two county offices, they said, yes that is right. Now then, my question is: Is this not considered by them to be fraud and abuse by Medicare which does not allow the write off of co-pays, co-insurance or deductibles? Yes, I did contact Medicare and OIG and they have agreed it sounds like it would fall under this category. Can someone let me know what I am missing, because I also see this is popping up in another state also. Thanks in advance for your kindness. OH and no I am NOT turning any one in, that is not my point and why I didn't mention any names. I am just totally wondering myself, before I take on a client and find out I am involved.