TBS

Thanks, Doczilla! That and this were EXACTLY what I was looking for! flight-lp, I appreciate your concerns...maybe I should have mentioned in my post that I have 16 years billing experience, am a certified biller, belong to 5 professional billing associations, have had no fewer than three jobs in which I managed the reimbursement of multi-provider facilities and organizations. I am familiar with Medicare guidelines, but if you will re-read my post, and then look at the general urls you posted, you will see that your information was absolutely useless. In fact, your Texas link was not even to the Medicaid contractor's website, which is where program rules and regulations are listed. Furthermore, each one of those professional associations I belong to have message boards like this one - because, nowadays, "networking" is done mostly online, and because medical reimbursement is such a complex issue that NO ONE can know EVERYTHING, no matter how much education and experience they have. Furthermore, many things are up to interpretation, and before making any decisions, some people like to hear everyone's interpretations and then form there own opinions. This networking, via the internet message boards, are a valuable tool for this purpose. Unfortunately, most of those boards have small memberships, and, in fact, only on the largest board are there any ambulance billers. Since none of them are from Texas, and you will see one of my biggest concerns were what TEXAS considers ALS or BLS, I decided to seek other routes for educating myself. Thank you for taking the time to answer my post. And, again, thank you, Doczilla, for clarifying things for me once and for all.

And I hope you don't mind helping a biller semi-new to transport billing... I have billed ambulance before, so the territory isn't totally foreign, but I only collected TX Medicaid for an emergency tranport company. Now I am doing collections for commercial and TX Medicaid, but this environment is such that I really need a familiarity with Medicare, too, and also coding/billing. The women here have no desire to help me out (since they fear, wrongfully so, that once I learn their jobs they will likely lose theirs). I need to know how to tell the difference between ALS and BLS. From posts on a general billing board I frequent I figure it's probably dictated by state laws, but since googling has not turned up a usefull website for Texas I need some general guidelines. Also, even though we are non-emergency, apparently we will on occasion make an emergency run. I need to know how I can look at the run sheet and determine what is an emergency transport and what is a non-emergency transport. Lastly, if anyone has done a study on this, I would like to know approximately how many Medicare claims, by percentage, do you get denied for medical necessity - particularly if you are doing non-emergency transports. How many of these (again, by percentage) do you estimate to be valid, and how many do you appeal? If anyone has similar figures for Texas Medicaid, I would appreciate those, too. Thanks for any and all insight.