Simplify your EMS operations and improve your cash flow

What are the four levels of ambulance services?

• The four levels of ambulance services are: Basic Life Support (BLS); Advanced Life Support (ALS), which includes Level 1 (ALS1) and Level 2 (ALS2); Specialty Care Transport (SCT); and Paramedic Intercept (PI).

What types of services does AIM offer to ambulance providers and EMS agencies?

• AIM provides two main types of services to EMS agencies.
  • Our secure, cloud-based software for billing, dispatch, and patient care reporting (PCR) helps improve your staff’s efficiency, increase your revenue, and boost your cash flow.
  • Our turnkey outsourced EMS billing services take the billing burden off your shoulders. AIM’s experienced, NAAC-certified billing specialists optimize every step in the process to speed claims reimbursement, prevent denials, and keep cash flowing through your agency. We can also provide billing assessments, guidance on optimizing revenue cycle management, and short-term billing assistance.

How does ambulance dispatch work?

• For emergency calls, when a caller dials 911 the phone number they’re calling from determines which 911 center receives the call for assistance. Cell phone calls are processed based on the closest cell tower. Once the dispatcher analyzes the EMS situation, they notify the closest appropriate EMS agency for response. Many 911 centers communicate with EMS agencies using dispatch software, such as the AIM Dispatch software module.
• For scheduled and non-emergency calls, the referring hospital, skilled nursing home, or other caretaker or facility coordinates the transport directly with the EMS agency. Dispatch software, such as the AIM Dispatch software module, is often used to coordinate schedules between the facility and the EMS agency.

How do paramedics prioritize different emergencies?

• Paramedics follow state and local guidelines for prioritizing emergencies and assigning clinical priority. They typically follow a system that prioritizes emergencies based on these categories:
  • Critical: The patient is critically ill or injured and needs immediate attention.
  • Urgent: The patient has a less serious condition that requires emergency medical attention but is not immediately endangering their life.
  • Non-Urgent: The patient has a non-emergency condition that requires medical attention but not on an emergency basis.

What are the three types of EMS services?

• EMS services are typically fire-based, hospital-based, or third-party/private-based.

What challenges can dispatch software help our EMS agency solve?

• A robust dispatch software module will give you better control of every transportation process, eliminate time-consuming and error-prone manual tasks, and help you avoid the information gaps that can jeopardize claims reimbursement. Dispatch software also ensures your dispatchers and EMS crews collect the right data every time, with automated workflows, data validations, alerts, and other features that streamline their work and improve their accuracy. Using a solution like AIM’s dispatch software module, they can easily track locations and transport status, respond to emergencies faster for better patient care and satisfaction, communicate more effectively with 911 centers and facilities, gain a real-time view of current and scheduled transports via a mobile device, and set up automated alerts and notifications about calls and crew members.

How does ambulance billing software differ from general medical billing software?

• Ambulance billing involves a level of complexity that most medical billing software isn’t designed or equipped to handle. Unlike billing for other medical specialties, ambulance billing is not based on a single diagnosis; it’s based on the patient’s apparent condition. Coding and billing are done based on the Patient Care Report (PCR), which includes critical information about how the patient was found on the scene, assessment results, the procedures performed and medications administered, mileage, and much more. The PCR must clearly support the medical need for the transport and provide enough detail to determine the level of service (such as BLS or ALS) and the number of loaded miles that can be billed. Software that is specifically designed for EMS billing, like AIM’s billing software module, helps ensure claims are submitted right the first time and paid timely.

What does the Revenue Cycle Management (RCM) process involve for ambulance billing?

• The RCM process, or full-cycle billing, for ambulance transports begins when the ambulance leaves the station and ends with a successful payment collection. Along the way, many steps must be completed accurately and efficiently to ensure timely payment. These include gathering supporting documents (like PCRs and medical necessity documents), verifying insurance, coding the bill, handling charge entry and transmission, following up on accounts receivable, managing and responding to denials, and posting payments. Depending on the size of your EMS agency, these steps might be handled by a single biller or split among multiple experts in different functions. Regardless of your EMS agency’s size, it’s important to use EMS billing software that is specifically designed to help you manage the RCM process from start to finish.

How can the right software improve our EMS agency’s collections?

• Cash flow is the backbone of any business, and EMS agencies are no exception. Ideally, your EMS billing software should be purpose-built for billing ambulance transports and enable you to improve collections by automating the process of transmitting bills and receiving payments. A robust EMS billing software solution will also include features that simplify the payment process. But proper collections also requires skilled, trained staff. It’s best to partner with a vendor that will go beyond simply training on the software’s features and functionality and also provide your internal billers with guidance and best practices on EMS coding and billing.

What challenges can billing software help our EMS agency solve?

• The right billing software can help your EMS agency avoid billing errors, prevent claims denials, reduce reimbursement delays, avoid compliance issues, and solve cash flow challenges. Billing software that is purpose-built for EMS agencies, such as AIM’s billing software module, provides all the features and functionality you need to improve the speed and accuracy of billing coding and claims submission in order to optimize your revenue and get cash in the door faster, while ensuring HIPAA compliance. When you choose billing software from an experienced vendor like AIM, you’ll get much more than responsive support; you’ll also receive guidance on how to properly bill ambulance claims with common EMS payers like Medicare and Medicaid to ensure you’re set up for success.

What types of billing services does AIM provide?

• Our turnkey outsourced billing services help EMS agencies maximize ambulance transport reimbursement, focusing on the entire revenue cycle management process. AIM’s NAAC-certified billing specialists optimize every step in the billing process, taking the burden off your shoulders and uncovering every opportunity to improve revenue and cash flow.
• We also offer customized EMS billing consulting services for EMS agencies that handle the billing function in-house, helping your internal billing staff product accurate work as efficiently as possible. And we provide interim billing help for EMS agencies that have a temporary backlog, a staffing shortage, or an unforeseen staffing issue.

What is an ePCR?

• An ePCR is an electronic version of the Patient Care Report (PCR), which is designed to collect all care and pertinent patient information required to provide a clear clinical picture of the patient’s needs. The ePCR must include, but is not limited to, documentation of the event and incident, the patient’s medical condition and medical history, and the treatment provided.

What are the benefits of implementing ePCRs?

• ePCRs make PCR data consistent, retrievable, and reportable for billing, quality assurance, state and national reporting (including NEMSIS), and other improvement initiatives. Documenting patient care information electronically also contributes to improving patient health outcomes by making it easier to capture, share, monitor, and analyze patient health data at the local and national level. Additionally, ePCR features should make it easier for EMS crews to communicate with dispatch and receiving facilities.

Who has access to ePCR records?

• The primary users of ePCR software are EMS crew members, such as the EMTs and paramedics who document patient care. ePCRs also are used by the quality assurance staff assigned to review the ePCR records, medical directors who want to analyze certain call types, and managers authorized to view and analyze ePCR reports and analytics.

What challenges can ePCR software help our EMS agency solve?

• ePCR software will help your EMS agency maintain better control over patient care data, share the data in response to local or national data requests or for audit purposes, and use the data to produce accurate bills that speed reimbursement. Integrated ePCR software also makes it easier for crews to communicate with dispatch, quality assurance, and management. Robust ePCR solutions, like the AIM ePCR module, provide analytics and reports on key performance indicators, enabling your agency to identify and correct shortfalls.

What types of ePCR services does AIM offer?

• AIM offers secure, cloud-based ePCR software designed to improve the quality and accuracy of the PCR while reducing the time it takes for EMS crews to complete the documentation. Our ePCR software easily integrates with our dispatch and billing software modules, along with third-party vendor solutions, eliminating extra steps and improving data accuracy. AIM’s ePCR software is accessible anytime, anywhere, on a computer, tablet, or smart mobile device, and it’s backed by a customer success team that’s highly committed to each EMS agency’s success.

How does ambulance billing differ from medical billing?

• Ambulance billing involves a level of complexity that most medical billers don’t readily understand. Unlike billing for other medical specialties, ambulance billing is not based on a single diagnosis; it’s based on the patient’s apparent condition. Coding and billing are done based on the Patient Care Report (PCR), which includes critical information about how the patient was found on the scene, assessment results, the procedures performed and medications administered, mileage, and much more. The PCR must clearly state the medical necessity for the transport and provide enough detail to determine the level of service (such as BLS or ALS) and the number of loaded miles that can be billed. Software that is specifically designed for EMS billing helps ensure claims are submitted right the first time and paid timely.

Does Medicare pay for ambulance transports?

• Medicare Part B covers ground ambulance transportation when a patient needs to be transported to a hospital, critical access hospital, or skilled nursing facility for medically necessary services and transportation by any other vehicle could endanger the patient’s health. Medicare may pay for emergency ambulance transportation by plane or helicopter if the patient needs immediate and rapid ambulance transportation which ground options can’t provide.

What challenges can ambulance billing services help our EMS agency solve?

• Outsourced ambulance billing services can help EMS agencies overcome a number of challenges. It frees your internal staff from the burden of administrative billing tasks, enabling them to focus on caring for patients and other important work and potentially reducing your operational costs. Outsourcing your EMS billing also reduces the errors and delays that can slow reimbursement and hamper cash flow, since the task will be handled by a team of highly experienced EMS billers who keep current on the latest EMS billing and compliance practices.

What is EMS revenue cycle management?

• EMS revenue cycle management (RCM) consists of administrative and financial processes designed to mitigate common dispatch-to-discharge gaps that can cause your EMS agency to lose revenue. RCM processes also help identify opportunities to reduce your costs and improve your cash flow. By understanding every step of the EMS billing process, RCM uncovers where delays are occurring and identifies improvement opportunities.

Why is revenue cycle management important to an EMS agency?

• An effective RCM workflow helps EMS agencies keep costs down and focus on improving patient outcomes. By implementing an integrated billing and coding system, ambulance providers can experience higher rates of error-free claims and fewer past due payments, resulting in higher revenue and profits.

What information does HIPAA protect?

• HIPAA laws protect all individual identifiable health information that is held by or transmitted by a HIPAA-covered entity or business associate.

What does it mean to be HIPAA compliant?

• An EMS agency that is HIPAA compliant has done what’s needed to satisfy the requirements set by the Security Rule, has policies and procedures in place to address the elements, and is knowledgeable about HIPAA as it applies to the agency. It also means that the EMS agency documents its processes, ensures document version control, and employs an ongoing training program to ensure it remains HIPAA compliant.

What penalties will result if an agency is not HIPAA compliant?

• The penalties for failing to comply with HIPAA regulations are based on the level of negligence. They can range from $100 to $50,000 per individual violation, with a maximum penalty of $1.5 million per calendar year for violations. Some severe violations could result in jail time.

Does HIPAA compliance require a compliance officer?

• The Healthcare Insurance Portability and Accountability Act (HIPAA) requires that a person within a covered entity or business associate is assigned the duties of a HIPAA compliance officer. This role can be filled by an existing employee, or a new position can be created.

What is the difference between PHI and ePHI?

• According to HIPAA regulations, protected health information (PHI) is identifiable information that a covered entity or business associate uses, maintains, stores, or transmits as part of healthcare services. ePHI is electronic protected health information that is held or transferred in electronic form.

How can AIM help our EMS agency with HIPAA compliance?

• AIM is committed to satisfying the requirements set by the Security Rule and has policies and version-controlled document processes in place to address each element of the Rule. Our secure, cloud-based billing, dispatch, and ePCR software solutions are backed by an external data center that’s is SOC-certified and registered with the Cloud Security Alliance (CSA) Security, Trust, Assurance & Risk (STAR) Registry. Our billing experts are highly knowledgeable about HIPAA as it relates to EMS. And our staff participates in ongoing HIPAA training to ensure we maintain compliance and can pass along useful knowledge to our customers.