In an effort to reduce improper payments, the Centers for Medicare & Medicaid Services (CMS) implemented several initiatives with the goal of identifying and addressing billing errors. In 2015 The Federal Government estimated that about 12.7 percent of all Medicare Fee-For-Service (FFS) claim payments were improper. In an effort to reduce these improper payments, the Centers for Medicare & Medicaid Services (CMS) implemented several initiatives with the goal of identifying and addressing billing errors. One of these initiatives is a Prepayment Review, where claims submitted with a certain criteria are automatically pulled and reviewed prior to receiving payment. No big deal if you're doing everything right, right? Wrong! You could have exceptional documentation and above average accuracy rates and still be subject to this type of review simply due to the fact that you fit the audit profile. For ambulance agencies, the profile is typically a service that performs a high volume of non-emergency transports and/or has been flagged in the past for high denial rates.

Ignoring the OIG Exclusions list could result in lost revenue for your EMS Agency. What is the OIG’s List of Excluded Individuals/Entities (LEIE)? LEIE is a published list of individuals and health care entities that the Office of Inspector General has excluded from participating in Medicare, Medicaid, and all Federal health care programs. Why it is important for EMS providers and EMS Billers to know who is on LEIE? Severe penalties can be imposed for employing, contracting with, or billing for items or services ordered by a person excluded from participating in federal health care programs.

Do you find yourself constantly worrying about cash flow? Are you frustrated by how long it takes to get paid? Is it hard to find qualified billers who are reliable and trustworthy? If you've been nodding yes to any of these questions, AIM's Billing Services is the answer. With our EMS Billing Services, you receive your payments in half the time. You don't have to worry about delayed or short-payments. Best of all, you can check your billing status on the web 24 hours a day, 7 days a week.