Ambulance Transportation Billing: Definitions

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• Ambulance Transportation Billing Definitions

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Ambulance Transportation Billing Definitions
Ambulance transportation is a billable event. All
insurance companies including Medicare and
Medicaid both pay for Ambulance transportation
service. Billing and coding for ambulance
services is complex because of the unique and
comprehensive modifiers. There are various modes
of transport includes ground, water, emergency
air ambulances. Medisys Data has certified
ambulance transportation billers and coders. As
we discussed that AT billing for the services
more difficult than for other providers, as a
result documentation for an ambulance trip and
appropriate coding is need to reported correctly
because these are the key elements in identifying
whether or not the service will be
reimbursed. Ambulance transportation (AT)
reimbursement rates are varying based on the
service provided to patient. Ambulance
transportation billing and coding rigorously
based on the documentation. The EMR systems can
help AT providers to organize clinical
documentation. Medisys Data has expertise in
ambulance billing and a assurance to error free
billing and coding and increased cash flow. To
optimize ambulance transportation reimbursements,
you need to make sure that your documentation is
done well. Ambulance Services Definitions We
have listed some definitions pertaining to
payment and claim processing follow. Ref CMS
Regulations and Guidance
Medical Billing Services in Oregon
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Ambulance Transportation Billing Definitions
A/B MAC (A) Definition The term refers to those
contractors that process claims for
institutionally-based ambulance providers billed
on the ASC X12 837 institutional claim
transaction or Form CMS-1450. A/B MAC (B)
Definition The term refers to those contractors
that process claims for ambulance suppliers
billed on the ASC X12 837 professional claim
transaction or a CMS-1500 form. Date of Service
Definition The date of service (DOS) of an
ambulance service is the date that the loaded
ambulance vehicle departs the point of pickup. In
the case of a ground transport, if the
beneficiary is pronounced dead after the vehicle
is dispatched but before the (now deceased)
beneficiary is loaded into the vehicle, the DOS
is the date of the vehicles dispatch. In the
case of an air transport, if the beneficiary is
pronounced dead after the aircraft takes off to
pick up the beneficiary, the DOS is the date of
the vehicles take-off. Point of Pickup (POP)
Definition Point of pickup is the location of the
beneficiary at the time he or she is placed on
board the ambulance. Application The ZIP Code of
the POP must be reported on each claim for
ambulance services so that the correct Geographic
Adjustment Factor (GAF) and Rural Adjustment
Factor (RAF) may be applied, as appropriate.
Medical Billing Services in Oregon
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Ambulance Transportation Billing Definitions
Provider Definition For the purposes of this
chapter only, the term provider is used to
reference a hospital-based ambulance provider
which is owned and/or operated by a hospital,
critical access hospital, skilled nursing
facility, comprehensive outpatient rehabilitation
facility, home health agency, hospice program,
or, for purposes of section 1814(g) and section
1835(e), a fund. Supplier Definition For the
purposes of this chapter, the term supplier is
defined as any ambulance service that is not
institutionally based. A supplier can be an
independently owned and operated ambulance
service company, a volunteer fire and/or
ambulance company, a local government run
firehouse based ambulance, etc., that provides
Part B Medicare covered ambulance services and is
enrolled as an independent ambulance
supplier. Ambulance services are separately
reimbursable only under Part B. Once a
beneficiary is admitted to a hospital, CAH, or
SNF, it may be necessary to transport the
beneficiary to another hospital or other site
temporarily for specialized care while the
beneficiary maintains inpatient status with the
original provider. This movement of the patient
is considered patient transportation and is
covered as an inpatient hospital or CAH service
and as a SNF service when the SNF is furnishing
it as a covered SNF service and payment is made
under Part A for that service.
Medical Billing Services in Oregon