5 Billing Issues You Probably Didn’t Know Were Hurting Your EMS Organization

Emergency medical services, or EMS, is a noble field to work in. When people think of the work an EMS organization does, the most prevalent image they have is likely that of emergency first responders in action. But something that even EMS professionals sometimes forget is that their organization is also a business, with the same needs and functions as any other enterprise. In order to fulfill its mandate to provide quality emergency care for as many patients as possible, an EMS organization needs sufficient financial resources as well as adequate strategies for resource management.

Billing is one focal area that EMS providers should concentrate on if they want to improve their resource management. An organized and dependable billing system makes it easier for EMS organizations to continue the important work that they do for society. The converse is also true: an issue-laden billing system can cause backlogs, delays, financial losses, and other problems that could get in the way of timely and efficient patient care.

That said, what can your EMS organization do to bolster its revenues, streamline its operations, and improve patient outcomes all at the same time? Look for any one of these five billing issues in your current system and work towards resolving them before your finances go in the red.

Billing Process Driven by Manual Operations

Chief among the things that may be holding your EMS organization back is your fragmented, manual process for billing and invoicing. Even though modernization may seem expensive or daunting for your organization, now’s the time to update your billing system and opt for a streamlined, consolidated, and fully automated emergency billing software solution. Not only will such a solution ensure fast, accurate, and complete bills for every step, it will unclog the amount of manual work your staff members need to do and make your general EMS operations a lot more cost-efficient. Wean your organization off of slow, ineffectual manual billing systems and increase your overall competence at billing and invoicing with a digitalized, integrated billing approach.

Billing and Documentation Errors

Another issue that may be getting in the way of your patient care delivery is your billing system’s propensity for billing or documentation errors. Too often, your patient records may contain either incomplete, erroneous, or out-of-date information about the patients and their conditions, the care they’ve received, and who their insurance providers are. Any discrepancies here, as well as with regard to how much they’ve paid your EMS finance department and how much they owe, could build up to a huge drain on your organization’s resources. Part of the solution lies in upgrading your billing system so that patient care records and bills are fully integrated and up to date. The other part lies in training your staff to observe best practices when calculating bills and encoding patient information, for instance, in the proper classification of “medical necessities.”

Unpaid Accounts Receivable

Yet another urgent issue for your EMS organization’s billing department is the debt accumulating from your accounts receivable (ARs). The longer your ARs are left unpaid, the less your EMS organization will have in its coffers for future patients—which is not the kind of scenario you want, especially in the face of the current health crises. You and your staff should pay special attention to your current ARs, particularly those belonging to patients who’ll pay for their own care. Your billing system should be able to cross-check sources for info about the patient’s capacity to pay, like the accuracy of their billing address and their creditworthiness. Based on what you’ve gathered, you should institute measures for tracking payment and making sure that all your ARs are fully paid within a reasonable amount of time.

Discrepancies in Insurance Coverage

What happens when there’s no immediate answer for whether the patient’s insurer will cover the cost of their treatment? For sure, heartbreak will ensue on the part of the patient, and more strain will be added to your EMS’s billing operations. Neither you nor your patients want to deal with a wrong assumption about insurance coverage, only to learn belatedly that the patients hoping to be covered aren’t actually eligible. Ideally, your billing system should deploy customizable rules that make it easy to monitor your patients’ deductibles and add clarity about whether or not their care is covered. That ability will grant your patients peace of mind and keep you and your staff from grappling to make ends meet.

Vulnerability to Fraudulent Claims

No EMS wants to assume the worst of its patients, but any organization that does not protect itself from potentially fraudulent claims will suffer greatly when they actually do happen. Remember that desperate times often call for desperate measures, and that it’s possible for someone to falsify their medical documents or lie about their insurance just to get treatment. Knowing this, your EMS organization’s billing system should have safeguards like a verification system for patient documents and random sample reviews for claims. Don’t run the risk of losing a lot of your cash to fraudulent activities, and do your part to fortify your billing system.

Conclusion

Though mission-critical activities for an EMS organization look very different from those of other businesses, they must be sustained with the same rigor, transparency, and attention to detail. Your organization should aim for efficient and fully integrated patient care from end to end, from delivering first response to billing. If you’re in the “business” of saving lives, you should also improve the business side of your operations and increase people’s trust in what your EMS organization can do—both from the perspective of your own people and from the point of view of patients and their loved ones.