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HomeMy WebLinkAbout20100706 - VIII-C-2HASTINGS FIRE DEPARTMENT MICHAEL T. SC HUTT, FIRE & EMS DIRECTOR 115 lit 5 11 Street Hastings, MN 55033-181 Business Office (051 ) 480-6150 Fax (651 480-6170 TO: Honorable Mayor Hick and City Council Member F R O M: Michael T. Schutt, Fire & EMS Direct Penne Scheldt, Office Mann DATE: July 1, 2010 SUBJECT: E lectronic Ambulance B illing We are experiencing electronic ambulance billing issues due to Minnesota State law enacted in 2009, which mandates us to electronically submit ambulance bills to insurance companies. The original clearinghouse we are using to electronically submit our ambulance bills, because it was free service, is unacceptable, and they are no longer willing to assist our needs. I have made several attempts to contact additional clearinghouses and they have not fully cooperated. Other agencies are experiencing these sane i ssues. The initial start - up costs with another clearinghouse would be: purchasing two modules to adapt our current computer software program, Ortivus, at approximately $ 3, 0 0 0 for both mo dules, as well as paying for Tech Support on each module t approximately 7, annually. In addition to the higher tart -up costs, there are several fees involved in submitting and resubmitting claims; there is an extended process to initiate the submission o ambulance bill claims, as well as Ic�ala carte" charges, which would end up costing us more than a billing service. We also investigated the option of purchasing a software program which would allow us to subrnit our own bills. This is a field with limited software companies and I was able to spear with two different companies. In spearing with a representative from each o f those two companies, it was determined that the first so ftware program would not work for our individual bill needs and the second company I spore with does not offer a program for only submitting our bills electronically t insurance companies. . We would purchase a pr ogram through th en, a billing program, which we already utilize with our current billing program called. O rtivus, and we would then need to submit our bills through either a clearinghouse or a billing serce. In addition to this, it has also been determined that even if we were to locate a billing software ware which would allow us to submit our own ambulance bills electronically, there would be a tremendous amount of staff work involved to contact hundreds of insurance companies to arrange us to submit claims to each one of them. Eac insurance company can have specific requirements from others, for example, one insurance ace eompatny requires all data to be submitted in all capital letters and if it is not, they will deny the claim, whereas other insurance companies ill accept it in lower case letters. We also received information that some insurance companies would not accept ambulan bills electronically directly from our ambulance service. FIRE SUPPRESSION — FIRE EDUCATION — FIRE PREVENTION — AMBULANCE SERVICE Page Electronic Ambulance Billing July 1, 2010 After meeting with administration and finance, our preferred choice would be Expert T Billing service. There would be no out-of-pocket expenses with .start -up costs with Expert T Billing as there would be with another clearinghouse. In discussion with other ambulance services, they have established a service fee to cover the cost of electronically submitting their ambulance bills through a billing service. The fee through Expert T Billing would be$ per billable call and with the establishment of a service fee of $24.90 applied to each ambulance bill; we would recoup most of our billing service expense therefore having little or no cost to the city. Expert T Billing would handle our billing claim from start to finish. They would electronically retrieve our data through a program called Image Trend, which is stored off-site, electronically submit our ambulance bills to insurance companies and not charge us any additional fees to submit a paper claim to an insurance company which is not able to receive electronic claims, monitor the status of the ambulance hill, if payment has not been received, they will contact insurance companies on our behalf, as well as contact the patient in case of misinformation with the insurance company, subunit three follow -up letters to the patient, plus one final delinquent letter followed by placing a final phone call to the patient before referring the delinquent account to a collection agency. Expert T Billing would also utilize MN Revenue Recapture, which would assist us in collecting on an outstanding bill from any patient who receives a state tax refund. The insurance payments would cone directly to us ors. being sent to the patient and having the opportunity of never receiving those insurance funds. Even though the cost may be slightly higher, we would gain more benefit from this company than from the clearinghouse. In closing, we have looped at other companies and have found Expert fi Billing to be a reputable company, in business for over 2 years, and with many neighboring ambulance services successfully utilizing this company. They are continually on top of the ever- changing insurance industry. W recommend Obtaining Expert T Billing for our electronic ambulance billing service. Re Action Staff is requesting approval of a service fee be added to ambulance hills and conduct electronic ambulance billin g business with Expert T Billing. The Finance Committee met and reviewed this on June 29th, They are recommending this be forwarded to the full city council for approval. We will be in attendance at the July 6th City Council meeting to answer any questions you may have. Please feel free to contact either Mike Schutt via his cell phone 651 - 775 -5547 or Pene schuldt via her cell phone 651- 796 -8651 at anytime should you have questions before the meeting. Thant you.