We understand that increased costs and pressures can prohibit your system from providing the best and most effective care to your community. Municipalities currently face a variety of obstacles when it comes to decreased reimbursements, increased costs and regulatory requirements, healthcare reform, etc. Our job is to uncover the supplementary revenue sources available to you. Our programs have generated anywhere from $220,000 to $1 million+ annually for our clients. By establishing and administering supplementary revenue programs, we partner with you to increase quality and efficiency of service while lowering costs. Our proven ability to optimize municipalities’ revenue to provide higher quality service helps keep community members happy and healthy.
Commercial Insurance Contracts
EMS|MC acts in a consultative role in assisting clients with their commercial insurance contracts. Based on our extensive experience in these areas and the ability to provide accurate reimbursement projections, we consult with our clients to determine whether the commercial insurance contract is in the client’s best interest. The client will make the final decisions related to the contract based on the data that we provide.
With the assistance of EMS|MC, the client will make a well informed decision as to whether to contract with the various insurers in order to maximize their reimbursement.
We assist clients in developing facility contracts to ensure that the contract is compliant with the latest discounting policies, OIG safe harbors, and CMS regulations. EMS|MC often meets with the facilities alongside our clients to ensure prompt payment, and serves as the reimbursement expert in determining the facilities responsibility to pay for services. We often conduct presentations to facilities in our client’s service area to educate facility directors and hospital staff on ambulance reimbursement guidelines, such as establishing medical necessity of an ambulance transport, physician certification statement requirements, and facility contracting responsibilities.
Partnering with EMS|MC ensures a compliant relationship in which the facility is well informed of their financial responsibilities in ambulance transportation.
Debt Setoff Programs
We partner with our clients to implement and maintain several innovative collection efforts. Several states have implemented programs to allow municipal clients to garnish state tax return refunds when an outstanding debt is owed to the municipal agency. EMS|MC administers the process for our clients by maintaining the master balance accounts, submission of electronic files to the program, assisting the patients with their written and telephone inquiries, and providing reporting to our clients to support the financial impact of the program. We have been successful in enacting legislation in certain states to implement the program to allow other clients to benefit from the program.