May 20-26, 2018, we celebrate EMS Week with the American College of Emergency Physicians (ACEP) and the National Association of EMT’s (NAEMT), our partners, clients and most importantly, their staff. We work with incredible organizations that have all-star EMS practitioners and billing administrators.

During this week, we are highlighting Chris Davison, Ambulance Billing Manager of the Tucson Fire Department in Tucson, Arizona, as one of the all-star EMS billing administrators. I met her several years ago at a conference after she had moved from her role at the City of Tucson to the Tucson Fire Department. Since then, she has guided the department to work more efficiently, increase revenue opportunities and improve morale. During our interview, she shared specific ways she has been able to make changes and see results.

Payor Logic: When you started at the fire department almost four years ago, you were hired to make changes and improvements regarding the billing process, bring in revenue and manage the billing office. Can you share what the department was like when you began and how you identified issues and then prioritized changes?

Chris Davison: There was a lot of opportunity to improve the fire department’s billing process when I started. Prior to my role at the fire department, I worked for the City of Tucson for nearly 20 years, and 16 of those were in Risk Management. When I became the ambulance billing manager, I had the benefit of working with the people in the department previously and with property damage claims. But, I didn’t have a background in medical claims, so I jumped right in and read medical and legal documents that were relevant to my new role. With a fresh perspective on the department dynamics and on medical claims, I was able to observe the state of things and make three immediate and ongoing changes:

  1. Attitude: Though I inherited a team of hard workers, there was a lack of positivity, collaboration and open communication. When I joined the department, I made it clear I was there to help identify the problems and fix them—not spend time on who created the problem. My mantra was “I don’t care.” Not that I didn’t care about my team or our work at hand, but I didn’t care about how things were done in the past. I was hired to move our department forward. Once people were onboard with this approach, more time could be spent creating and implementing solutions, not finger pointing.
  2. Training: Knowledge is power. Ambulance billing is tricky because we work with so many different types of payors: Medicare, workers’ comp, self-insured, etc. Plus, Arizona is different because we are managed a by fee schedule. My team has to understand the differences between each payor type, how each wants to obtain patients’ bills and receive communication. To ensure the team is properly educated and constantly informed about changes, I send out a “Cost Recovery Communications” bulletin so employees can receive the same information and file it away for long-term reference. I get a lot of information from reading everything I can in the industry and learning from the abc360 conference and my billing software provider’s annual conference.
  3. Accountability: Following up with claims can be exhausting and intimidating. There needs to be ownership of who on the billing team follows up on what claims, with specific payors and for specific types of patients. I created a centralized position on the billing team to support the claim follow-up process which helps keep insurance companies, patients and my billings team accountable. Often, patients don’t know the rules when it comes to billing after being in an ambulance, so it’s my team’s job to go to bat for them with the insurance company or to provide the patient with a gentle reminder about payments owed.

With these three main changes in the department, we have seen improved department morale, better understanding of regulations and increased revenue through claims follow-up.

To continue reading part two of the interview, click here »