Emergency medical services companies must be compensated appropriately for the critical services they provide. Too often bills go uncollected because ambulance and transport services can’t identify the patient—or verify insurance coverage.

Ambulance providers lack complete and correct patient demographic and insurance information at the time of transport for their emergency trips. Even for non-emergent transports, providers face challenges in checking deductibles, proving medical necessity, and obtaining prior authorizations.

Insufficient information leads to delayed payment for claims and an escalating number of receivables. And because EMS transportation claims are downstream in the billing process, both payors and patients neglect bills or are slow to pay. This is especially true for the growing number of patients with high deductible health plans (HDHPs).

Patients unable to furnish coverage trigger billing issues, claims rejections and lost reimbursement. Without an effective method to quickly gather demographics, verify insurance and bill patients, EMS companies write off millions of trips annually and leave significant amounts of revenue behind. Today’s EMS companies simply can’t afford to chase down revenue from difficult payors, including self-pay patients.

Conquer Financial Risk

Payor Logic plugs cash flow leaks by gathering more complete and accurate demographic and insurance information for every trip—resulting in a 6:1 return on investment and fewer write-offs.  Up-front improvements add real dollars to your bottom line:

  • Cut operational costs
  • Capture up to 12% more revenue
  • Clear patients and get claims paid faster

Benefits for Emergency Medicine Services

Payor Logic customers capture more reimbursement and get their claims paid faster. Our solutions eliminate manual processes, reduce return mail and minimize risk of rejected claims.  Specific benefits include:

  • Obtain complete and correct patient demographic and insurance information for every trip without manual intervention.
  • Send claims to the correct responsible party the first time, every time, and within a few days of transport.
  • Confirm prior authorization and check deductibles to reduce manual workloads and expedite clean claims processing—even for the most difficult payors and self-pay patients.
  • Determine a patient’s propensity to pay—high likelihood accounts are worked internally and others are outsourced.
  • Reduce write-offs to increase revenue and improve cash flow.
  • Identify which self-pay patients fall within FPL guidelines to correctly offer hardship discounts and payment plans.
  • Provide a single source of truth to financially clear patients.
  • Streamline workflow, reduce manual interventions and decrease operational costs.
  • Lower overall cost to collect for your EMS business.
Pennsylvania EMS provider achieves major billing milestones through Payor Logic partnership and ESO integration. View case study here ⨠
“By using Payor Logic, we quickly found billable payors and ran claims before sending them to collections, even for self-pay. Payor Logic’s service is far more cost-effective and faster than hiring people to manually chase down patients and payors.” Regional EMS, 50,000 Transports Per Year