Solving the Unique Revenue Cycle Challenges of EMS Providers

Common front-end hurdles wreak havoc for back-end EMS staff efficiency.

By Chris Watanabe, RHIA, CHPS, vice president of business services and HIPAA officer, Regional Emergency Medical Services Authority

Emergency medical service (EMS) providers face unique, inherent challenges in capturing correct patient demographics and verifying insurance coverage. During ambulance transports, attention is focused solely on patients’ emergency medical conditions—as it should be. And once transports are complete, EMS staff can’t easily visit patients’ rooms to obtain financial details, as is best practice in acute care hospitals and health systems.

This common front-end hurdle wreaks havoc for back-end EMS staff efficiency. At one large ambulance provider organization, the Regional Emergency Management System Authority (REMSA), in Reno, Nevada, inability to find insurance for EMS patients drained staff productivity and burgeoned the number of accounts sent to collections. This was especially true for REMSA’s rising volume of self-pay accounts.

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This is an excerpt from HFMA Revenue Cycle Strategist April 2017