Guest guest Posted December 9, 2006 Report Share Posted December 9, 2006 Here is a question for those that do billing. You transport a mother and new born going from a lower level ER to a level 1 ER. Do you bill for one pt or two, since you are treating two and completing two pt. Mother has no insurance, including Medicaid that you know of. Baby was delivered early because mom was doing drugs. I say you bill as two calls--self pay. Some say you have to bill as one pt only. wayne __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2006 Report Share Posted December 9, 2006 If you render care to both patients then you should bill for two patients. Ruhnke, NREMT-P/CCEMT-P Flight Paramedic Spirit Medical Transportation Services > >Reply-To: texasems-l >To: Texas EMS list <texasems-l > >Subject: Billing Question >Date: Sat, 9 Dec 2006 18:43:36 -0800 (PST) > >Here is a question for those that do billing. You transport a mother and >new born going from a lower level ER to a level 1 ER. Do you bill for one >pt or two, since you are treating two and completing two pt. Mother has no >insurance, including Medicaid that you know of. Baby was delivered early >because mom was doing drugs. > >I say you bill as two calls--self pay. Some say you have to bill as one pt >only. > >wayne > >__________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2006 Report Share Posted December 9, 2006 In that situation, with or with out insurance, it would be billed as two seperate patients/runs but only one can get billed the mileage. - Wayne D wrote: Here is a question for those that do billing. You transport a mother and new born going from a lower level ER to a level 1 ER. Do you bill for one pt or two, since you are treating two and completing two pt. Mother has no insurance, including Medicaid that you know of. Baby was delivered early because mom was doing drugs. I say you bill as two calls--self pay. Some say you have to bill as one pt only. wayne __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2006 Report Share Posted December 9, 2006 Bill mother and baby seperately, but only one gets the mileage charge. ________________________________ From: texasems-l on behalf of Wayne D Sent: Sat 12/9/2006 8:43 PM To: Texas EMS list Subject: Billing Question Here is a question for those that do billing. You transport a mother and new born going from a lower level ER to a level 1 ER. Do you bill for one pt or two, since you are treating two and completing two pt. Mother has no insurance, including Medicaid that you know of. Baby was delivered early because mom was doing drugs. I say you bill as two calls--self pay. Some say you have to bill as one pt only. wayne __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2006 Report Share Posted December 9, 2006 You bill for 2 patients. You also contact the Medicaid office to get medicaid for the baby and probably emergency Medicaid for the mom. Wayne D wrote: Here is a question for those that do billing. You transport a mother and new born going from a lower level ER to a level 1 ER. Do you bill for one pt or two, since you are treating two and completing two pt. Mother has no insurance, including Medicaid that you know of. Baby was delivered early because mom was doing drugs. I say you bill as two calls--self pay. Some say you have to bill as one pt only. wayne __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2006 Report Share Posted December 9, 2006 Thanks for the information. I knew that I was right and the person doing the billing was wrong. They are so dumb that they think that by billing for both people that it was a Medicare/Medicaid violation. How stupid can you be...this was a person without any insurance. How many druggies are going to have insurance, even Medicaid. Any place to look to confirm that this can be billed as two runs? Wayne Billing Question Here is a question for those that do billing. You transport a mother and new born going from a lower level ER to a level 1 ER. Do you bill for one pt or two, since you are treating two and completing two pt. Mother has no insurance, including Medicaid that you know of. Baby was delivered early because mom was doing drugs. I say you bill as two calls--self pay. Some say you have to bill as one pt only. wayne ____________ _________ _________ _________ _________ __ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2006 Report Share Posted December 9, 2006 bill for two pts., one trip! --- Wayne D wrote: > Here is a question for those that do billing. You > transport a mother and new born going from a lower > level ER to a level 1 ER. Do you bill for one pt or > two, since you are treating two and completing two > pt. Mother has no insurance, including Medicaid > that you know of. Baby was delivered early because > mom was doing drugs. > > I say you bill as two calls--self pay. Some say you > have to bill as one pt only. > > wayne > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2006 Report Share Posted December 10, 2006 Well now, hold on. IF by some reason it was a Medicare patient, you have to split the bill between the two. Re: Billing Question I knew that I was right and the person doing the billing was wrong. They are so dumb that they think that by billing for both people that it was a Medicare/Medicaid violation. How stupid can you be... Wayne Billing Question Here is a question for those that do billing. You transport a mother and new born going from a lower level ER to a level 1 ER. Do you bill for one pt or two, since you are treating two and completing two pt. Mother has no insurance, including Medicaid that you know of. Baby was delivered early because mom was doing drugs. I say you bill as two calls--self pay. Some say you have to bill as one pt only. wayne ____________ _________ _________ _________ _________ __ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2006 Report Share Posted December 10, 2006 , This pt did not have medicare, but if they had, it would be done differently. This was a self pay pt. Billing Question Here is a question for those that do billing. You transport a mother and new born going from a lower level ER to a level 1 ER. Do you bill for one pt or two, since you are treating two and completing two pt. Mother has no insurance, including Medicaid that you know of. Baby was delivered early because mom was doing drugs. I say you bill as two calls--self pay. Some say you have to bill as one pt only. wayne ____________ _________ _________ _________ _________ __ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2006 Report Share Posted December 10, 2006 Section 9.5.1 of the Medicaid manual details reimbursement for multiple patients. They will reimburse 80% of THEIR reimbursement for each patient, and divides the mileage equally. Page 139 of the Medicare Ambulance Manual states that the payment allowance depends upon the number of patients in the ambulance. If there are two patients, Medicare reimburses 75% of the service payment allowance for the level of care provided to the patient, and 50% of the mileage allowance. If there are three patients, the service reimbursement drops to 60% and the mileage reimbursement is split 3 ways. With both Medicare and Medicaid you must inform them that there are multiple patients (by using the correct modifier/code) sharing the same ambulance. There are no guidelines as to what you charge the patient, but as indicated above your reimbursement may be reduced. Jack _____ From: texasems-l [mailto:texasems-l ] On Behalf Of Wayne D Sent: Saturday, December 09, 2006 11:27 PM To: texasems-l Subject: Re: Billing Question Thanks for the information. I knew that I was right and the person doing the billing was wrong. They are so dumb that they think that by billing for both people that it was a Medicare/Medicaid violation. How stupid can you be...this was a person without any insurance. How many druggies are going to have insurance, even Medicaid. Any place to look to confirm that this can be billed as two runs? Wayne Billing Question Here is a question for those that do billing. You transport a mother and new born going from a lower level ER to a level 1 ER. Do you bill for one pt or two, since you are treating two and completing two pt. Mother has no insurance, including Medicaid that you know of. Baby was delivered early because mom was doing drugs. I say you bill as two calls--self pay. Some say you have to bill as one pt only. wayne ____________ _________ _________ _________ _________ __ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2006 Report Share Posted December 10, 2006 How differently does your organization bill Medicare versus how it bills others? Remember this is a public forum...there is some danger expressing all you know in a venue such as this. Dudley Re: Billing Question , This pt did not have medicare, but if they had, it would be done differently. This was a self pay pt. Billing Question Here is a question for those that do billing. You transport a mother and new born going from a lower level ER to a level 1 ER. Do you bill for one pt or two, since you are treating two and completing two pt. Mother has no insurance, including Medicaid that you know of. Baby was delivered early because mom was doing drugs. I say you bill as two calls--self pay. Some say you have to bill as one pt only. wayne ____________ _________ _________ _________ _________ __ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2006 Report Share Posted December 10, 2006 Jack, Does this apply to self-pay pts also? This is the big question. My dumb billing person says that it does. But the pt had nothing for insurance. Self pay is just that self-pay, and no guidelines covers that...right? Wayne Billing Question Here is a question for those that do billing. You transport a mother and new born going from a lower level ER to a level 1 ER. Do you bill for one pt or two, since you are treating two and completing two pt. Mother has no insurance, including Medicaid that you know of. Baby was delivered early because mom was doing drugs. I say you bill as two calls--self pay. Some say you have to bill as one pt only. wayne ____________ _________ _________ _________ _________ __ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2006 Report Share Posted December 10, 2006 Both Medicare and Medicaid want you to be consistent with your billing practices. in fact, they require it. There are services that split the charges between multiple patients, and there are those who charge full fare. I don't think either is wrong, but the key word is consistent. Items like this should be covered by policy in your Billing Procedures Manual and your CMS Compliance Manual. Jack _____ From: texasems-l [mailto:texasems-l ] On Behalf Of Wayne D Sent: Sunday, December 10, 2006 9:20 PM To: texasems-l Subject: Re: Billing Question Jack, Does this apply to self-pay pts also? This is the big question. My dumb billing person says that it does. But the pt had nothing for insurance. Self pay is just that self-pay, and no guidelines covers that...right? Wayne Billing Question Here is a question for those that do billing. You transport a mother and new born going from a lower level ER to a level 1 ER. Do you bill for one pt or two, since you are treating two and completing two pt. Mother has no insurance, including Medicaid that you know of. Baby was delivered early because mom was doing drugs. I say you bill as two calls--self pay. Some say you have to bill as one pt only. wayne ____________ _________ _________ _________ _________ __ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 11, 2006 Report Share Posted December 11, 2006 Actually, for Medicare and Medicaid, you don't have to do the splitting of the charges for multiple patients. They will do it for you if you use the appropriate extra modifiers on the two claims. Jack is absolutely right.....you have to be consistent on how you charge every payer and cannot pick and chose how you bill particular payers. > > Both Medicare and Medicaid want you to be consistent with your billing > practices. in fact, they require it. There are services that split the > charges between multiple patients, and there are those who charge full fare. > I don't think either is wrong, but the key word is consistent. > > > > Items like this should be covered by policy in your Billing Procedures > Manual and your CMS Compliance Manual. > > > > Jack > > > > _____ > > From: texasems-l [mailto:texasems- l ] On > Behalf Of Wayne D > Sent: Sunday, December 10, 2006 9:20 PM > To: texasems-l > Subject: Re: Billing Question > > > > Jack, > > Does this apply to self-pay pts also? This is the big question. My dumb > billing person says that it does. But the pt had nothing for insurance. > > Self pay is just that self-pay, and no guidelines covers that...right? > > Wayne > > Billing Question > > Here is a question for those that do billing. You transport a mother and new > born going from a lower level ER to a level 1 ER. Do you bill for one pt or > two, since you are treating two and completing two pt. Mother has no > insurance, including Medicaid that you know of. Baby was delivered early > because mom was doing drugs. > > I say you bill as two calls--self pay. Some say you have to bill as one pt > only. > > wayne > > ____________ _________ _________ _________ _________ __ > Quote Link to comment Share on other sites More sharing options...
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