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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

__________________________________________________

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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

>

>__________________________________________________

>

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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

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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

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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

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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

____________ _________ _________ _________ _________ __

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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

>

> __________________________________________________

>

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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

____________ _________ _________ _________ _________ __

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,

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

____________ _________ _________ _________ _________ __

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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

____________ _________ _________ _________ _________ __

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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

____________ _________ _________ _________ _________ __

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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

____________ _________ _________ _________ _________ __

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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

____________ _________ _________ _________ _________ __

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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

>

> ____________ _________ _________ _________ _________ __

>

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