Thinking about bringing your EMS Billing In-House?Thinking about bringing your EMS Billing In-House?Presented by: Stacey Bickford, Product ManagerPresented by: Stacey Bickford, Product Manager

Summary

� NAAC CEU Approved!

� Assumptions

� Outsourcing Your Billing

� Example Outsourcing Costs

� Bringing Billing In-House

� ZOLL ePCR Integration

� Example In-House Costs

� Questions??

This webinar is CEU approved for 1 CEU Credit. All certifications will be delivered to all attendees

after the webinar.

Assumptions

� Average transport reimbursement $429 per the latest U.S. Government Accountability Office (GOA) findings

• http://www.gao.gov/products/GAO-13-6

� ZOLL recommends 4000-6000 runs per biller per year• 4000 Low end for Non-Emergency

• 6000 Low end for Emergency

� $35,000 annual salary for billers

Outsourcing Your Billing

� 6-15% cost on average

• % of reimbursement collected by the billing agency

• I have seen up to 25% on accounts over 90 days

� No billing staff needed in-house

� No hardware costs

� Some billing agencies offer ePCR with services!

� For a list of ZOLL Preferred Billing Partners, visit http://www.zolldata.com/preferred-billing-partner-program/

Outsourcing Your Billing

� PCR documentation is KEY to outsourcing

� Billing agency codes/bills based on documented treatment/assessment

� NEMSIS provides a standard for sending PCR’s from one agency to another electronically

� Paper PCR’s could impact your DSO if agency has to complete data entry of runs when received

Outsourcing Your Billing

� Things to keep in mind:

• Billing agency responsible for software/compliance changes

• Monitor KPI’s to validate data and revenue

• For our latest white paper on monitoring KPI’s visit:• http://info.zolldata.com/ambulance-billing-kpis-white-paper

� Potential hurdles with Outsourced Billing:

• No direct access to data

• Limited visibility into accounts

• Solely reliant on Billing Agency to collection revenue

What do you mean 6-15% Cost?

Example: ABC Ambulance (3000 runs p/year)

3000 Runs x $429 (avg. p/run) = $1.29 M

@ 6% of 1.29 M = $77,400 cost p/year

@ 15% of 1.29 M = $193,500 cost p/year

*Calculations based on earlier assumptions

What do you mean 6-15% Cost?

Example: XYZ Ambulance (20,000 runs p/year)

20,000 Runs x $429 (avg. p/run) = $8.58 M

@ 6% of 8.58 M = $514,800 cost p/year

@ 15% of 8.58 M = $1.29 M cost p/year

*Calculations based on earlier assumptions

Bringing Billing In-House

• No % cost on collections

• ZOLL provides communication to notify customers of necessary industry changes!

• Costs primarily comprised of:• Staffing

– Recommended: 4000-6000 runs per year per biller

– Billing Manager

– IT Staffing

» Contract IT an option

– Hardware

» Server and Workstations

• Billing staff education

– Recommended billing education

» NAAC or other EMS Billing accreditation

Bringing Billing In-House

� Potential hurdles with In-House billing:

• Staffing

• If you are in a rural area, staffing may not be possible

• Compliance and industry changes• Providers will have to upgrade for regulatory changes

– No Billing agency to handle this if In-House

– Software vendors should notify of changes

• Depending on software vendor, upgrades aren’t free• ZOLL provides free upgrades with annual maintenance

• Liability

• It’s important to know the “rules” when doing billing in-house

– “Ignorance” is not an excuse with Medicare

Bringing Billing In-House

� Integrated software provides streamlined efficient solutions

• ZOLL ePCR integrates directly with RescueNetDispatch-Billing

• Reduces data entry and staffing needs

– Reallocate staff to other billing office duties

» Pre-bill eligibility

» Follow-up and Collections

ZOLL ePCR Integration

� ZOLL ePCR Direct Integration with Billing enhances documentation

� Closed call rules used in ePCR to ensure all Billing information is captured at the time of the trip

Compare Outsourcing to In-House

Outsource Example: ABC Ambulance (3000 runs p/year)

3000 Runs x $429 (avg. p/run) = $1.29 M

@ 6% of 1.29 M = $77,400 cost p/year

@ 15% of 1.29 M = $193,500 cost p/year

*Calculations based on earlier assumptions

In-House Costs: ABC Ambulance (3000 runs p/year)

3000 Runs x $429 (avg. p/run) = $1.29 M

1 Biller @ $35K p/year

IT Staffing

Hardware Costs

What do you mean 6-15% Cost?

Example: XYZ Ambulance (20,000 runs p/year)

20,000 Runs x $429 (avg. p/run) = $8.58 M

@ 6% of 8.58 M = $514,800 cost p/year

@ 15% of 8.58 M = $1.29 M cost p/year

*Calculations based on earlier assumptions

Example: XYZ Ambulance (20,000 runs p/year)

20,000 Runs x $429 (avg. p/run) = $8.58 M

20,000 / 4000 = 5 Billers

5 @ $35,000 = $175K

IT Staff x 2

Hardware – Server & Workstations

So, Outsource or Bill In-House?

� My personal opinion, it depends on staffing capabilities and size of your organization

� Review all possible impacts before deciding

� Check with your software vendor for educational resources

� Each agency is different! Do your research!

� Ask your ZOLL sales representative about the ROI calculator for bringing Billing In-House!

Contact Information

� Stacey Bickford, ZOLL Billing Product Manager

• sbickford@zoll.com

• Direct Dial: (303) 801-1068

� ZOLL Support

• support@zoll.com