Ambulance billing is a highly-complex process subject to regulatory compliance and the pressure to get it right to avoid over-charging clients and patients and, worse, accidentally violating the law.
Unlike other medical specialties, the care provided by the emergency medical personnel of an ambulance service is not based on a definitive diagnosis. Instead, patients often have to be treated based on their apparent condition. As a result, the coding and billing for services rendered are based on the patient care report filed by the ambulance crew as well as the run sheets filled out at the time a patient is picked up. Accurate documentation in the patient care report is absolutely critical, especially for compliance and insurance claims. That can make all the difference in the world between claims and payments being processed smoothly or having them stuck in limbo and the patient potentially getting stuck with a bill that would have been covered by insurance had the coding and billing been handled properly.
So why is ambulance service billing so complicated?
