Thinking about bringing your EMS
Billing In-House?
Thinking about bringing your EMS
Billing In-House?
Presented by: Stacey Bickford, Product Manager
Presented 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
This webinar is CEU approved for
1 CEU
Credit.
All certifications will be delivered to all attendees
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
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
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
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
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
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
Bringing Billing In-House
Integrated software provides streamlined
efficient solutions
• ZOLL ePCR integrates directly with RescueNet Dispatch-Billing
• Reduces data entry and staffing needs
– Reallocate staff to other billing office duties
» Pre-bill eligibility
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
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
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
• Direct Dial: (303) 801-1068
