DM Medical Billing Case Study

We begin each new relationship by evaluating call volumes for our clients, and assigning billing staff based on our formula for optimum service levels. Call volume and staff allocation are re-evaluated quarterly, and updated as necessary. This has proven not only successful in DM Medical servicing our clients with consistent quality, expeditious claim filing and appeals, but also ensures that our client’s accounts have the dedicated staff that their services warrants, and deserves.

Management will then set a cash benchmark or cash projection for the client. This projection is based on Payer Mix, City resident demographics, call volume, and trip level of care. Our projections have proven accurate for the industry within a 2% margin. With

Medicare has recently begun to scrutinize Emergency Medical Ambulance Transports just as routinely as non emergent ambulance transportation. They have begun denying emergent transports when it is deemed that the patient did not warrant the service, or could have been transported by other means. It is imperative that municipal providers of emergent ambulance services, not only code for the proper levels of service, but also use the correct ICD10 codes, in order to avoid Medicare post payment reviews, and other avoidable pitfalls.

DM Medical Billings is Level II HIPAA complaint. We currently have a certified Medicare Compliance Officer on staff, and three additional certified ambulance coders. Our staff is trained on proper levels of coding, and we perform continuing education and updated training throughout the year. Our Compliance officer will come to your place of business, as needed, to educate your EMS personal on required Medicare PCR documentation for proper payment. This documentation is expected to be precise and needs to produced, should Medicare request a post payment

The dunning process is specific to each claim type, such as Medicare, Medicaid, motor vehicle accidents, private pay customers, and resident vs. non-residents. These processes are completely automated in the Amazon Billing System and are closely followed from the time a claim is entered into the billing system to the time that a claim is settled.

Many billing companies claim to utilize “Best Practices”, to collect more cash, but, when you look at performance and the ability to sustain operations, DM Medical Billings has better cash projections, and has created the best practices currently in use for our clients. “Best Practices”, simply, must include continuous insurance phone contact for claims that are erroneously denied, not paid in full, or not promptly paid. Vigorous, yet courteous patient contact protocols must also be in place. It must be policy and must be adhered to, and documented, not simply stated that it is