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Session Track: Revenue Cycle

Medicare Update Part 2

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Please join A.A.A. Medicare Consultant Brian S. Werfel, Esq. for the second part of our Medicare Update series. In the first presentation, we covered changes to the Medicare Program’s reimbursement of ambulance services. In this session, we will focus on the compliance challenges facing EMS providers. This will include the recent uptick in Unified Program Integrity Contractor (UPIC) audits, the current status of Target Probe and Educate (TPE) audits, the ongoing impact of the Repetitive Scheduled Non-Emergency Ambulance Transport (RSNAT) Prior Authorization Model. We will also discuss several recent enforcement actions by the HHS Office of the Inspector General and the Department of Justice. The session will conclude with a Q&A session.

All Things Advocacy

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Join the AAA Government Affairs Team for an update on the latest federal advocacy efforts! The AAA is spearheading numerous efforts on Capitol Hill related to the EMS Workforce Shortage, Medicare Reimbursement, VA Final Rule, and much more. The team will provide an update on the status of each of our federal priorities and the behind-the-scenes activity on various policy issues important to your operation as well as how you can assist in our advocacy efforts.

This session will also cover the ways that your organization can better engage in advocacy efforts at the federal, state, and local levels! Hear from experts in advocacy from around the nation as they share their secrets to success.

Session Sponsor: Bound Tree
Session Moderator: Harry Larson, Bound Tree

From EMT To C-Suite: EMS Finance at Every Level

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Financial information is too-often reserved for positions with a strong say in the money-making decisions in EMS. But there are a number of reasons why business acumen should be expanded out of the accounting department and shared with every member of an EMS service. By expanding the financial knowledge base, you create a number of key benefits for both your employees and agency. Encouraging staff to understand the financial “why’s” behind decision-making reduces stress, undue skepticism, and ultimately creates buy-in and support for the goals of the organization. This session will cover a number of key economic and financial topics important for all EMS providers to understand, from line staff to top level management, as well as why it’s important to view EMS with a “profit-friendly” lens.

Balance Billing Update

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Join us for a deep dive into both federal and state balance billing initiatives! Our expert presenters will cover the next steps in our efforts at the federal level related to balance billing following the recommendations from the Ground Ambulance Patient Billing Advisory Committee and the efforts taking place in various states across the county to pass their own state-level balance billing laws.

But WHY?! The Benefits of Participating in a Healthcare Coalition

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Healthcare Coalitions (HCCs) bring together individual healthcare and response organizations in a defined geographic area, such as acute care hospitals, emergency medical service (EMS) providers, emergency management agencies, and public health agencies, to prepare healthcare delivery systems to respond to emergencies and disasters. HCCs collaborate to ensure each member has what it needs to respond to emergencies and other events, including medical equipment and supplies, real-time information, communication systems, and more.

Learn the benefits of being involved in a healthcare coalition and how participation can help you better prepare and respond during small and large events.

In God We Trust – Everyone Else Bring Data!

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You’re good! Are you? Really? What measures are you using? How do you compare to other agencies? How do you compare to yourself over time? Proving the value of the services you deliver has never been more important than it is today. If you want to remain the provider, or if you need funding for your services from payers, including taxpayers, you need to show that the service you provide makes a difference and is valuable. This session will provide key metrics your agency should be measuring, reporting, and improving to show that you bring value to the community you serve.

Medicare Advantage Plans: Insights for EMS

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In this presentation, we will dive into the impact of Medicare Advantage plans on the ambulance industry. The landscape of Medicare Advantage plans is constantly evolving, and we will explore how these changes affect ambulance providers. We will provide an overview of the various types of Medicare Advantage plans and shed light on the key differences between traditional fee-for-service Medicare and Medicare Advantage, focusing on plan features and patient cost sharing. The transition to Medicare Advantage plans brings forth a range of considerations and implications for the ambulance industry. We will identify and evaluate the unique challenges faced by ambulance providers in this new landscape. Topics of discussion will include network participation requirements, changes in reimbursement models, denial management, prior authorization processes, and data analysis from Fair Health by HMA. As the Medicare Advantage landscape continues to evolve, it is crucial for ambulance providers to stay informed and prepared. By grasping the impact of Medicare Advantage plans on the ambulance industry, and by considering the unique challenges they present, providers can position themselves for success. We hope that through this presentation, you will gain valuable insights into the implications of Medicare Advantage plans and discover opportunities to navigate this changing landscape effectively.

Understanding Medicaid Managed Care

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This presentation will dive into the unique challenges faced by ambulance providers in the context of Medicaid Managed Care. Under traditional Medicaid fee-for-service, the reimbursement process is well-defined, but with Medicaid Managed Care, the landscape has become more complex. Medicaid beneficiaries are now enrolled in managed care plans across many states, which necessitate ambulance services to navigate a different set of rules and guidelines. Through real-life case studies and industry experiences, we will examine the practical implications and discuss effective strategies for navigating these challenges. Medicaid Managed Care presents unique challenges and opportunities for the ambulance industry. By understanding the intricacies of managed care, collaborating effectively with MCOs, implementing best practices, and leveraging data, ambulance providers can navigate the evolving landscape successfully. We hope this presentation will provide you with valuable insights and actionable strategies to optimize your services and improve outcomes for Medicaid beneficiaries.

Medicare Update Part 1

Written by Amanda Riordan on . No Comments on Medicare Update Part 1

Please join Brian S. Werfel, Esq., Medicare Consultant for the American Ambulance Association for a two-part discussion of the latest news affecting Medicare’s reimbursement for ambulance services. In the first session, we will discuss the changes impacting Medicare reimbursement for calendar year 2024. We will also look at the most recent aggregate Medicare payment data. This data is useful in identifying long-term trends in reimbursement. This data can also help us understand some of the potential reimbursement changes Congress might consider once it receives the Medicare Payment Advisory’s (MedPAC) report on Ambulance Cost Data. The session will conclude with a Q&A session.