About Electronic Filing...

Electronic filing is the "wave of the future". Many services are large enough that HIPPA is requiring them to submit their claims electronically. Other smaller services, who are eligible to submit their claims on paper are being pressured to submit electronically for the convenience of the insurance industry.

Electronic filing is a complicated industry that must be flexible enough to meet the needs of the thousands of insurance carriers nation-wide. For those who have been submitting claims to Medicare and Medicaid, the standardization promised by HIPAA simply has not yet occurred. Ambulance claims make up an extremely small percentage of the medical insurance claims, and as such are often misunderstood and thus mis-processed by the carriers. In many cases (including many Medicare and Medicaid carriers) poorly documented and non-standardized requirements are imposed for ambulance claims submissions that if not complied with can result in confusing refusals without explanation.

Providing electronic filing capabilities is a complicated process that requires vast man-hours to keep up with the ever-changing requirements of thousands of carriers as well as the complicated connection process for transmitting claims from providers to carriers. Software packages that provide this complete service cost many thousands of dollars and require stiff annual support fees.

The EMS Accounting System uses the "clearinghouse" concept to provide electronic claims for a nominal fee per claim. This concept allows us to keep the cost of The EMS Accounting System down as well as the annual support fee. The clearinghouse keeps-up with all the requirements for the numerous carriers and handles the connection and transmission of claims. The EMS Accounting System generates the raw data that is sent to the clearinghouse. The clearinghouse then checks the data, converts it to properly formatted ANSI claims and forwards the claims to the carriers.

The clearinghouse utilized by The EMS Accounting System is EAC Submissions. EAC Submissions specializes in ambulance claims and was designed to be fully integrated with The EMS Accounting System.

There is no set-up fee for EMS Accounting System users and claims are charged at 30 cents per claim. EAC Submissions performes extensive front-end edits that are specific to ambulance claims and the carrier being submitted to. Claims that fail these edits are not charged and the user is merely notified by email of the need to correct and resubmit those claims.