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.
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.
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
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.
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
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.