-July 9, 2024

How To Bill NEMT Services in 2024?

Accuracy is a matter of trust. Your customers will trust you only if they believe that you provide an accurate bill for your NEMT services. Billing, whether found in NEMT or other healthcare systems, serves as a bridge between service providers and patients.

Facts and figures from a recent study indicate that 80% of bills in the US contain errors. However, these poor billing practices result in losing approximately $125 billion annually.

So how do you accurately bill your NEMT services?

What is NEMT Billing?

NEMT billing is not similar to hiring a cab or scheduling a trip via an application. Although billing services differ when serving patients with varying needs.

For example, a person who is able to move or walk freely does not require the same vehicle as another who is dependent on a wheelchair. Additionally, a person who uses a wheelchair requires a different type of vehicle for support as compared to the one who needs a stretcher.

Likewise, every passenger also has a different location for pickup. Therefore distance is also one of the most crucial factors that impacts billing.

Types of Payments Options for NEMT Services

There are 2 categories of payment options for NEMT services:

Private Pay

Private Pay refers to a person who directly pays for NEMT services either from his own pocket or through private insurance plans. But those who can bear the expense of NEMT trips independently don’t need to undergo the complexity of insurance payments. Instead, they just book a ride, get an invoice for the trip, and make direct payments.

Insurance/Medicaid

In contrast, Medicaid is a government-funded payment system that offers health coverage to patients who are eligible. The eligibility criteria for Medicaid vary from state to state due to factors like income, age, disability status, and household size.

Private Pay	Medicaid
Pay through out-of-pocket	Government Funded Program
Customers bear full cost of transportation	Bear transportation cost for qualifying beneficiaries.
No Eligibility Criteria	Requires Eligibility Criteria
Higher amount of payment	Lower amount of payment
Anyone can utilize this service	Only available for medicaid beneficiaries

What are the Common Billing Errors to Avoid in NEMT Services?

Following are the most common errors especially when submitting claims in NEMT.

1. Inaccurate ICT Codes

The International Classification of Diseases (ICD) is a tool that gives a code to every single disease, symptom, and abnormal findings. So, utilizing these codes correctly will prevent errors in record-keeping in every department of a healthcare facility.

However, medical and billing coders go to school and train for their positions. It is necessary to understand all ICD codes and their functions. Thuse, even the simplest errors in these codes cause the rejection of claims.

2. Incomplete Documentation

Incomplete documentation can be a potential problem in billing. Therefore, if your documentation is incomplete or inaccurate, it will cause imperfect billing and claim denials. So it is a duty of NEMT service providers to make sure that every service they provide is well-documented and perfect.

3. Ineligibility of Passengers

In many cases, denials prevail due to the ineligibility of passengers for the service they want. This is the reason why NEMT staff must be aware of insurance policies.

4. Other Clerical Mistake

An ordinary clerical mistake can cause rejection in claims. When this happens, your NEMT business bears losses that greatly impact your revenues.

How To Avoid Common NEMT Billing Errors?

It is mandatory for NEMT services to be systematic with their billing and invoicing procedures. To do so, you must follow these ways to get rid of expensive mistakes:

1. Review It Thrice

All documents must be checked three times by different professionals having different expertise. A biller might fail to identify an error because the procedure becomes repetitive from their end.

So, in many companies, treasurers are partnered with auditors so another pair of eyes can check the numbers.

2. Improve Data Accuracy

The best way to minimize billing errors lies in the accuracy of data collection. This process begins by systematically accumulating and verifying patient information. Thus, make sure that all the personal details of patients and other specific transportation needs are perfectly met.

3. Complete Documentation

Beyond patient information, the perfect documentation of the service provided is essential. This includes detailed trip details (pickup and dropoff), distance covered, and other services offered during transit.

4. Effective Training and Communication

Ongoing training of brokers is essential if you want to balance a higher status of billing. However, Training employees regarding major billing problems and their solutions is a productive approach to error omission.

In addition to this, developing unbreakable communication channels with clients and medical providers is crucial. Hence if all groups have a mutual understanding of the services and corresponding billing expectations, it minimizes the chances of communication gaps and ambiguities.

5. Outsource NEMT Billing Services

Some NEMT providers have minimum staff to manage billing and invoicing. A NEMT billing service provider will handle all the complexities of taxing work of billing insurance companies and following up on claims. They are players in this field and are less likely to commit errors.

Conclusion

Billing addresses one of the most critical aspects of NEMT services, that affects your revenues, cash flows, and overall financial outcomes. Although, NEMT providers cannot run their business well and will not be able to render the best services if it is not paid in real-time. But to be paid, the NEMT service must require perfect billing and invoicing.

Insurance claims can be handled efficiently with minor clerical or typographical errors. Therefore, outsourcing NEMT billing will considerably reduce or completely remove these errors in billing from scratch.

Contact NEMT Billing Solutions and we will manage your NEMT billing from start to finish.

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