Air Methods CorporationBest Practices

Presented by Matthew Smith

AIR METHODS CORPORATION

Headquartered in Englewood, CO Established in 1980 306 Bases More than 4,000 employees Currently operate in 47 states Patient Business Services office

located in San Bernardino, CA Employ 100 employees in our billing

department Billing Service – Complete Billing

Solutions Publicly Traded NASDAQ: AIRM

TRAINING / COMPLIANCE

Best Practices - Training

All Billing Staff goes through a new hiring training program to include: HIPAA training HITECH Training Red Flags Training Sexual Harassment Violence in the Workplace

Best Practices - Training

Productive Work Environment RNB Training Medicare/Medicaid Training Ambulance Billing Training Review performance standards and

expectations Review Policies and Procedures

Best Practices - Training

Policies and Procedures Have written policies and procedures Update policies and procedures regularly Policies and Procedures should be readily

accessible to your team Reviewed annually and employees are

required to sign an acknowledgement that they have read and understood the policies

Best Practices - Training

The signed acknowledgement becomes part of their personnel file

Employees are required take post training tests and demonstrate that they understand the material covered

Best Practices - Compliance

Employ a full time Standards and Compliance Auditor who performs a variety of audits throughout the year

Internal Audit Department conducts multiple audits throughout the year

Best Practices - Compliance

Air Methods hires an independent claims review consultant to perform annual audits to ensure compliance with Federal and State regulations, and provide any recommendations or feedback for any areas that may need improvement

REPORTING

Best Practices - Reporting A weekly KPI is produced and provided to

our top levels of leadership to monitor and track the performance of the billing department A/R Aging by financial class Denial Tracking (Expected vs. preventable) Number of Claims Billed by Financial Class Number of Flights on Hold and the $ value Cash Collection vs. Cash Goal Collection Agency Assignments vs. Recoveries Transport to staff ratio

Denial Summary Report

Best Practices – Reporting

Unbilled Report This reports captures any accounts in

the system that have not been billed in over 4 days.

Distributed to the leadership team every Monday▪ Distributed by financial class

Reporting – Unbilled Report

Best Practices - Reporting

Stagnant Account Report Report that captures any account that

has not had any follow up action in over 30 days

Automated report that goes to the leadership team every week

Includes the last note and the last note date on the account to allow for quick and easy spot checking of accounts

Best Practices - Reporting

A weekly report is produced that is shared with our bases of any missing documentation that is either stopping or causing a delay to the submission of claims

Report is sent to all local and regional management, to include the names of the individuals that are delaying the billing process

Missing Documentation Report

Best Practices - Reporting Monitor Employee Performance

Each employee has a daily production standard User Activity Reports and Phone Activity Reports Supervisor gets a summary of all activity for the

previous day, to include the time of each entry in the system, and what notes were entered on each account to allow for quick and easy spot checking

Department Supervisors perform Supervisor Spot Checks on each employee every month, and provide feedback to each employee

User Activity Reports (Summary)

Insurance Department (Collectors) - User Activity Report

For The Period 4/26/2012 To 4/26/2012

User Change Date Change Time Trip Date Run # Last Note Type History Entry

Team Member A            

Total Changes For: Trips Touched History Entries % of Total % of Daily Goal    

Team Member A 47 131 10.0% 94.0% (50 accounts per day)  

Team Member A            

Total Changes For: Trips Touched History Entries % of Total % of Daily Goal    

Team Member A 47 166 10.0% 94.0% (50 accounts per day)  

Team Member A            

Total Changes For: Trips Touched History Entries % of Total % of Daily Goal    

Team Member A 53 208 11.28% 106.0% (50 accounts per day)  

Team Member A            

Total Changes For: Trips Touched History Entries % of Total % of Daily Goal    

Team Member A 54 222 11.49% 108.0% (50 accounts per day)  

Team Member A            

Total Changes For: Trips Touched History Entries % of Total % of Daily Goal    

Team Member A 30 194 6.38% 60.0% (50 accounts per day)  

User Activity Reports (Detailed)

2012-04-26 08:44:09 2011-12-16 130386 Insurance Collection Call Called BCBS of FL (blue card) @ 800-727-2227, spoke to Erica and explained that the appeal was mailed on 04/19/12; need to verify that the appeal was received and sent for review. She states the appeal was received on 04/24/12 and she is forwarding the a

2012-04-26 08:44:20 2011-12-16 130386 Insurance Collection Call Changed Call Back Date from 04/26/2012 to 05/10/2012

2012-04-26 08:44:20 2011-12-16 130386 Insurance Collection Call Changed Next Event Date from 06/01/2012 to 06/10/2012

2012-04-26 08:44:42 2012-01-06 2345 Insurance Collection Call Added Note: Insurance Collection Call - Per the USPS.com website the certified letter was delivered on 04/24/12.

2012-04-26 08:44:42 2012-01-06 2345 Insurance Collection Call Called BCBS of FL (blue card) @ 800-727-2227, spoke to Erica and explained that the appeal was mailed on 04/19/12; need to verify that the appeal was received and sent for review. She states the appeal was received on 04/24/12 and she is forwarding the a

2012-04-26 08:45:04 2012-01-06 2345 Insurance Collection Call Changed Call Back Date from 04/26/2012 to 05/10/2012

2012-04-26 08:45:04 2012-01-06 2345 Insurance Collection Call Changed Next Event Date from 06/01/2012 to 06/10/2012

Phone Reports

Talk/Down Time By Extension 4/18/2012

Extension Talk Time Internal Time Down Time Down Time %Insurance Collector 1 6:03:36 0:02:18 1:24:06 18.69%Insurance Collector 2 5:54:30 0:04:00 1:31:30 20.33%Insurance Collector 3 1:21:42 0:03:54 6:04:24 80.98%Insurance Collector 4 1:14:54 0:00:00 6:15:06 83.36%Insurance Collector 5 4:10:12 0:00:00 3:19:48 44.4%Insurance Collector 6 4:58:24 0:03:00 2:28:36 33.02%Insurance Collector 7 4:22:36 0:00:30 3:06:54 41.53%Insurance Collector 8 6:42:36 0:00:00 0:47:24 10.53%Insurance Collector 9 6:09:42 0:03:18 1:17:00 17.11%Insurance Collector 10 4:36:30 0:00:00 2:53:30 38.56%

Total Talk Time: 45:34:42 0:17:00 29:08:18  

Percentage Total: 60.77% 0.38% 38.85%  

Best Practices - Reporting

Open Accounts We monitor the number of open

accounts in each financial class to help us to manage the A/R and ensure that accounts are worked timely and appropriately

Reconciliation Reports

Weekly and monthly reconciliation of all ambulance trips to ensure timely billing / collections and identify any potential problems quickly

Reconcile our A/R posting to our bank deposits on a daily basis

BILLING

Best Practices - Billing

All Billing Activities are documented within the RescueNet Billing System

Each team member has a monthly review to evaluate their performance and address any performance issues, and recognize those team members who are meeting and/or exceeding our expectations

Best Practices - Billing

Extensive QA process that each biller must follow when submitting claims to the various payers Patient Demographics Insurance Eligibility Completion of required forms Medical Necessity Properly Documented,

HCPCS, Modifiers, Charges, etc Claims reviewed by multiple departments

Best Practices - Billing

File as many claims electronically as we can Medicare Medicaid Commercial Insurance Carriers Government Payers

Best Practices - Billing

Schedules and events are modified to mirror the payers payment cycle

Schedules are designed for unique situations▪ Payment sent to insured▪ Shorter / Longer Expected Payment Cycles▪ Specific Documents Needed

Schedules and events are closely monitored to ensure timely follow up activities

Best Practices – Billing

Move towards paperless operation: Electronic Claims Filing EFTs ERAs Online Claim Status Online Claims Appeals

Best Practices - Billing

Medicare Advantage Plans Matrix of all Medicare advantage plans is

kept up to date as to which plans accept fractional mileage, and which ones do not.

Medicare advantage plans that do not accept fractional mileage are rounded up to the next whole mile.

Best Practices – Billing

Utilize Vendor to verify insurance eligibility We send automated batches of all

private pay accounts to a third party vendor to search for Medicare, Medicaid, and the top 5 commercial insurance companies for the geographic region that the patient resides in

Best Practices - Billing

Each Insurance Collections specialist has been provided with the Prompt Pay Laws for each of the states, which are cited in their collection calls and the collection letters that we send to insurance companies

If the payer fails to pay claims in accordance to the prompt pay laws, we demand interest as outlined in the prompt pay laws

Persistent with the insurance companies

Collecting the Cash

Best Practices - Billing

All denied/underpaid claims are reviewed for appropriateness, and all claims inappropriately denied are appealed to the highest level

Standardized “skeleton” of appeal letters to address the most common denials

Recognize Employees

Incentive Programs Exceeding production goals Positive Customer Feedback Attendance Individual and departmental collections Meeting A/R and DSO goals

Years of Service Suggestion Box Exceeding our expectations

Questions?