错误的。
Many ambulance services use an outside company to handle their billing and reimbursement issues. Some decide that the billing and reimbursement rules are just too complicated to stay on top of. Others would just as soon not have to deal with the whole billing issue. Those are perfectly valid reasons to use one of the many excellent ambulance billing companies that are out there. However, just because you “farm out” your billing, it doesn’t mean you can just “wash your hands” of the whole affair.
实际上，远离它。
利用外部计费机构服务的救护车服务，消防部门和其他EMS组织与提供者的责任与内部帐单以确保其偿还和商业惯例的责任相同。毕竟，该医疗保险的名字是谁？您的救护车服务。该法案中谁的提供商号码？您的救护车服务。当患者或他的保险公司付款时，谁会收到钱？您的救护车服务。而且，如果发现不当帐单，猜猜谁必须偿还这笔钱？没错 - 您的救护车服务，而不是您的账单公司！
There have been many Medicare audits, False Claims Act cases and other legal actions brought against ambulance services over the years where their defense was simply, “we don’t pay attention to the billing – we use a billing company and just send them our trip sheets. They do the rest.” That’s never a defense. The ambulance service, under the law, must know if the claims that are being submitted in its name are accurate, truthful, complete and supported by the documentation. They must identify any overpayments or improper reimbursement they receive. They must ensure that they are properly billing for the services that were actually rendered. They must ensure that the proper codes are used and proper amounts billed.
Every ambulance service that bills — whether they use an outside billing agency or do their billing in-house — should have an effective, working compliance program in place. That program should, at a minimum, include:
- 书面合规计划；
- Periodic internal claim reviews supplemented by periodic outside, independent audits;
- 书面政策和程序，例如行为准则，背景筛选政策等；
- A designated compliance officer; and
- 许多其他元素。
救护车服务还应向其计费公司询问其制定的合规性政策，以及计费公司是否还制定了正式合规计划。OIG甚至发布了单独的“第三方医疗计费公司的合规计划指南”。您的计费公司是否知道这些准则？他们跟随他们吗？
救护车服务和计费公司寿ld be partners in compliance, making sure that important compliance issues don’t slip through the cracks. There should be a thorough written agreement in place between the ambulance service and the billing company that clearly sets forth each party’s responsibilities toward compliance. The agreement should contain language that will ensure an open channel of communication and that, among other things, sets forth their responsibilities and obligations in the event of a Medicare audit. The billing company should provide feedback and information to the ambulance service, in the form of regular reports or otherwise, on the status of their accounts. And, perhaps most of all, billing companies should be cooperative, and not defensive or equivocal, when the ambulance service decides to internally audit or review a sample of claims, or bring in a consultant to perform a claims review.
