About Electronic Filing...

Electronic filing is the "wave of the future". Many services are large enough that HIPAA 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 provides compatible electronic-submission files and places them in a folder designated by the clearinghouse. The clearinghouse software is then used to transmit the claims.

The clearinghouse being used is Lindsay Technical Consultants (LTC). Lindsay charges a one-time set-up fee of $95.00 and charges 39 cents per claim. Claims can be transmitted by direct dial-up or through their secure website. LTC will bill clients directly each month for the claims transmitted. LTC handles the technical support for the transmissions while Avocation Software handles the technical support for any EMS Accounting System issues.

For the user, transmitting claims electronically is as simple as clicking a button, The EMS Accounting System and LTC will handle the rest.