Or the CC should be anemia secondary to treatment for CA.
Think of root cause analysis when putting down your CC. This is an important concept in just about anything we do in life although most won't overthink it and apply it outside of the safety (HSE) world.
You putting the right CC also streamlines the entire process and helps increase revenue. It is easy to say or think "that is the billing department's job", but in reality it is all of you guy's jobs. If you put the right CC to start with then all they have to do is submit with the proper supporting documentation. The less time the billing coordinator spends deciphering your report, the faster they move onto the next one and profit is generated. The neater you write, the better documentation you have, the less mistakes you have, the better for everyone.
Truly, the Medic or EMT holds a lot of control over how and when the company can get paid...hence the hard-assery it sounds like you are experiencing.
I do not work for Acadian, however they are one of the leaders in figuring out the billing world. I did some emergency contract work for them back in 2005/2006 during several bad storms (Katrina and Rita) and I was very impressed with their billing system. Every Medic/EMT would call in their reports. They have paramedics who have been trained in billing and those folks run the call in center. You literally dictate your runs to them and they enter all the data, they ensure all the boxes are ticked and proper terminology description is used. At first I was very freaked out by this, but it suddenly became very nice.
If you do not state something relevant, they have prompt questions where you say "oh yeh, this and that" and then of course they have their experience to ask you if you saw this or did that as well. At the end of the shift, all of your reports are then sent back to you for final review. If you agree, you sign them. If you do not, then you make the changes or corrections then sign. Sweet right?
A lot of this from your employer is legitimate. Any medical business is tough, especially with billing and then capturing revenue. As an employer, you need staff who are committed to the company, who do their best every day. I have been on both sides of the coin and no matter how easy it looks or how rich the bosses or owners look, it is not always what it seems.
Here is a typical scenario and note the timelines...
Day 1: You run the call and submit paperwork.
Day 2-3: Billing reviews and submits (this is actually faster than most billing submissions which typically take a week or more due to mistakes, delays and back logs)
Day 4-5: Insurance company receives it.
The insurance company now has up to 90 days to make payment, deny, request more information!!!!
Day 89: Insurance company rejects payment, wants more info but is vague in what exactly.
This is now kicked back to your company 3-5 days later via mail and the above process starts all over. Only this time, your coordinators have to chase YOU for corrections or clarifications (possibly) and once received....
So that same claim is now resubmitted and guess what???
The insurance company now has 90 days to review and make payment, deny or reject. And YES...some companies do this over and over as they are playing the "float the cash" game.
Then around day 180, the insurance company will say We do NOT approve your bill of $100, however here is payment of $70...take it or leave it.
So as the business you TAKE it because you need cash and you have now been floating THEIR bill for 6 MONTHS!!!!
In addition to the partial payment, you have already used up more than half of that when you factor in all your employee's hands/time who have touched it. Essentially you have spent more than what the payment is trying to collect the payment. It is ridiculous.
Multiple this process by the 10000s and then see why so many services crumble. It takes a large bankroll to float operations such as ambulance service. Sure, eventually payments start to catch up and lessen the pain of this process but it does not mean the process has gotten any better. You could suddenly hit dry spells where everything is rejected and cash reserves start to dwindle (payroll, overhead, normal operating costs) and then of course employee attrition rears its ugly head.
Insurance billing is a nasty. nasty world and so much of it could be improved by the very first person who writes the chart.
