IFT (Non-Emergency Transport) Questions

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Rialaigh

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I have a whole host of questions that I have been scouring the internet trying to find answers for. I am hoping I could find someone who works as managment for one of these companies who would be willing to answer some question for me over PM.

If anyone wishes to chime in I am curious about billing and reimbursement for Medicaid/Medicare and private insurance companies. As well as Liability insurance and licensing requirements for your state ranging from DHEC to DOT and others. Also curious how medical control is handled for some of these smaller private companies.
 
It might help if you were to explain why you are curious regarding those issues.
 
The purpose of a forum is to ask questions out in the open, not via PM. You'll probably get more answers faster as well.
 
I am contemplating the idea of starting a IFT company with one or two ambulances in an area close to me. I have done a fair bit of research but would appreciate some input on liability insurance, The way your local IFT's do medical control (this will be a basic only service to start), and any licensing problems you have run into. As well as any issues you have run into with Medicare/Medicaid billing.
 
I would suggest that anyone contemplating such a venture should already be well versed in all facets of the industry, i.e. an expert of sorts. Such a person would have many years experience working all areas of an IFT company, from dispatch to managerial. Be knowledgeable enough to fill almost any role in the type of company they hope to run. From paper towels to paper work.

This requires many years of experience. To me, this is a key ingredient in the recipe for success.

The questions you have asked lead me to believe that you have not yet simmered enough in the sauce of experience to undertake such a task, as you should already know these things if you hope to run your own business. Then again that is just my opinion and I have been known to be wrong once or twice. For some reason I feel like making lunch...

At any rate good luck with that.
 
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Lol GL man. Not a business I or many people for that matter would get into.
 
People want to get on that Renal Rodeo bandwagon! More obesity leads to hypertension which leads to kidney failure which leads to dialysis resulting in Mercedes' for the owners of these companies. Pay a visit to LA for giggles.
 
Rialaigh said:
If anyone wishes to chime in I am curious about billing and reimbursement for Medicaid/Medicare and private insurance companies. As well as Liability insurance and licensing requirements for your state ranging from DHEC to DOT and others. Also curious how medical control is handled for some of these smaller private companies.
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The liability insurance, med control and licensing requirements should be questions for your state approving authority, call them and see if they'll do a consult with you (most are happy to since it can prevent issues later).

Billing and reimbursement for medicare can be a headache, which is why most services 3rd party bill. Reimbursement is slim in most places which will require a higher volume of transports than you initially estimate, as well as denials and overcharges which need appealing or sent to facilities/patients for payment. Expect a 4-6 month draught when starting, then your revenue cycle will really depend on the quality of your reports, promptness in billing, and accuracy. Staying compliant is a full time job as things are always changing.

Make sure you put together a solid business plan. You'll most likely find that running one or two trucks won't even get you close to breaking even (if you're following all the rules), but it will also depend on your payor mix, types of customers, etc.

And don't get me started on human resource issues, payroll numbers always coming in too high, legal issues (it can feel like someone will always be suing you for something, sometimes just because they can).
 
AlphaButch said:
The liability insurance, med control and licensing requirements should be questions for your state approving authority, call them and see if they'll do a consult with you (most are happy to since it can prevent issues later).

Billing and reimbursement for medicare can be a headache, which is why most services 3rd party bill. Reimbursement is slim in most places which will require a higher volume of transports than you initially estimate, as well as denials and overcharges which need appealing or sent to facilities/patients for payment. Expect a 4-6 month draught when starting, then your revenue cycle will really depend on the quality of your reports, promptness in billing, and accuracy. Staying compliant is a full time job as things are always changing.

Make sure you put together a solid business plan. You'll most likely find that running one or two trucks won't even get you close to breaking even (if you're following all the rules), but it will also depend on your payor mix, types of customers, etc.

And don't get me started on human resource issues, payroll numbers always coming in too high, legal issues (it can feel like someone will always be suing you for something, sometimes just because they can).
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I appreciate the advice. I was unaware that the state approving authority in most places is happy to assist... ;) I have spoken with people there a few times and will ask to set up a consult as you have said.
 
Better you than me, I wouldn't get involved with IFT at any price.
 
Billing Medicare/Medicaid can be a headache, but estimating a 4-6 month drought seems quite high to me. Your enrollment with the insurance companies is the lengthy process. Medicare would have to be done first & they take the longest, about 4 weeks, but the enrollment forms can be filled out months in advance, before patient's are even transported. As soon as the business is a for sure thing, I would start those enrollment forms. If those are completed before you start transporting patients, then those no reason why you couldn't see funds rolling in in the first 30 days of business!
 
BillingSpecialist said:
Billing Medicare/Medicaid can be a headache, but estimating a 4-6 month drought seems quite high to me. Your enrollment with the insurance companies is the lengthy process. Medicare would have to be done first & they take the longest, about 4 weeks, but the enrollment forms can be filled out months in advance, before patient's are even transported. As soon as the business is a for sure thing, I would start those enrollment forms. If those are completed before you start transporting patients, then those no reason why you couldn't see funds rolling in in the first 30 days of business!
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So you're trying to tell this person here that it takes 4 weeks to get medicare provider number? Hahahahahaha, when is the last time you applied for one when opening an ambulance company?
 
looker said:
So you're trying to tell this person here that it takes 4 weeks to get medicare provider number? Hahahahahaha, when is the last time you applied for one when opening an ambulance company?
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Yes, that's what I'm saying. I've done this many of times. I completed a full application for Medicare, for a new provider, and actually had the application approved in 3 weeks, and that was about six months ago. There are always factors that could come into play...government holidays, the time of year that you are sending it in, if it's filled out correctly, not missing any information...that can all play a huge factor in the process.

For a new company, starting up, if you have a start up date of May 1st, you can start your Medicare application today with a start date of May 1st 2013, and then you have the ability to allow for any of Medicare's hiccups that could cause a problem. You want to start these enrollments AS SOON AS you know a start date for the company.
 
BillingSpecialist said:
Yes, that's what I'm saying. I've done this many of times. I completed a full application for Medicare, for a new provider, and actually had the application approved in 3 weeks, and that was about six months ago. There are always factors that could come into play...government holidays, the time of year that you are sending it in, if it's filled out correctly, not missing any information...that can all play a huge factor in the process.

For a new company, starting up, if you have a start up date of May 1st, you can start your Medicare application today with a start date of May 1st 2013, and then you have the ability to allow for any of Medicare's hiccups that could cause a problem. You want to start these enrollments AS SOON AS you know a start date for the company.
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hahahahaha thanks for the laugh.
 
Even if you get billing figured out in 3 weeks, how long does it take for reimbersment... I've heard up to 90 days. So I think a 4-6 month drought is acurate.
 
90 days for reimbursement...that's the craziest thing I've ever heard!

You send claims to them electronically, a clean claim should have payment in 10 days. Back when Medicare still expected papers claims, processing one of them took about 4-6 weeks.
 
The 3 weeks was something that happened one time, but 4 weeks is the average turn around time on a fully completed, correct, enrollment application.
 
BillingSpecialist said:
The 3 weeks was something that happened one time, but 4 weeks is the average turn around time on a fully completed, correct, enrollment application.
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No such time frame in California. I know company's that had to wait for as long as 1 1/2 years to get their application approved. It also means their ambulance that they purchased in order to file for application is just sitting around doing nothing.
 
looker said:
No such time frame in California. I know company's that had to wait for as long as 1 1/2 years to get their application approved. It also means their ambulance that they purchased in order to file for application is just sitting around doing nothing.
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OH MY GOODNESS....that's INSANE!!!

I've never heard of it taking so long, and it leads to me believe there were problems some where, with the application, them requesting information, the site visit...something else had to be going on there.
 
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