Prison Transport

[lacey15890]

I am a biller and struggling hard to find answers! When billing for a transport originating out of a local prison, would you use the E modifier for the origin? Please Help!

 

[akflightmedic]

Ummm, I have zero clue what you are even referencing???

Wouldn't this be a question best directed to your specific service?

You have made an assumption that every one uses the same billing software, has the same policies, or even bills the prisons or jails within their response area. Just sayin...provide more details in the future, and more importantly, take questions like this up through your internal chain.

 

[lacey15890]

1

 

[lacey15890]

Ummm, I have zero clue what you are even referencing???

Wouldn't this be a question best directed to your specific service?

You have made an assumption that every one uses the same billing software, has the same policies, or even bills the prisons or jails within their response area. Just sayin...provide more details in the future, and more importantly, take questions like this up through your internal chain.

No, actually. We are a small private company and this sort of transport is very new to us. Origin/Destination modifiers are a CMS standard set of codes for ambulance billing across the country. The codes are exactly the same regardless of service area or billing software. No assumptions were made. I was hoping for help or insight on were I could find it or any information that could lead me in the right direction. I wasn't looking for someone to be so brash about something they do not even know anything about. I thought this was a place for people to come together in work, community, and in help for EMS related things; Not a place for someone to try and belittle someone seeking help. If you have 'ZERO' clue in what I am referencing, then why say anything at all? Just a thought.

 

[mgr22]

No, actually. We are a small private company and this sort of transport is very new to us. Origin/Destination modifiers are a CMS standard set of codes for ambulance billing across the country. The codes are exactly the same regardless of service area or billing software. No assumptions were made. I was hoping for help or insight on were I could find it or any information that could lead me in the right direction. I wasn't looking for someone to be so brash about something they do not even know anything about. I thought this was a place for people to come together in work, community, and in help for EMS related things; Not a place for someone to try and belittle someone seeking help. If you have 'ZERO' clue in what I am referencing, then why say anything at all? Just a thought.

Why would you reply that way? What could you possibly gain with such an adversarial tone?

 

[E tank]

I think s/he makes a good point...

 

[CCCSD]

No, actually. We are a small private company and this sort of transport is very new to us. Origin/Destination modifiers are a CMS standard set of codes for ambulance billing across the country. The codes are exactly the same regardless of service area or billing software. No assumptions were made. I was hoping for help or insight on were I could find it or any information that could lead me in the right direction. I wasn't looking for someone to be so brash about something they do not even know anything about. I thought this was a place for people to come together in work, community, and in help for EMS related things; Not a place for someone to try and belittle someone seeking help. If you have 'ZERO' clue in what I am referencing, then why say anything at all? Just a thought.

Then ask your company. If they don’t know, it’s their responsibility to find out by asking industry professional, eg: other billing companies.

You are a VERY rude person and it shows.

 

[akflightmedic]

So if origins are standard, then what is the issue? Seems like there would be other, very simple guidance regarding this, especially if industry standard...which I presume you are trained or educated in.

 

[Ewok Jerky]

OP I don't have an answer to your question. Its actually a very valid question for an EMS forum. Although most of us here probably don't do it own billing.

It's also quite useless to reply to a question that since YOU have zero clue what they are talking about then it's not an appropriate question. Billing codes are standardized regardless of software, policies, or response areas.

 

[Aprz]

I remember there used to be a user and post specifically about billing. I don't know if they'd get an e-mail if you reply to their post or message them, but couldn't hurt?

Here is the thread. https://emtlife.com/threads/ask-billing-questions-here.33163/

OP of the thread is @BillingSpecialist. They were last active 2018, but we also don't have a lot of billing discussions either. Billing is the less fun part of the job so thank you for what you do. Hopefully they receive e-mails if they get tagged or messaged. Your answer could be in the thread; I didn't see

Good luck!

 

[BillingSpecialist]

I am a biller and struggling hard to find answers! When billing for a transport originating out of a local prison, would you use the E modifier for the origin? Please Help!

Yes, E modifier is what you should use.

 

[BillingSpecialist]

I remember there used to be a user and post specifically about billing. I don't know if they'd get an e-mail if you reply to their post or message them, but couldn't hurt?

Here is the thread. https://emtlife.com/threads/ask-billing-questions-here.33163/

OP of the thread is @BillingSpecialist. They were last active 2018, but we also don't have a lot of billing discussions either. Billing is the less fun part of the job so thank you for what you do. Hopefully they receive e-mails if they get tagged or messaged. Your answer could be in the thread; I didn't see

Good luck!

Thank you! Yes I got the email & responded!

 

[BillingSpecialist]

This was a very good question & your right…this is exactly the place to ask it. Keep asking questions you may have & just disregard those who don’t reply with helpful information!

 

[DrParasite]

I have two billing questions, related to in custody/prisoner transport:
if someone is under arrest by LEO, and they need to go to the hospital, does that patient get billed for all services, or does the arresting agency cover the bill? if the person is admitted, and then no longer in custody, does that change the payor?

similarly, if someone is in prison (ie, county lockup in custody of the DOC), is the answer the same? I know many/most/some prisons have their own med unit, so if they send someone out, it's usually not at the prisoner's choice.

 

[BillingSpecialist]

I have two billing questions, related to in custody/prisoner transport:
if someone is under arrest by LEO, and they need to go to the hospital, does that patient get billed for all services, or does the arresting agency cover the bill? if the person is admitted, and then no longer in custody, does that change the payor?

similarly, if someone is in prison (ie, county lockup in custody of the DOC), is the answer the same? I know many/most/some prisons have their own med unit, so if they send someone out, it's usually not at the prisoner's choice.

The jail (or other similar facility) should only get the bill if the patient has been through booking. The patient isn’t “technically” their responsibility until that point. Anything outside of that, prior to the actual booking, the bill should go to the patient. There may be some circumstances in which the jail (or similar facility) may cover it, but most of the time this is going to be the standard.

 

[DrParasite]

The jail (or other similar facility) should only get the bill if the patient has been through booking. The patient isn’t “technically” their responsibility until that point. Anything outside of that, prior to the actual booking, the bill should go to the patient. There may be some circumstances in which the jail (or similar facility) may cover it, but most of the time this is going to be the standard.

So, if I get arrested (a fight, murder, tax evasion, whatever), silver bracelets are applied, and I develop chest pain and am taken to the hospital, I get the bill. if I'm transported to PD HQ, in a holding cell, and processing is still in the works, and develop chest pains, I get a bill. but if I go to county lockup (the actual jail), after being booked, then DOC takes over, so if i develop chest pains, and the med unit recommends transport to the ER, the jail picks up the tab. Do I have that correct?

 

[CCCSD]

So, if I get arrested (a fight, murder, tax evasion, whatever), silver bracelets are applied, and I develop chest pain and am taken to the hospital, I get the bill. if I'm transported to PD HQ, in a holding cell, and processing is still in the works, and develop chest pains, I get a bill. but if I go to county lockup (the actual jail), after being booked, then DOC takes over, so if i develop chest pains, and the med unit recommends transport to the ER, the jail picks up the tab. Do I have that correct?

Nope. Close though.

 

[BillingSpecialist]

So, if I get arrested (a fight, murder, tax evasion, whatever), silver bracelets are applied, and I develop chest pain and am taken to the hospital, I get the bill. if I'm transported to PD HQ, in a holding cell, and processing is still in the works, and develop chest pains, I get a bill. but if I go to county lockup (the actual jail), after being booked, then DOC takes over, so if i develop chest pains, and the med unit recommends transport to the ER, the jail picks up the tab. Do I have that correct?

Pretty much! I do billing for a federal prison & that’s how it’s done. But if u are killing people or robbing someone or some place….the likely hood of u paying the bill is slim. And 90% of the time…the offender has state Medicaid. So that’s who picks up the bill. If u don’t want to be in this predicament, don’t break the law lol!
Billing processes are not always fair….I get it, and no solution is perfect.