Ambulance Expertise

 

Pridemark has been successfully billing for emergent and non-emergent medical transportation services for ten years. Our experience includes billing for our own transportation service as well as for many other public EMS providers. Our perspective as an ambulance service gives us a unique insight into EMS operations and billing.

 

MEDICARE/MEDCAID BILLING EXPERTS

For efficiency and increased collections where possible all invoices to third party payors including Medicare, Medicaid and commercial claims area submitted electronically. The vast majority of commercial insurances claims are submitted electronically via a clearinghouse. In addition, we directly bill Medicare and Medicaid electronically.

We have been submitting claims electronically to Medicare and Medicaid in the mandated ANSI format since 2003. We also receive electronic submission confirmation and explanation (EOB) of benefits from Medicare and Medicaid. Utilizing electronic submission for all carriers and electronic submission confirmation and EOB’s significantly increase the pace of cash collections.

 

Private payors BILLING EXPERTS

Where there is no known third party payor, we process private pay invoices through a company called Dantom.  Dantom receives a daily electronic file and generates invoices. Dantom also provides bad address tools to research and obtain current address information on patients. Utilizing Dantom speeds the billing process and lowers the cost of mailing and printing.

In addition to Dantom, our trained staff uses several skip tracing tools for accuracy in obtaining the patient’s address and insurance information. We are currently using a web site based program, Accurint, for most of our skip tracing.  This has proven to be an excellent source of reference for obtaining updated residence information. 

 

Along with our online sources of patient insurance information we will work with the hospitals and other medical providers in an effort to gain more accurate patient insurance information. Our partner in this proposal, Medical Claims Specialists of North Charleston (MCS), has a long history of working with the hospitals within the County and has developed relationships that will help us gather the billing and insurance information necessary to process claims in a timely manner. MCS’s local knowledge and experience with the local hospitals makes them an ideal partner for this contract.