Maximizing EMS Revenue Through Proper ALS Assessment with HealthEMS

In today’s healthcare landscape, EMS agencies are under increasing pressure to optimize revenue while ensuring compliance with complex billing regulations. One of the most effective ways to achieve this is by accurately documenting and billing Advanced Life Support (ALS) assessments. Sansio's HealthEMS electronic Patient Care Reporting (ePCR) platform offers robust tools to streamline this process, ensuring that EMS providers can capture necessary information efficiently and accurately.

Understanding ALS Assessments and How HealthEMS Can Help

An ALS assessment is defined as an evaluation performed by an ALS crew during an emergency response, necessitated by the patient's reported condition at the time of dispatch. Importantly, this assessment does not require the administration of ALS-level interventions to qualify for billing purposes. 

The Sansio Team understands that proper documentation of ALS assessments is crucial, as it directly impacts the agency's ability to bill at the ALS1 level. Failure to document these assessments accurately can result in lost revenue and potential compliance issues. (JEMS.) We built our ALS assessment tool to determine recommended service levels based on the scenario and uses data points from your report to fine tune those recommendations. With this tool, your team can ensure proper billing procedures are completed.

The Importance of Accurate ALS Assessment Documentation

Billing for ALS assessments requires adherence to specific criteria:

• Dispatch Protocols: The dispatch must be based on standard or accepted protocols indicating the need for an ALS response. (aim-system.com+3JEMS+3Centers for Medicare & Medicaid Services+3)
• Qualified Personnel: The assessment must be performed by personnel qualified to provide ALS services, such as EMT-Intermediates or Paramedics. (eCFR+2EMERGICON+2UMWA Funds+2)
• Medical Necessity: The patient's condition must warrant an ALS assessment, even if no ALS-level interventions are ultimately provided. (Centers for Medicare & Medicaid Services+6UMWA Funds+6Centers for Medicare & Medicaid Services+6)

Accurate documentation ensures that these criteria are met and substantiated, thereby supporting appropriate billing and reimbursement.

Leveraging HealthEMS for Efficient ALS Assessment Documentation

Sansio's HealthEMS ePCR platform is designed to facilitate accurate and efficient documentation of ALS assessments. Key features include:

• Customizable Required Fields: Agencies can configure HealthEMS to require documentation of ALS assessments for applicable calls, ensuring that no critical information is omitted.
• Billing Review Feature: The platform's billing review functionality allows for the identification and correction of documentation issues before claims are submitted, reducing the risk of denials and ensuring compliance.
• Knowledge Base Resources: HealthEMS provides access to a comprehensive Knowledge Base, offering guidance on recommended service levels and calculations to help agencies determine appropriate billing levels based on their specific needs.

Maximizing Revenue Through Proper Billing Practices

By ensuring that ALS assessments are accurately documented and appropriately billed, EMS agencies can maximize their revenue streams. HealthEMS supports this goal by providing the tools necessary to capture essential information, validate documentation, and align billing practices with regulatory requirements.

 About Sansio, Inc. – HealthEMS and MobileTouch

Sansio is a recognized leader in healthcare software solutions, providing intuitive and reliable platforms such as HealthEMS to streamline healthcare operations. Sansio is dedicated to enhancing the efficiency and quality of healthcare services through cutting-edge technology and comprehensive support.

For more information visit www.sansio.com.

For media inquiries, please contact:

Lindsay Miller, Marketing Specialist
Sansio, Inc.
lindsay.miller@sansio.com