Solving Revenue Recovery Challenges Faced by Ambulance Services

Solving Revenue Recovery Challenges Faced by Ambulance Services

Emergency services, particularly ambulance providers, are grappling with a dire financial situation, exposing vulnerabilities in the current economic model. The broken system puts essential services at risk, exemplified by Berkshire County’s ambulance service facing a funding crisis due to reimbursement and insurance challenges.

1. Reimbursement Struggles: A Ticking Time Bomb

The broken economic model has led to reimbursement challenges for ambulance services, where private insurers are falling short on their financial obligations. Brian Andrews, president of County Ambulance, shed light on the exploitative practices of some carriers negotiating reduced reimbursements. Timely payments and sufficient coverage are vital, and without them, ambulance services may struggle to maintain response times and quality care.

Read more about Berkshire County’s funding crisis

2. Proposals to Combat Out-of-Network Bills

A government advisory committee proposes capping emergency ambulance ride costs at $100 to address out-of-network billing issues. With over 50% of insured patients at risk of receiving out-of-network bills, the committee suggests a payment system to create more predictable rates. Ambulance providers and insurers would enter a rate-setting arrangement, aiming to eliminate surprise billing and create fair compensation for services.

Explore the proposed solutions

3. Out-of-Network Challenges in Ground Ambulance Rides

In 2022, a majority of ground ambulance rides were out-of-network, leaving patients with limited provider choices and no federal protection from surprise billing. The limitations of Independent Dispute Resolution (IDR) in these instances, coupled with potential pushouts from health insurance carriers, underscore the need for ambulance providers to regain control and explore litigation strategies.

Read the report

Allia Group Helps Ambulance Services Recover Revenue

In the face of these challenges, Allia Group offers a unique business model tailored for ambulance providers. Increase revenue directly from insurance underpayments without patient-focused collection efforts. Explore our services here and reach out to start the conversation.

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