<img src="//trc.taboola.com/1221273/log/3/unip?en=page_view" width="0" height="0" style="display:none">
ARboostwebsitelogo
Let's Talk

Case Study

Mohawk Ambulance Service

Albany, NY

Proven Results

donut-graph-30

Improvement in staff efficiency
for insurance verification

donut-graph-67

Less time needed per case to screen
for Medicare deductibles

donut graph-100

Elimination of wait times to discover billable insurance for self-pay patients

Real-time insurance discovery and verification services eliminate lags, expedite claims and achieve 30 percent greater staff efficiency for EMS provider


Founded in 1964, now nationally recognized, Mohawk Ambulance Service is the largest privately owned ambulance service in upstate New York

The EMS provider services six emergency centers, makes 56,000 trips annually and employs a team of more than 250 staff members. Mohawk’s mission is to uphold the highest standard of EMS services with consistent devotion to delivering superior emergency medical care. Wendy Becofsky, business office manager and her management team commits the same level of service excellence to the organization’s revenue cycle.

Becofsky’s team maintains a vigilant watch over the verification, billing and collection functions at Mohawk. Working together with local hospitals and nursing homes, they have fine-tuned many standard processes—checks and balances to verify coverage, screen deductibles and reduce eligibility-related rejections before claims are submitted to a payer. The verification team also performs insurance discovery for patients without insurance.

 

Challenges

 

Solutions

icon-orange-exclamation-triangle

Reduce the number of screens, websites and systems searched by billers to find information and populate a claim

icon-green-check-circle

Integrates AR Boost insurance verification and discovery into front-end workflow for real-time searches versus batch processing

icon-orange-exclamation-triangle

Eliminate lag days waiting for verification, deductible screening and insurance discovery

icon-green-check-circle

Uses AR Boost demographic verifier to validate patient data and fill in the blanks for emergency transports

icon-orange-exclamation-triangle

Find more insurance coverage to reduce eligibility-related rejections, convert self-pay accounts and collect revenue from the right source

icon-green-check-circle

Greatly reduces the number of patient statements by effectively finding and billing insurance coverage first

Real-Time Insurance Discovery Eliminates Batches

To achieve her efficiency goals, Becofsky turned to long-time technology and service partner AR Boost to innovate Mohawk’s insurance discovery process for patients with no known coverage.

Mohawk’s original process to find demographic and insurance information for these patients involved building a list, submitting it to AR Boost, waiting three days for feedback, and then re-entering information into the system. With efficiency in mind, AR Boost recommended a new workflow and technological capability.

AR Boost provided an interface for Mohawk billers to access their payor search options. Now the insurance verification team at Mohawk has immediate access to AR Boost’s search capabilities. No more batches, no more searching payor websites, no more waiting.

Becofsky’s team queries AR Boost online, in real time, for each self-pay case to find updated demographic information and potential coverage. With crosswalks to patient location, customizable exclusions and dynamic Medicaid tracking, Mohawk can find more insurance coverage and dramatically reduce the number of patient statements they send.

Becofsky has been with Mohawk for more than 20 years and describes AR Boost’s new real-time insurance discovery option as “amazing.”

Automated Verification and Discovery Capabilities Increase Staff Efficiency

Because the Mohawk team now finds and verifies more insurance coverage, fewer denials or rejections based on eligibility are encountered. Billers can see insurance coverage up front versus after the fact.

“We’ve always done up-front verification, but now our processes are more efficient, more immediate and more effective,” concludes Becofsky.

 

Common Self-Pay Scenario for EMS Providers

Ambulance providers are often called upon to transport patients experiencing chest pain, but with no information available. Billing the patient directly instead of submitting a Medicare claim leads to a lengthy payment delay—30 to 90 days or more. If correct demographics and insurance coverage can be identified up front through better automation, the EMS staff can easily identify Medicare and submit the claim—and expect to receive payment within 14 days.

ar-boost-logo-white-180px-svg-2

Boost Your AR

Check out our blog to learn from industry experts on how you can make sure you are billing efficiently and receiving maximum reimbursements.