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.
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.”
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.
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.