NEMT Billing Workflow From Transportation to Transaction
Non-emergency medication transportation (NEMT) is an essential service in the healthcare industry. With NEMT, the most vulnerable people in society get the medical care they need. This involves senior citizens, persons with disabilities, and those with low incomes.
It has been widely reported that many people, especially those with special physical needs, would often miss their doctor’s appointments due to the lack of transportation. NEMT is the answer to them.
What is NEMT?
NEMT is a special type of transportation that caters to people who need medical-related assistance but not in an emergency situation. For example, a person in a wheelchair could comfortably get a ride to their medical appointment on an ambulatory NEMT.
Other NEMT vehicles could cater to people who need to go to their appointments on stretchers or with oxygen tanks.
And even when people don’t use specialized medical devices or equipment, NEMT can still be a great option. For example, a senior citizen can walk without assistance. However, public transport may not be the best option, and they may not have private options immediately at hand. NEMT can provide door-to-door pickup, vehicle designed for the specific type of transportation, and a trained driver.
NEMT providers are better off using robust software to streamline the medical billing process.
Overview of the NEMT Billing Process
Healthcare billing is quite complex, and even more so when it comes to NEMT. Using NEMT billing software will make everything more efficient and accurate.
One of the reasons why the billing process is so complicated is due to the different players in the NEMT industry.
Players in the NEMT Billing Flow
So, who is billed for every NEMT service?
1. Private Pay Patients
Perhaps the easiest to bill among all NEMT players are the private pay patients. Billing is quite straightforward.
How much does NEMT cost? You could bill based on distance traveled or hours of using the vehicle. It could also be a blend of the two.
With private pay clients, the transport company receives the payment immediately after the completion of the service. Clients could pay with cash, credit card, check, or digital or mobile payment systems.
2. Brokers
Many NEMT businesses coordinate with brokers for the booking of NEMT trips. In this case, it is usually the broker that accepts the client’s scheduled appointment and prepares the trip plan for the company and driver.
The middle man adds a layer to the billing process, adding a bit of a medical billing challenge. However, the use of reliable NEMT software will make things simple.
3. Insurance
Many Americans have insurance coverage, whether from a private provider or Medicaid, a federal health insurance program administered by the state. The NEMT company will bill the insurance provider in this case.
Medical insurance billing software will surely make the billing flow much cleaner.
NEMT Billing Flow
How does billing in NEMT work?
First, details of the NEMT trip must be considered. The farther the destination, the higher the price. Some companies also consider the time it takes to travel—the longer you use the NEMT vehicle, the higher the amount.
Price also depends on the type of NEMT service requested. Ambulatory rides are less expensive than options that can accommodate a wheelchair or stretcher. Additional equipment costs more, es well as having an attendant.
Once all expenses and corresponding service charges and markups are added up, you should have the amount that will be charged for the service.
Your invoice can be paid by your insurance or Medicaid, or you can just pay from your pocket (also known as private pay trips).
For a streamlined, accurate, and timely process, the use of billing software will ensure that billing errors are prevented.
ClaimGenix billing software is a very reliable platform that can efficiently compute service charges while managing claims and generating electronic health records.
Keep Up With Billing Trends
Decades ago, medical billing took ages because staff had to collate physical documents across various departments before they could assess charges. The medical billing workflow has undoubtedly improved over the years.
Keeping abreast of crucial medical billing trends will help your business remain competitive.
What billing trends do you need to watch out for?
Updates
The best software continues to upgrade its features. Watch out for new developments and ensure your software provider delivers updates regularly.
New Codes
Medical billing relies on complex codes for standardization. Your software provider must keep track of relevant codes for NEMT and note whether there are newly introduced ones.
Industry News
You must also be updated on the recent trends in NEMT and healthcare as a whole. This way, you can provide the best service to your clients.
Conclusion
Technology is at the heart of NEMT service. Make sure you have the best under your belt to ensure top-notch billing workflows.
ISI Technology is a modern platform that could take your NEMT service to the next level.