Billing that starts before the handoff breaks.
When the ePCR locks, the ambulance billing record is already forming - charges, codes, mileage, payer context, and compliance flags carried forward from the run. Billers inherit a clean workflow, not a stack of disconnected PCRs.
Built around the realities of ambulance revenue cycle.
The compliance workflows private EMS billing actually runs on - built into the data model, not bolted on after the chart is done.
Eligibility at booking
Run 270/271 eligibility when the transport is requested, return a clear coverage signal, and carry the result into dispatch and billing.
Chart-driven charge capture
Build charges from the locked ePCR with HCPCS, ICD-10, modifiers, loaded mileage, level of service, and billable supply consumption.
PCS, ABN, and RSNAT
Manage medical necessity, physician e-signatures, Medicare notices, repetitive-transport authorization, expiration alerts, and dispatch safeguards.
Native claim scrubber
Apply payer-specific checks for documentation, modifiers, mileage, authorization, and required attachments before a claim leaves the agency.
837P claims and status
Generate X12 837P claims, route them through a configured clearinghouse, attach supporting documents, and follow claim status through the queue.
Insurance discovery
Turn self-pay uncertainty into a structured search for coverage, Medicare identifiers, retroactive Medicaid, liability coverage, and demographic corrections.
Keep the revenue cycle moving after submission.
Remittance, denials, patient responsibility, collections, and executive performance stay connected to the same transport and the same financial truth.
835 remittance and payment posting
Parse electronic remittance, post payments and adjustments, classify CARC and RARC responses, and update patient responsibility and the A/R ledger.
Denials and appeals
Prioritize denials by reason, assemble the supporting record, draft appeal language, re-scrub corrections, and track the outcome through resolution.
A/R and collections worklists
See 30, 60, 90, and 120-plus aging by payer and facility, focus follow-up on at-risk balances, and preserve every collection note.
Patient financial experience
Generate clear statements and support online payment, insurance updates, e-signature, payment plans, and membership billing from a patient-facing portal.
Revenue and data-quality KPIs
Track clean-claim rate, denial rate, days in A/R, collection performance, cash per trip, projected unbilled revenue, and field documentation quality.
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