The preceptor at my internship had me conduct a record audit review for all flights that had Medicare as the payor. Apparently, there were a large volume of charts being billed out without going through the review process. It appears that a vast majority of the charts slip through the review process because the coders were sending the charts directly to the billing specialists to the billed out and the billing specialists were billing the charts out, without verifying to see if they were reviewed to meet Medicare guidelines for Air Ambulance. Unfortunately, the margin of errors was due to a high turn over in employees. A small percentage of the new employees were not familiar with the guidelines for Air transportation, including myself.
My preceptor thought this topic would be a good idea for my project as well as a new training session for new employees. The purpose of this assignment was to implement a Medicare transport review policy for new employees by conducting a record review. In order for me to present my presentation I had to get a better understanding of the guidelines as well as the workflow of the record. For one week I followed the flow of a medical record by training with each team that handles the medical record.

Regulations

According to the Emergency Medical Treatment and Active Labor Act (EMTALA), rotary and fixed wing air ambulance services are covered when a patient is transported to the closest appropriate facility that is inaccessible by ground, great distances, or obstructed by obstacles such as heavy traffic. The Ambulance Fee Schedule was originally implemented in April 2002 based on a Final Rule published in the Federal Register. The elements of this final rule allowed for payment for various air and ground ambulance services. The payment for these services is based on the type of service provided and on the geographical points of pick up. The final rule also establishes increased payment for services furnished in rural areas based on the location of the patient at the time the patient is placed on board the ambulance (CMS.gov).