EMS Live in Wisconsin Podcast

>> Click for on-demand playback of this podcast.

In 2016, the number of non-emergent ambulance transports in the state totaled between 1,100 and 1,200 BLS and ALS runs per month.  In 2013, that number was between 200 and 400.  A dramatic increase.

According to MTM General Manager Danielle Dale, "We manage transportation for just under one-million eligible members in the state's Medicaid program".  Transportation includes bus, member or personal caretaker mileage reimbursement, taxis, wheelchair vans and non-emergent ambulances."

The Professional Ambulance Association of Wisconsin's President Patrick Ryan, along with board members Dana Sechler and Larry Knuth, have been holding regular conference calls the past few months with MTM to open lines of communication, and remedy some of the operation and billing challenges between ambulance services and MTM, the state's third party Medicaid transportation broker since 2013.

Two items highlighted in the podcast, include:

1. A two-day rule to file post-authorization with MTM for hospital to discharge, or hospital to hospital transfers.  Many ambulance services have difficultly submitting their bill within two-days, and any bill sent after two-days is declined.  MTM recently established a dedicated email address to help streamline the process.  In Illinois, MTM's contract with the state is a bit more forgiving with a post-authorization rule of 30-days.
   
2. If an ambulance is dispatched emergent, but the call is later deemed and billed non-emergent there is a black hole whereby the transporting ambulance service cannot file a billable claim.  Of course, this type of call was not pre authorized and is not included in the two-day post authorization rule.  Under this circumstance, MTM won't offer forgiveness and will decline the claim since they must follow the contract established with the Wisconsin Dept. of Health, so the transporting ambulance service can't bill and must write it off as non collectable.
   

To help hospitals and ambulance services with the process, file a claim and hopefully be reimbursed in a timely manner, MTM has offered a >> fact sheet to navigate.  The new email address to file a two-day post-authorization claim is wipostauth@mtm-inc.net.  To file an appeal, email ambulanceappeals@mtm-inc.net.

On Tuesday, January 10, PAAW completed an EMS Live in Wisconsin podcast with MTM General Manager Danielle Dale and Transportation Manager Chris Behling.  >> Click for on-demand podcast playback.