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Comparative Billing Report

July 31, 2013
AAA Member Advisory
TO: AAA Membership
FROM: David M. Werfel, Esq.
RE: Comparative Billing Report

You may have recently received a letter from SafeGuard Services, LLC with the results of a Comparative Billing Report. If not, you probably will very soon.

In sum, CMS hired SafeGuard Services to review ambulance claims and do a comparison of each entity versus other ambulance providers for transports for dialysis. Claims selected for this study were BLS non-emergency claims paid in 2012.

They looked at the percentage of BLS non-emergency transports that were for dialysis (using the "G" or "J" modifier). They also looked at the percentage of claims that were from a dialysis facility to a residence, from an origin other than a dialysis facility to a residence, from a dialysis facility to a SNF and from an origin other than a dialysis facility to a SNF.

The Comparative Billing Reports provide charts and graphs listing the volume of these transports with comparisons to other ambulance providers in your state and nationally.

THIS IS NOT AN AUDIT - - it is only informational, so that you can see how you compare to other ambulance organizations. Unfortunately, SafeGuard Services grouped all providers who bill BLS. That means you have some providers that bill only emergency, some who bill only non-emergency and others who bill both. Thus, the comparison of your non-emergency data to others may be very high, particularly where there are many fire departments and other emergency only providers.

Again, it is informational only. The comparisons to others in the state or nationally will have little, if any, meaning.

Guaranteed cash flow during transition.