NEMT (Non-emergency Medical treatment)
NEMT (Non-emergency Medical treatment)
Non-Emergency Medical Transportation (NEMT) is a critical service in the healthcare industry, ensuring patients have reliable access to medical appointments, treatments, and procedures. However, billing for NEMT services can be complex due to varying payer guidelines, different transportation codes, and the need for precise documentation. At ARCDOTT, we offer specialized NEMT billing services designed to streamline your revenue cycle, ensure compliance, and maximize reimbursement for all types of non-emergency transportation services.
Whether you’re a transportation provider, a healthcare facility, or a broker managing NEMT services, ARCDOTT is here to help you navigate the complexities of billing, reducing administrative overhead and ensuring timely, accurate payments.
Complete NEMT Billing Solutions
We provide end-to-end billing services to ensure that all aspects of the NEMT service process—from trip scheduling to claims submission—are covered, improving your efficiency and bottom line:
- Trip Data Management: We help capture and manage essential trip information such as patient details, trip origin and destination, medical necessity, and special needs.
- Coding and Documentation: Proper coding and documentation are crucial for accurate billing. We ensure every NEMT trip is properly documented and coded using the appropriate billing codes (e.g., HCPCS, CPT), adhering to payer and regulatory requirements.
- Claims Submission and Follow-Up: Our team manages the submission of claims to all relevant payers, ensuring accurate coding and comprehensive supporting documentation. We also track claims, providing proactive follow-up to minimize claim denials and ensure timely reimbursement.
- Payer-Specific Billing: We understand the complexities of billing for different payers, including Medicaid, Medicare, private insurers, and managed care organizations, and customize our services based on each payer’s guidelines.
Common Codes Used in NEMT Billing
NEMT billing relies on specific codes to ensure proper reimbursement. ARCDOTT ensures accurate coding for each service, reducing claim rejections and speeding up reimbursement. Here are some of the most commonly used codes in NEMT billing:
1. HCPCS Codes (Healthcare Common Procedure Coding System):
- A0425 – Ground ambulance transport, basic life support, non-emergency.
- A0426 – Ground ambulance transport, advanced life support, non-emergency.
- A0428 – Ambulance transport, non-emergency, by stretcher van or wheelchair van.
- A0130 – Non-emergency patient transport for dialysis patients.
- A0140 – Non-emergency transport for patients requiring stretcher transport (e.g., dialysis or outpatient treatments).
- A0420 – Air ambulance, transport, emergency services.
2. CPT Codes (Current Procedural Terminology):
- 99499 – Unlisted service, used for miscellaneous services in NEMT when no specific HCPCS or CPT code is applicable.
- 99070 – Supplies and materials provided during the transportation, when applicable.
3. ICD-10 Codes (International Classification of Diseases):
- Z00.8 – Encounter for other specified examination (for non-emergency transport to a health service).
- Z51.81 – Encounter for medical care involving non-emergency transportation services (i.e., transport to medical treatments).
- Z99.81 – Dependence on wheelchair (for patients requiring wheelchair transport).
Billing for Special NEMT Services
Some patients require special accommodations during transport, such as those with medical needs, disabilities, or complex conditions. ARCDOTT ensures that specialized services are accurately captured and reimbursed:
- Wheelchair and Stretcher Transport: We ensure that patients requiring wheelchair or stretcher transport have the proper coding, including medical necessity documentation, to guarantee reimbursement for these specialized services.
- Dialysis Transport: For patients requiring transportation to dialysis appointments, we ensure that the trip is properly coded for reimbursement under programs like Medicare, Medicaid, or private insurers.
- Transportation for Non-Ambulatory Patients: Our team ensures that trips involving patients who are not ambulatory or require additional assistance are correctly billed, capturing all necessary details to reflect the complexity of the service.
Compliance and Documentation Management
In NEMT billing, compliance with regulatory guidelines and payer requirements is paramount. ARCDOTT ensures all billing practices meet the necessary standards, reducing the risk of audits and penalties:
- Medicare and Medicaid Compliance: We ensure your billing is compliant with Medicare and Medicaid regulations, including coverage rules, documentation standards, and medical necessity requirements.
- Medical Necessity Documentation: One of the most important elements in NEMT billing is ensuring that each trip is medically necessary. ARCDOTT assists with gathering the correct medical documentation to justify the need for transportation, particularly for non-emergency services.
- Patient Consent and Verification: We help manage patient consent forms, eligibility verification, and necessary signatures to comply with insurance and payer requirements.
- Audit Preparation and Support: Our team helps ensure that your NEMT services are fully documented and compliant, so your company is prepared for any audits, saving you time and reducing the risk of claim rejections.
Automated Claims and Payment Follow-Up
- Automated Claim Submission: We use AI-driven tools to automatically submit claims, ensuring all relevant information is included, reducing the likelihood of claim denials and speeding up the reimbursement process.
- Real-Time Claim Tracking: Our system provides real-time tracking of your claims from submission to payment, allowing us to proactively address issues and resolve them quickly, ensuring a more streamlined revenue cycle.
- Automated Denial Management: In the case of claim denials, we leverage automated workflows to quickly identify the cause of denials, make necessary corrections, and resubmit claims without delay.
Reporting, Analytics, and Insights
Gain complete visibility into your NEMT service performance with ARCDOTT’s detailed reports and dashboards:
- Revenue Cycle Dashboards: Our real-time dashboards allow you to monitor key performance metrics such as the total number of trips, claim approval rates, days to payment, and overall revenue generation.
- Trip and Route Analytics: Understand the volume and frequency of transportation requests, analyze routes, and optimize service delivery to increase operational efficiency.
- Payer Reports: Track payer-specific performance, allowing you to see which insurers are paying promptly and which are delaying reimbursement, helping you make data-driven decisions for future contracts.
- Financial Health Reports: Generate detailed reports on revenue trends, outstanding claims, and account receivables to better understand the financial health of your NEMT business.
Why NEMT Providers Choose ARCDOTT for Billing Services
- Expert Knowledge of NEMT Codes: Our team has a deep understanding of the unique codes and billing processes required for NEMT services, ensuring all claims are accurate and compliant.
- End-to-End Billing Services: We handle every aspect of your NEMT billing process, from trip management and coding to claims submission and follow-up, streamlining your revenue cycle.
- Advanced Automation: Our AI-driven solutions help automate claims submission, denial management, and claims tracking, reducing human error and speeding up reimbursement.
- Compliance & Documentation Expertise: ARCDOTT helps ensure full compliance with Medicare, Medicaid, and other payer regulations, protecting your NEMT business from audits and penalties.
- Real-Time Analytics & Reporting: Gain valuable insights into your NEMT service performance with customizable reports and dashboards that help you optimize your business operations.
Transform Your NEMT Billing with ARCDOTT
Managing NEMT billing can be complicated, but with ARCDOTT’s specialized expertise, advanced technology, and end-to-end service offerings, you can streamline your operations, reduce errors, and maximize reimbursement. Whether you’re a transportation provider, healthcare facility, or NEMT broker, ARCDOTT is your trusted partner in managing the complexities of NEMT billing.
Contact us today to learn how ARCDOTT can help optimize your NEMT billing processes, ensure timely payments, and improve your financial health. Let’s work together to take your NEMT business to the next level!