This proposed EMS cost recovery Program requires no additional spending by the state Medicaid agency beyond what it pays providers now. PCG works on behalf of EMS providers to accurately identify all allowable revenue sources, ensure compliance, and prepare annual cost reports.
Using our web-based cost reporting system, our team will work with you to:
PCG’s web-based cost reporting system can be customized to meet a state’s unique EMS cost reporting requirements. Our system integrates the federally-approved cost reporting template into an easy-to-use online application. The system streamlines data input and calculations and implements numerous real-time validation checks for quality assurance and accuracy. The cost reporting system handles all calculations related to the determination of allowable costs and cost settlement, and it allows providers to easily create financial and billing reports to view year-to-year trend analysis.
With a well-designed EMS supplemental payment program, agencies will see that the gap between the cost of providing services to Medicaid recipients and what Medicaid pays for those services can be significantly reduced. A sound supplemental payment program will increase Medicaid reimbursement for states and the providers that partner with them. These incremental revenues can be realized with limited cost to the state and EMS providers. PCG’s consultants and cost reporting professionals have the experience and expertise to assume the administrative burden throughout all phases of the design, development, and implementation of a supplemental payment program. Let the PCG team work for you.
PCG has more than 30 years of experience developing, implementing, and administering EMS revenue enhancement programs. PCG will apply our proven approach, deep program knowledge, and team experience to design and/or implement an EMS cost recovery program for your state that leverages existing EMS expenditures to maximize Medicaid revenue related to the delivery of emergency medical services. Once a program is designed and implemented in your state, we can also work with you at a state and/or provider level to develop online tools, define processes, stay compliant, and maximize your reimbursement.
Ask us about our successful EMS revenue maximization projects, including the following:
Designed and developed the ambulance supplemental payment program and have worked with the state Health and Human Services Commission and the provider community to implement and operate the program for last eight years.
Developed a state-wide Certified Public Expenditure (CPE) program that provides additional Medicaid reimbursement to ambulance providers through a cost settlement process. Designed and implemented a web-based platform to expedite cost reporting, providing program oversight to more than 70 EMS providers across the Commonwealth.
In FY16, PCG provided Cost Recovery services for over 30 participating Public Emergency Medical Transport (PEMT) program providers.
From FY11-FY16, PCG helped more than 25 providers participating in the Ambulance Supplemental Payment Program (ASPP).