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ICASARRUS COUNTYJ <br /> <br />FROM: <br /> <br />DATE: <br /> <br />SUBJECT: <br /> <br />Caharrus County Board of Commissioners <br /> <br />Aubrey L. Attkisson, Director~, <br /> <br />Emergency Medical Services <br /> <br />January 10, 1995 <br /> <br />Changes in Medicare Rules & Regulations <br />for Ambulance Billing <br /> <br /> We were informed in August of 1994 there would be <br />changes in Medicare ambulance billing for ambulance providers <br />and that further details would be forwarded to us. On <br />October 20, 1994 information was received from the American <br />Ambulance Association and distributed to each County by the <br />North Carolina Association of EMS Administrators (NCAEMSA). <br />The information we received listed potential codes and the <br />effective date of January 1, 1995 for its implementation. On <br />October 27th, a position paper from the NCAEMSA was mailed to <br />CIGNA. As late as Decen~ber 1, 1994, no information had been <br />received by any provider from CIGNA/Medicare Administration. <br />We also at that time had not received pay profiles for 1995. <br />Since there are four methods to choose from, meetings were <br />held during the month of Dece~Der between representatives <br />from the NCA~MSA and CIGNA to determine which method of <br />payment NC would fall under. The NCAEMSA decided Method 4 <br />was best suited for North Carolina. In mid December, pay <br />profiles for Cabarrus County arrived but only included two <br />codes which affect patient charges. CIGNA was immediately <br />contacted, told of the mistake, and informed we needed codes <br />provided for the other eight services rendered by Cabarrus <br />County. To date this still has not been received. <br /> <br /> CIGNA has decided it will apply Cabarrus County's base <br />rate of $185 to the most serious patient condition code and <br />downgrade from that point. In the area of the lowest <br />priority Medicare code we will be losing approximately $40 <br />per approved Medicare filing, which includes approximately <br />50% of all Medicare forms filed. The other codes which fall <br />in the middle will have a decrease in collection ranging from <br />$15 - $35. <br /> <br /> Emergency Medical Services <br /> <br />P.O Box 707 · Cnn~nrd NC ?R~)6.f17n7 · (7N4~ 7Rfi. Qlq~ <br /> <br /> <br />