The American Taxpayer Relief Act of 2012 has hit all healthcare providers in the pocketbook pretty hard with the 2% across-the-board “sequestration” cuts in Medicare payments. For EMS, the 2% reduction in payments for ambulance service applies to all claims with dates of service after April 1, 2013. Operational changes are happening as a result of these payment cuts. Some ambulance services are looking to “retool” and streamline operations to become more efficient. In some cases, spending for new equipment is being placed on hold and pay increases for EMS staff are being deferred. Take Responsibility. Too often we hear field providers say they “didn’t get into EMS to do paperwork” or that the PCR is secondary to the actual patient care. That is a cop out. It ignores the reality that good patient care documentation is an essential part of providing health care. Accurate, honest and complete documentation of the patient’s condition and the treatment you provide is a critical aspect of providing EMS and the professional responsibility of every EMT and paramedic. EMS field providers play a critical role in the financial aspect of the EMS operation. The adequacy and accuracy of your PCR affects everyone–including field providers. When legitimate reimbursement dollars are left on the table because the documentation is not sufficient to support the claim for ambulance service, the entire organization suffers because it may not be able to afford new equipment or fund planned pay increases. Field provider documentation can make a huge difference in the finances of your EMS agency. Here are some tips for “tuning up” your PCR documentation: “Paint a Clear Picture.” Your PCR documentation must be accurate, complete and honest, and it should paint a clear picture of the patient’s condition. It should allow the reader to visualize the patient just as you saw the patient on the scene. Medicare’s standard for medical necessity for an ambulance comes down to this: Medicare will only pay for ambulance service when other means of transport are contraindicated. Your PCR documentation must address the issues that relate to this standard. Why does the patient need to go by ambulance now? When reading the documentation, is it clear why the patient cannot be safely transported by wheelchair van, car or taxi? In what position was the patient found, and how was the patient moved to the stretcher? What is the patient complaining of now, and what does the physical assessment reveal? What treatment was provided, and what was the response to this treatment? These are just a few of the questions that relate to “medical necessity” that your PCR documentation should address. Clearly, not all ambulance transports will meet the Medicare medical necessity rules, but your documentation must be complete, accurate and honest so that those who must decide whether the claim is billable will have all the objective information they need to make that decision. Although a 2% payment reduction may not seem like a lot of money, most ambulance services operate on relatively thin profit margins and very often the “payer mix” of those who pay the ambulance bills usually finds Medicare as the largest payer of ambulance service. And on top of this bad news, Medicare has increased its auditing of all healthcare claims, including ambulance claims. Medicare is more frequently denying payment where the patient care documentation does not support medical necessity for the ambulance service, where patient loaded miles aren’t accurately documented, or there’s no patient signature authorizing the ambulance service to submit the claim for payment in the first place. The bottom line: Your patient care report (PCR) is critically important when it comes to your ambulance service getting reimbursed properly for the services you provide. Clear, accurate and complete documentation can minimize the negative impact of the 2% sequestration cuts. Incomplete or sloppy PCR documentation leads to denied claims for payment or claims that can’t be submitted in the first place because the documentation is so poor. Now more than ever, we cannot afford inadequate PCR documentation. Obtain the Patient’s Signature. Medicare and other payers require that the patient sign an authorization form that allows your agency to submit the claim for payment. Without this authorization, in most cases the claim cannot be submitted to Medicare, and then the billing staff must put the claim on hold to try to chase down the patient to get it. This delays payment and costs your agency valuable time. Most patients are capable of signing the simple “assignment of benefits” form while in the back of your ambulance. And if the patient is mentally or physically incapable of signing, then there is a host of other authorized representatives who can sign on behalf of the patient. The bottom line is that getting a patient signature is extremely important to the entire billing process–the ability of your agency to get paid for the service you provide may hinge on the effort you make to get this signature.
A Post-COVID Shift in Global Supply Chains I begin this week by acknowledging Caribbean Community (CARICOM) Day, which is customarily July 4, but this year, will be commemorated on Monday, July 6. Also, on July 1, the Prime Minister of St. Vincent and the Grenadines, Dr. Hon. Ralph Gonsalves, will assume the chair of the CARICOM Conference of Heads of Government. I read a recent news report about a Jamaican company, Spur Tree Spices, beginning to export its products to Costa Rica. Given the importance of this development, I decided to look this week at CARICOM’s trade with Latin American countries, focusing specifically on Mexico, Central and South America. CARICOM’s natural trading partners are in this hemisphere, Canada, USA, and the countries in Latin America and the Caribbean. The region’s principal trading partners, however, are USA, European Union (EU) including Britain, and Canada. Where are the Latin American countries? You will note that there is something in common between CARICOM and its principal trading partners which is a historic relationship with Britain. In most of CARICOM, the official language is English, while in Latin America, it is Spanish and Portuguese. In the 18th and 19th centuries, there was a relationship with some countries in Latin America e.g. Venezuela. British West Indians would later find work and residence in Ecuador, Colombia, Honduras, Costa Rica, Panama and Nicaragua leaving a West Indian diaspora in most of these countries. In the 1990s and 2000s, there was CARICOM interest in promoting trade with Latin America. The CARICOM/Venezuela Trade Agreement was concluded in 1992; the CARICOM/Colombia trade agreement in 1994, and CARICOM/Costa Rica in 2004. There was quite a bit of activity around the Free Trade Area of the Americas (FTAA) negotiations which were abandoned in 2005. There was also the PetroCaribe Agreement with Venezuela which, besides petroleum, had a trade component. These trade agreements have been under-utilized. The relationship with Venezuela is now mired in political controversy. Trade in Services – For CARICOM, Tourism dominates By Elizabeth Morgan Trinidad and Tobago has partial scope agreements with Panama, El Salvador and Guatemala; Guyana with Brazil; and Belize has agreements with all her neighbours. You may be interested in… The twenty (20) Latin American countries from Mexico in the north to the tip of South America present CARICOM countries with a market of 595 million people. Panama is about an hour’s flying time from Jamaica in the north; Trinidad and Tobago is less than an hour from Venezuela in the south; Belize is in Central America; and Guyana and Suriname are in South America. Yet, for some in CARICOM, language and culture are barriers to trade. Trade figures between CARICOM and these Latin American countries have been consistently low. In 2019, total CARICOM goods exports to the 20 countries is estimated at about US$2.2 billion and imports at about US$3 billion giving Latin America a trade surplus. In trade in services, there has been some attempt to encourage tourism and investments from Latin America. There should be room to expand trade. Oct 1, 2020 What has been CARICOM’s Foreign Trade Strategy and Agenda? Sep 16, 2020 The question is now being posed; post COVID-19, should there be a relocation of global supply chains to regions, would Latin America and the Caribbean be able to benefit? I am more narrowly asking whether CARICOM countries could benefit? Would they be able to collaborate with Latin American countries in joint ventures? What has been CARICOM’s Foreign Trade Strategy and Agenda?By Elizabeth Morgan On February 20, 2019, my article in the Gleaner was titled “Needed: A CARICOM Foreign Trade Strategy and Agenda”. On September 2, 2020, I addressed “Jamaica’s Trade Performance: Turbulence Ahead”. This article was relevant to CARICOM generally. Last week, referring specifically to Jamaica’s Cabinet appointments in Foreign…September 16, 2020In “Indepth”Can CARICOM/Canada Trade and Investment flows be revitalized?By Elizabeth Morgan Canada, although having a longstanding relationship with the Caribbean Community (CARICOM) and its Member States, being in the hemisphere and the Commonwealth and the third major trading partner, does not usually generate much attention and scrutiny in the region. The planned visit by Prime Minister Justin Trudeau…July 22, 2020In “CARICOM”CARICOM’s Trade with Asian Countries: Mainly about importsOver the past months, I have written a series of articles on CARICOM’s trade with its trading partners – USA, Canada, United Kingdom (UK), European Union (EU), Latin America and Africa. I had also looked previously at trade discussions within the Commonwealth. This week, I will complete this series by…September 23, 2020In “Indepth”Share this on WhatsApp Resident diplomatic representation is also weak. Several Latin American countries are represented in the CARICOM region but few CARICOM countries are resident in Latin America. The main countries having more than one CARICOM embassy were Brazil, Mexico, and Venezuela. Trade-in-Services and Technology: More missed opportunities… There were proposals to negotiate trade agreements with Central America and MERCOSUR, neither of which came to fruition. There was also interest from Mexico and Chile. Promoting trade with Brazil has not borne fruit as intended. Oct 7, 2020 Submitted by Elizabeth Morgan, Specialist in International Trade Policy and International Politics Share this:PrintTwitterFacebookLinkedInLike this:Like Loading… There have been efforts to promote regional integration through the Community of Latin American and Caribbean Countries (CELAC) and the Association of Caribbean States (ACS) headquartered in Trinidad and Tobago. It has also been an objective of the Inter-American Development Bank (IDB). Free Trade Agreements Oct 14, 2020 Latin America and the Caribbean, however, is not a well-integrated region. COPA is the only Latin American airline which flies into the CARICOM region (Guyana, Belize, Barbados, Trinidad and Tobago, and Jamaica). Caribbean Airlines goes to Caracas, Venezuela. Otherwise, the route to Latin America is through Miami, Florida. Relations within the Western Hemisphere: an uneasy alliance CARICOM countries need to consider Latin America as a viable market for both goods and services. Language, culture, and market requirements should not be insurmountable barriers to trade. Spur Tree Spices is showing that there could be opportunities if CARICOM private sectors and governments are prepared to conduct further exploration even with projected economic recession.
Staff [email protected] Commander is the new title sponsor of the Independence Bowl, Independence Bowl Foundation officials announced Wednesday.The game will be known as the Duck Commander Independence Bowl.“The Independence Bowl is proud Duck Commander has agreed to become our new title sponsor,” said current Bowl Chairman, John Hubbard. “Their success has been phenomenal. As we both explored this opportunity, it was clear this national and growing worldwide success could help bring new business relationships to the Independence Bowl and enable us to showcase Louisiana as a Sportsman’s Paradise.”Bowl officials say the partnership will reinstate “Independence” as part of the bowl’s name following a one-year hiatus.“The Independence Bowl Foundation and this community are thrilled to have Duck Commander as our new title sponsor, and we’re honored they’ve chosen to place ‘Independence’ back in the bowl’s name,” incoming bowl chairman Paul Pratt said. “The Independence Bowl has a long history of bringing valuable and exciting sports entertainment to the Shreveport-Bossier City area. This is a new day and an excellent opportunity for college football in Louisiana.”Willie Robertson, CEO of Duck Commander, sees strong connectivity with the values the Independence Bowl offers its fans.“College football is very important to us, both as fans and former players. The Independence Bowl is what college football is all about: It has great tradition and it’s All-American,” said Robertson, whose father founded the company 42 years ago in West Monroe, La. “Add in its Louisiana location and appreciation of the military and it creates a winning partnership for both parties, It’s especially exciting to see our brand help the Independence Bowl create an awesome fan experience.”According to Bill Glenn, president of The Breakout Group and the key architect of this partnership, this deal truly differentiates the bowl.“College football, patriotism, military appreciation and the state of Louisiana offered a nearly perfect strategic alignment. The partnership puts the Independence Bowl in a distinct, national position among nearly 40 bowls in 2014 and it offers Duck Commander an excellent promotional platform in their home state.”Glenn added, “The bowl will be distinguished by its title partner, name and its opportunity to also enhance the fan experience with major events related to outdoors, music and cuisine. In effect, the bowl can extend its calendar and potentially offer bowl sponsors additional value.”The partnership with Duck Commander – the Independence Bowl’s sixth title sponsor – will run through 2019. The Independence Bowl Foundation’s current contracts offered stability in establishing a longer term agreement with Duck Commander. Its broadcast agreement with ESPN runs through 2019. In addition, its primary conference partnerships with the Atlantic Coast Conference and Southeastern Conference and its secondary agreements with Conference USA and the American Athletic Conference run through 2019.The date and time of the 2014 game will be determined in the coming months.Premier Diamond BoutiqueHong Kong’s first lab-grown diamond empirePremier Diamond Boutique|SponsoredSponsoredUndoInstant Voice TranslatorInstant Voice Translator (43 Languages) Takes Hong Kong By StormInstant Voice Translator|SponsoredSponsoredUndoPerfect-Dating.comAre You Ready to Meet Cool Guys in Tung Chung?Perfect-Dating.com|SponsoredSponsoredUndoStanChart by CNBC CatalystBlockchain Is Changing the Game for Trade Financing. Here’s How It’s Driving Future Global Trade.StanChart by CNBC Catalyst|SponsoredSponsoredUndoDating.comThe Most Handsome Guys In Hong Kong On This Dating SiteDating.com|SponsoredSponsoredUndoStrategyCombatIf you own a Computer, then you have to play this Game. No Install.StrategyCombat|SponsoredSponsoredUndo