Working with a Detached Biller

A detached biller is an outside contractor who performs insurance claims work on behalf of your company. The detached biller accepts run reports, and sends back EOBs.

AngelTrack was designed to support this arrangement, so that you can convert your operation to mobile/paperless/cloud without perturbing the relationship you already have with your billing contractor.

Certainly there are advantages to inviting your outside biller to integrate -- to make use (free of charge) of your AngelTrack cloud server... but if he or she does not wish to integrate, that's fine too.


An Urgent Warning About Detached Billers

Detached billers impose certain risks; learn the potential hazards so you can protect your cashflow.

This industry does not self-police and is not regulated

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The EMS billing industry does not self-police and is not subject to direct regulation, nor to required certifications. It is still the wild west.

There are certifications available (e.g. CAC, CACO, CAPO), but they are voluntary. Not all EMS billers hold any of these certifications, and even if they do, they may not keep them renewed.

We have a training video you can watch to educate yourself about the EMS billing process. You will learn how to measure your biller's performance, and you will learn what you can rightfully demand from them. It is one hour long, and just covers all the basics -- just enough to give you a bird's-eye view of the process.

If you have chosen to trust a detached biller with your receivables, protect yourself with this free education.

You can only monitor what they allow you to monitor

When all of your receivables are in somebody else's billing software, then you can only monitor the things they allow you to monitor. All of AngelTrack's workflow and cashflow reports will be useless.

Consequently, if your biller becomes irresponsible (either suddenly or gradually), you might not find out until your cashflow is already in jeopardy.

Protect yourself by scrupulously entering all EOBs into AngelTrack. You have the right to demand them, and you have the right to receive them in electronic format (as X12.835 EDI documents) for quick import into AngelTrack. (If the phrase "X12.835 EDI document" is unfamiliar to you, read the EDI primer.)

Demand that the biller send you the past week's EOBs every week, without fail, so that you can spot problems sooner rather than later.

Alternatives

Instead of allowing your biller to remain detached, you can require them to perform your billing in AngelTrack. Remember, they can access the system from their office, or from home, or from anywhere.

Nor does it cost anything. You can freely create user accounts for your biller's employees to use. It is all included in your AngelTrack license.

Another alternative is to bring your billing in-house. As an AngelTrack customer, you already have a full-featured EMS billing system, including training materials. The billing process in AngelTrack is straightforward, and is designed specifically for EMS. If you watch the training video above, the last chapter of the video includes a walkthrough of the entire process.


Sending Reports Out to the Biller

There are two data offload points in AngelTrack, from which your outside biller can pull data for billable calls.

AngelTrack recommends against the offload of billing data for calls that have not yet graduated from QA, as the QA review process can alter the service level that was provided.

Both of the data offload points below assume that you will use AngelTrack for QA review, and therefore will not be offloading calls until after they've reached  Billing office . They also assume that you will not be offloading data for calls that were delegated to an affiliate who is marked ☑ Independent billing, nor calls that were marked non-billable; both of the aforementioned will go straight to  Finished  after graduating or skipping QA.

Offloading data using the workflow API

AngelTrack has a webservice by which your biller can automatically pull data for trips that are ready for billing, and in the process, advance them to  Awaiting payment  or  Finished .

To learn more, read the API Reference for AngelTrack's PostprocessWorkflow webservice.

Offloading data using AngelTrack's user-interface / Master Billing Queue

AngelTrack's user-interface has a data-offloading facility in the Master Billing Queue, accessible from the Billing Home page.

You will use the queue with its default filter settings, in order to show only those trips which are at  Billing office . The queue will pick up all billable trips that have passed QA, without waiting for someone to perform insurance reviews.

The queue has a bulk exporter that can bundle up run reports in a .ZIP file. Each run report can be exported as a NEMSIS version 3 XML file (if your outside biller's software can import NEMSIS 3) or as a PDF file. Both formats include all attached documents, signatures, ECG strips, etc, and so either format is fully suitable for sending to an outside biller. Let the outside biller decide which format he or she prefers.

The queue can process 100 items at a time. After exporting the items and verifying that the data downloaded correctly, click the "Advance to 'Finished'" button to push the marked trips to  Finished . Those trips will then drop out of the queue, allowing you to select the next 100 trips.


Monitoring the Performance of a Detached Biller

It is inherently difficult to monitor a detached biller's activities and performance.

AngelTrack can provide assistance -- but only if someone in-house is uploading into AngelTrack all of the EOBs that come back from the biller, as well as all invoice payments. Only then can the software help you track your revenues and denials, verify no receivables were overlooked, and prove (yay or nay) that your biller is doing their job right.



Help Index - AngelTrack EMS Billing Software