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FAQs

AmbCoach, Inc. is located In Pennsylvania, approximately 60 miles north east of Pittsburgh, PA. Over our 22+ years in business we have from time to time provided on-site services to an Ambulance Agency with such a need. Those partnerships are typically built to allow the Ambulance Agency to reclaim the process in-house after a defined period, should they desire. This arrangement is predicated on size, need, and cost.
AmbCoach, Inc (AmbCoach Reimbursement Management Solutions) has been providing Accounts Receivable Management (Revenue Cycle Management) to medical transportation services since 1996, celebrating our 20th anniversary in 2016.

The Owner & President, Kimberly M. Walk has over 39 years of physician, nursing home, and medical transportation administrative and accounts receivable management experience. Kimberly has served on the Board of Directors for the Ambulance Assn of Penna. (AAP) for 27 years and has served in the capacity of Reimbursement Chair for the AAP for 27 years as well.

The Office Manager, Fran Schroth has 25 years of experience in medical transportation accounts receivable management.

Various staff members have attained their Medical Secretary degrees, and all staff are trained and skilled in Ambulance Billing and Reimbursement Federal and State rules and regulations. AmbCoach, Inc. employees receive training through the Ambulance Assn. of PA, the American Ambulance Assn., the PWW CAC and ABC360 programs, Medicare MedLearn, and various other relevant and timely educational programs. All AmbCoach billing staff are trained to effectively use ICD-10 coding in accordance with Federal and State ambulance billing guidelines.
AmbCoach, Inc. typically charges a flat per billable trip fee that is invoiced the first week of each month, for the previous months work. This flat fee includes all insurance verification/validation, billing/coding, follow up, payment posting, and reporting. The Center for Medicare and Medicaid Services (CMS) has strict guidelines related to the billing agency charge structure. Although AmbCoach, Inc. has no access to Client Medicare or Medicaid dollars, we at AmbCoach feel there is much less question of billing compliance when the billing agency financial structure is not dependent upon Client billable or collectable dollars.

Medicare Claims Processing Manual Chapter 1 - General Billing Requirements Table of Contents (Rev. 4001, 03-16-18)
30.2.4 - Payment to Agent - Claims Submitted to Carriers (Rev. 1, 10-01-03) A3-3488.1, B3-3060.10

A. Conditions
The FI or carrier makes payment in the name of the provider (Carriers additionally may pay in the name of supplier or employer, facility, or organized health care delivery system.) to an agent who furnishes billing or collection services if:
  • The agent receives the payment under an agreement between the provider and the agent;
  • The agent’s compensation is not related in any way to the dollar amount billed or collected;
  • The agent’s compensation is not dependent upon the actual collection of payment;
  • The agent acts under payment disposition instructions which the provider may modify or revoke at any time; and
  • In receiving the payment, the agent acts only on behalf of the provider (except insofar as the agent uses part of that payment to compensate the agent for the agent’s billing and collection services).
For this purpose, an agency is an entity that provides computer and other billing services to prepare claims, and receive and process Medicare benefit checks for the provider, supplier, physician or other practitioner.

B. Background
The primary purpose of this exception is to permit computer and other billing services to claim and receive Medicare payment on behalf of and in the name of the provider, supplier or eligible party). The conditions for payment insure that the billing agent has no financial interest in how much is billed or collected and is not acting on behalf of someone who has such an interest, other than the provider/supplier itself.

The conditions specified in subsection A do not apply if the agent merely prepares bills for the provider and does not receive and negotiate the checks payable to the provider/supplier.

The conditions specified in subsection A also do not apply where the entity receiving payment in the name of the physician qualifies to receive payment for the physician’s services by definition in law and regulations. Thus, a hospital which is entitled to bill and receive payment in its name for a physician’s service under §30.2.7 may bill and receive payment in the physician’s name (negotiating the checks under a power of attorney) even though its compensation is related to the amount billed or collected or is dependent on collection.

AmbCoach works with each Client to determine what billing and payment structure best suits the Ambulance Agency needs while maintaining compliance with federal and state requirements.
AmbCoach, Inc. is fully committed to compliance with all federal and state regulations related to billing agency services for medical transportation.
AmbCoach, Inc. maintains skilled and educated staff to perform all of the billing and accounts receivable management processes internally. AmbCoach staff include those with Associate Degrees in Specialized Business/Medical Secretary and those who have attained Certified Ambulance Coder (CAC).

See “Experience” above for additional information.
AmbCoach, Inc. works in partnership with each Client. The Owner, Office Manager and Assistant Office Manager are easily accessible at the business office, or after hours via cell phone and email. The Billing/Coding Department and the Follow up Department each have a senior staff member in a supervisory role who are able to lend assistance to a Client at any moment. AmbCoach, Inc. also welcomes Client visitation, and we are willing and available to visit a Client site to review reports, or discuss accounts receivable management concerns.
AmbCoach, Inc. periodically provides seminars or conferences for Clients to provide updates related to medical transportation billing and accounts receivable management rules and regulations. Client on-site documentation training for field staff is also available thru AmbCoach, Inc. The documentation program covers essential information factors for comprehensive medical care documentation and provides insight to the field provider on how their patient care documentation translates to the billing office.

AmbCoach also provides periodic information bulletins posted to each Client menu on our secure web portal for education and clarification of billing related matters.

AmbCoach, Inc. working in partnership with you as a Client, is open and available to meet with you. We urge you to engage in the billing process through one-on-one phone calls, team conference calls, and on-site visits. We don’t have to do a formal education session, if your preference is just to discuss specific concerns or find out what’s on the billing horizon.
AmbCoach Verification/Billing/Coding staff prepares all ePCRs for the billing process, whether insurance payment eligible or private pay patient invoiced. All ePCRs are insurance verified through Trizetto, Navinet, PA DHS EVS, Novitasphere, and individual insurers as situationally required. Each ePCR submitted for billing is also checked for accurate and complete Assignment of Benefit/Encounter Signatures, Advanced Beneficiary Notices (as required), and Physician Certification Statements (as needed). ePCRs are also reviewed for medical necessity documentation, and dispatching information based on the insurance requirements situationally. When there is missing information, AmbCoach will reach out to the Client and/or Patient to explain and obtain the required information. This is a Patient Engagement step in the billing process that is the first important step in getting you paid.
Clients have the opportunity to choose a method that best suits their business model. We have several different models available for Clients to choose from and we are happy to work with you, the Client to develop a customized process when necessary.

Patients and Insurers who wish to make electronic payment can do so via our secure payment portal at www.ambcoach.com and click on the $.
AmbCoach, Inc. provides each Client with daily, weekly, monthly, yearly reporting. Reporting is provided electronically via the AmbCoach secure web portal. Our team will work with yours to provide the appropriate reporting to support your organizations management needs. When you need reports, you will have them!

AmbCoach will also work with your accounting/auditing firm if you desire. We are able to provide them the information needed to fulfill the reporting needs as they outline.
AmbCoach believes that Client and Patient engagement is essential for appropriately turning patient care into dollars. We urge both Clients and Patients alike to work in partnership with us to build an amicable solution to bringing in healthcare dollars in a timely manner with as little inconvenience for the Client and Patient as possible.

Clients and Patients are provided with toll-free phone access to AmbCoach. The ambulance billing team will work with you and your patients as often and long as necessary to answer questions, explain insurance rules, and develop reasonable and timely payment processes based on each patients’ medical transportation insurance coverage situation.

Todays’ healthcare reimbursement arena places much more responsibility on the patient than ever before. Higher deductibles and co-payments/cost shares are creating greater private pay collection headaches. AmbCoach will work with you to offer efficient and user-friendly payment options for your private pay consumers.

Patients and Insurers can provide secure information and electronic payment via www.ambcoach.com or can email questions via the website to patients@ambcoach.com.
AmbCoach, through our efforts to maintain 100% compliance, maintains restricted access to every area of our structure where billing services are performed. When visiting AmbCoach, persons are required to check in and remain with assigned staff persons at all times. Visitors are never allowed to view any patient information, or be party to any internal discussions related to patient protected health information.
All Billing System Data is backed up daily by our contracted secure cloud software vendor. Data and backups are stored at various secure locations to avoid system failures in times of disaster or catastrophic loss.

AmbCoach, Inc. uses Center Square (Tritech Software Systems Respond Billing) as our billing platform. This software has the ability to integrate with the majority of ePCR software systems currently on the market. AmbCoach will happily work with your organization and any ePCR software vendor you employ to pull your data into our processes for billing and accounts receivable management purposes.