Billing modifier module for integrated emergency medical transportation database system

摘要

An integrated medical database system for the emergency medical transportation business. The system includes a dispatch and demographic module, a clinical module, an administration module and a billing module. Each module may communicate data with one or more of the other modules to form a system incorporating data sharing, thus achieving an end-to-end automation of emergency medical care accounting. Internal consistency checks are performed by the system to ensure that proper treatments are performed according to a chosen diagnosis. The system includes a billing modifier module operating on data from the dispatch and demographic module. In one embodiment, the billing modifier module applies Geographic Practice Cost Index (GPCI) and Metropolitan Statistical Area (MSA) billing modifiers based on modifiable computerized rules so as to provide a more accurate charge to the payer. The results of the billing modifier module are forwarded to the billing module.

主权项

1. A method of modifying charges for a bill using one or more transport associated geographic billing modifiers based on a location of an emergency encountered during emergency medical transportation, the method adapted to be performed on a processor, wherein the processor is connected to a memory to execute the following steps:
obtaining, by the processor, the location of a medical emergency remote from a hospital emergency room; checking, by the processor, a library comprising a plurality of geographic areas corresponding to one or more geographic billing modifiers against the location; and if a match is found of the location being within one of the geographic areas, applying, by the processor, the library's geographic billing modifiers to modify charges associated with the emergency medical transportation based on the location.