End Surprise Billing for Ambulance Rides with VectorCare Hub

Surprise medical bills happen when a member receives an invoice for the difference between the out-of-network provider’s fee and the amount covered by their Medicare Advantage plan. It's often for care or services that the member did not know were out-of-network.

Surprise billing is such a significant problem, the U.S. Departments of Health and Human Services (HHS), Labor, and Treasury, and the Office of Personnel Management have INTRODUCED THE “NO SURPRISES ACT” TO PROTECT CONSUMERS.

However, the legislation, which goes into effect in 2022, does not address out-of-network ambulance rides － this means your members are still at risk of receiving a surprise medical bill.

This exemption is critical because ambulance rides often result in a surprise bill:

• 51% OF EMERGENCY AMBULANCE RIDES RESULT IN A SURPRISE BILL
• 39% OF NON-EMERGENCY AMBULANCE RIDES RESULT IN A SURPRISE BILL
• IN 7 STATES －CALIFORNIA, COLORADO, FLORIDA, ILLINOIS, TEXAS WASHINGTON, AND WISCONSIN －MORE THAN TWO-THIRDS OF EMERGENCY AMBULANCE RIDES RESULTED IN A SURPRISE BILL

Your Medicare Advantage plan can reduce the likelihood that members will receive a surprise medical bill by using VECTORCARE HUB’S COMPREHENSIVE PATIENT CARE LOGISTICS SOLUTION to manage a healthy and extensive network of contracted ambulance providers.

Use VectorCare Hub to Manage Contracted Emergency and NEMT Ambulance Services

Medicare Advantage plans can quickly grow and manage a large network of third-party ambulance providers for emergency and non-emergency medical transport (NEMT) from a single system.

The larger your network of contracted transportation providers is, the less likely your members will utilize an out-of-network ambulance service.

However, it can be challenging to maintain and grow your in-network providers without the right technology.

Here are seven ways VectorCare Hub can help your Medicare Advantage plan create and manage a healthy network of ambulance services to minimize the risk members will receive a surprise medical bill for transportation.

1. Establish a source of truth for in-network transportation providers accessible via a single user interface.
2. Add and remove NEMT brokers and vendors as needed.
3. Customize information fields for specific geographic locations or partners within your network.
4. Manage contracted pricing, schedule member transportation, and pay invoices from a single system.
5. Gain visibility into your network with comprehensive reporting.
6. Reduce operational inefficiencies associated with managing NEMT brokers and ambulance providers manually or across systems.
7. Grow and maintain in-network partnerships to better serve your members.

Medicare Advantage plans can also utilize VectorCare Hub to FIGHT NEMT FRAUD, WASTE, AND ABUSE. Undetected fraudulent claims, such as excess mileage, may unwittingly be passed along to members in the form of a surprise bill.  

Help Members Avoid Surprise Medical Bills

Members trust their Medicare Advantage plan to cover the emergency and non-emergency ambulance services they need to manage their health.

Since the “No Surprises Act” does not cover ambulance services, Medicare Advantage plans must take an active role in protecting members against surprise medical bills.

The larger and healthier your in-network of emergency and NEMT ambulance service providers, the less likely members are to ride in an out-of-network ambulance.

Learn how VECTORCARE HUB’S PATIENT CARE LOGISTICS SOLUTION can help Medicare Advantage plans grow healthy and extensive in-network and contracted emergency and NEMT ambulance services ﹣ and say goodbye to surprise medical bills.  

‍

Want to learn more about costs savings in healthcare? Check out our last post, all about the Hub roadmap to cost savings.