Regulatory demands and staffing shortages are putting pressure on EMS agencies to streamline workflows, reduce errors, increase revenue cycle efficiency and empower data-driven decisions.
To that end, AI and automation technologies such as offered by AIM EMS Software & Services through its AIM Intelligence platform are streamlining EMS billing.
Leveraging human expertise to build smarter automation
Michelle Corey, AIM vice president of operations, explains that AIM harnesses the deep expertise of experienced billers to systematically build automation capabilities, implement performance metrics and establish quality assurance protocols that continuously enhance their AI systems. Rather than simply replacing human knowledge, the company strategically captures the insights of seasoned billing professionals to create more sophisticated automation that learns from real-world expertise, allowing human staff to focus on complex, judgment-based tasks that drive further AI development.
“EMS billing presents unique complexities that require specialized expertise,” Corey explained. “Certain tasks demand the nuanced judgment that only experienced billers can provide. Our goal should be to free them up to focus on these high-value activities by automating the routine processes that don’t require their specialized skills.
“That started with a deductible management tool, with the goal to have it work smarter for billers in terms of giving them the ability to set up specific criteria so they don’t have to review. It just automatically gets released by what that criteria was.”
The tool has become a big hit and standard feature in AIM’s billing software.
Key features that streamline billing efficiency
AIM Intelligence empowers EMS billing professionals by reducing the time spent on manual tasks such as data entry, reconciliation and invoice generation, allowing staff to focus on mission-critical operations and high-value decisions.
Its top three features are deductible management, Medicaid management and the ICD-10 (International Classification of Diseases, 10th Revision) list that offers suggestions based off past similar criteria met in a patient care report.
Addressing common EMS billing pain points with AI
Without a doubt, EMS billing and operations are challenged by several major pain points.
AIM Intelligence is designed to address those pain points:
- Revenue cycle inefficiencies. By automating sub-tasks related to patient data capture, claims review, denial management and payment posting, AIM significantly reduces manual labor and billing cycle delays.
- Data fragmentation: It consolidates operational, clinical and financial data for more cohesive analysis and reporting. Configurable workflows route billing items for approvals, escalate discrepancies and generate recurring invoices without manual intervention.
- Compliance risks: Real-time rule validation helps agencies stay aligned with state and federal billing requirements and contractual obligations. It can proactively flag missing documentation, inconsistencies or coding issues to help ensure accurate, auditable documentation and coding practices that meet evolving EMS regulations and ensure the agency is prepared for internal and external audits. It minimizes human mistakes, which is critical for grant-related billing and reimbursement processes tied to strict standards.
- Staffing shortages and burnout: Automation minimizes repetitive tasks, alleviating the administrative burden on billing staff and improving job satisfaction. As call volume or service complexity increases, automation allows billing operations to scale without hiring additional personnel or introducing bottlenecks.
- Inconsistent financial performance: AIM helps maximize collections and reimbursement rates by flagging anomalies and opportunities through intelligent analytics. Automated billing expedites the submission process and improves the accuracy of supporting documentation, helping agencies get reimbursed sooner.
- Custom reporting: Metrics can surface actionable insights, such as billing trends, aging accounts and common error patterns, helping EMS operations make informed decisions and improve processes.
Improving Medicaid and deductible management
Medicaid management benefits from the tool by optimizing Medicaid reimbursement with automated Medicaid eligibility checks and minimizes lost revenue with automated deductible management.
Additionally, it saves time with scheduling automation for reporting, printing and transmitting tasks and improves workflow collaboration through customizable reports and work queues that can be saved and easily shared.
“It’s set up to do all of those manual administrative tasks for you based off certain configurations for what that provider wants to do,” Corey noted.
A recent addition to AIM Intelligence is payer profiling, designed to allow for specific field configuration based off what type of transport it is and who the payer is.
Depending on the payer, there might be specific fields in a bill that need to be coded to transmit or to submit that claim to the insurance.
AIM Intelligence is especially useful for services that might be bringing on new billers. It ensures the fields are populated based off a certain transport type and a specific payer.
For example, if an insurance company has certain requirements, AIM Intelligence will will use the configuration setup for that particular insurance company’s needs.
AIM Intelligence’s deductible management tool is designed to maximize revenue and reduce operational costs by automatically keeping tabs on the deductible status on a specified schedule against a specified threshold.
The software keeps track of each payer’s timely filing date to ensure it isn’t missed. Once the deductible threshold is hit, the software releases the claim to the payer.
AIM’s billing platform integrates with records systems, automatically pulling in service data to support accurate billing and reduce redundant data entry.
In the case of AIM Intelligence, automation is not replacing human expertise but instead enhancing it. Health care leaders are embracing it: 92% of health care leaders say investing in AI and automation for revenue cycle operations is a top priority, and nearly half have already started using these tools.
For more information, visit AIM EMS Software & Services.
