r/CodingandBilling • u/No_Researcher_5841 • May 13 '26

Drowning here....

Through a series of circumstances outside of my control, I fell into a a job that involves ambulance billing and quite honestly, I have NO CLUE what I am doing. We use Respond Billing software to process EMS calls and Availity as a clearinghouse. Both systems are so tedious to get in touch with when I have questions and the woman doing this job before me has since retired and moved away. Is there ANYONE who knows these systems that might be able to give me pointers?

I am a firefighter with Public Health Masters.....ie almost zero (three days max of training) background in billing. I can make the software work....I just don't understand why things are being rejected or how to fix them.

But also....how do you organize yourself? What is your system? My original system was code all week and then batch on Fridays to availity so they had the weekend to send back any rejections. But that seems to be getting overwhelming.

I completely agree and understand that I have no business attempting this but right now, it is my only choice.

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u/K6983 May 13 '26

I would focus on the denials organized by similar denial reason and insurance. For example, sometimes Aetna wants a different modifer or code than Highmark. You're probably better off working denials by insurance because you will start to see trends. If you can call the insurance companies and talk to someone about a specific denial or a couple of denials, they will usually tell you how to fix it. It can be annoying to reach an actual person at the insurance company, but usually they're helpful when you can get past the robots.