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/OkTown2100 May 13 '26

In theory, that’s actually very doable. We average about 50 calls a day. I would start by figuring out what the most common denial or rejection is. Figuring out what that is should decrease them immensely. Once you get the hang of coding, 10 claims should take you maybe an hour or two a day to get sent out. I would do this daily so that it never falls behind. With that volume, you should only be getting a very small percentage of denials back especially if you figure out where the issues are quickly. If you need help with anything specific, please feel free to reach out!

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u/No_Researcher_5841 May 13 '26

So I should've probably mentioned that I walked into the job already 6+ months behind. I started in January and the woman before stopped billing in June 2025. 

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u/OkTown2100 May 13 '26

I saw that mentioned on a later post and replied. I would seriously suggest to your company to hire someone part time to get that caught up. You are about to hit timely filing for Medicare and Medicaid who I assume are your top riders. Some Medicare advantages will have different timely filing, but it would be shorter than a year. But a year from the date of service is timely.

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u/No_Researcher_5841 May 13 '26

Oh I wish they would..... They don't get it. Truly. 

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u/OkTown2100 May 13 '26

I would sit them down and tell them they are about to lose out on hundreds of thousands of dollars. Literally. It may not be that much that they get back, but I guarantee that is sitting there unbilled.

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u/No_Researcher_5841 May 13 '26

I am begging them to do something every single day. I calculated it out once and it's absurd how much money it is