In November the centers for Medicare and Medicaid Services (CMS) announced the 2007 inflation factor for ambulance services will be 4.3%, a substantial increase over the 2006 factor of 2.5%. It's not too often we get good news from Medicare, so enjoy it while you can.

We have had so many questions recently regarding charging out an ALS assessment that we felt a refresher was probably in order.

Briefly, if you are dispatched to a scene ALS and after you arrive you find that the patient could safely be transported BLS you can release the patient to a BLS crew and still bill the transport ALS1 Emergency (as long as the BLS crew is also from your agency). The criteria for an ALS assessment are that the response must be emergent, that the patient’s reported condition required an ALS response according to your protocol, they are transported to a medical facility and a Paramedic examines the patient.

In addition, there are a few documentation musts when billing an Assessment. The patient’s condition and level of dispatch must be included in the narrative of your MIR. Also in your narrative you must state that an ALS Assessment was done and by whom. For example, “Patient examined and released to BLS crew by Paramedic Jones.”. If all criteria are met, don’t hesitate to bill for these assessments.

Last month we were visited by Mark Rapoza and Linda Mastin from the Pierce County team of the State Auditor’s office. We extended an invitation to them so they could see our operation first hand.

They are in the process of designing an audit guide specifically for Systems Design clients. This manual will be made available statewide to Fire District Auditors and will serve to educate and guide them through your audits.

We are very excited to be invited to participate in its development. It is our hope that by working together now, we can reduce the time spent by your staff when your audit rolls around. Once the guide is completed, we will be posting a list of recommendations about audit preparations on our website. Again, thanks to Linda and Mark for this valuable opportunity to serve our client needs.

Jennifer Flanagan (Forney)
- Office Assistant

We've had a wedding! Best wishes to Jennifer, our billing unit clerk, and her new husband Andy. Jennifer joined the System Design team in July. She brought with her five years medical records experience and we are very fortunate to have her. She is an invaluable resource to our Account Managers. Now that all that wedding planning is done, Jen is looking forward to spending time with her three year old nephew Jay and finding time to knit.

December 22 - Close at noon.
December 25 - Closed
January 1 - Closed

Three sons left home, went out on their own and prospered. Getting back together, they discussed the gifts they were able to give their elderly Mother for Christmas.

The first said, "I built a big house for our Mother." The second said, "I sent her a Mercedes with a driver." The third smiled and said, "I've got you both beat. You remember how Mom enjoyed reading the Bible? And you know she can't see very well any more. I sent her a remarkable parrot that recites the entire Bible. It took Elders in the church 12 years to teach him. He's one of a kind. Mama just has to name the chapter and verse, and the parrot recites it."

Soon thereafter, Mom sent out her letters of thanks: "Milton," she wrote one son, "the house you built is so huge. I live in only one room, but I have to clean the whole house."

"Gerald," she wrote to another, "I am too old to travel any more. My eyesight isn't what it used to be. I stay most of the time at home, so I rarely use the Mercedes. And the driver is so rude!"

"Dearest Donald," she wrote to her third son, "you have the good sense to know what your Mother likes. The chicken was delicious!"

Although we always welcome your phone calls, there are times you may wish to contact us via e-mail.

Gina Behrens	GinaB@SystemsDesignNW.com
Shelley Brewington	ShelleyB@SystemsDesignNW.com
Lori Christenbury	LoriC@SystemsDesignNW.com
Cris Connors	CrisC@SystemsDesignNW.com
Judy Dunn	JudyD@SystemsDesignNW.com
Tammy Flanagan	TammyF@SystemsDesignNW.com
Karen Guay	KarenG@SystemsDesignNW.com
Laurel Hoch	LaurelH@SystemsDesignNW.com
Kim Mayes	KimM@SystemsDesignNW.com
Lois Pierce	LoisP@SystemsDesignNW.com
Lisa Rogalsky	LisaR@SystemsDesignNW.com
Sue Schmitt	SueS@SystemsDesignNW.com
Juls Smith	JulsS@SystemsDesignNW.com
Cindy Tomeo	CindyT@SystemsDesignNW.com
Susan Wytko	SusanW@SystemsDesignNW.com
Roger Zegers	RogerZ@SystemsDesignNW.com