Colleton Software to attend 2016 North Carolina EMS Today

Colleton Software will attend and display at the 2016 North Carolina EMS Today conference in Greensboro, North Carolina.

The 2016 Emergency Medicine Today Trade Show will be held at the Sheraton Koury Center, Greensboro NC, October 2-5, 2016. The conference will start on Sunday October 2, 2016 and run through Tuesday October 4, 2016

Please stop Booth 124 to visit with us during the show.

Reprocessing of Crossover Claims for Services Rendered to Qualified Medicare Beneficiaries

May 18, 2016

Reprocessing of Crossover Claims for Services Rendered to Qualified Medicare Beneficiaries

Dear Provider,

In adherence to Centers for Medicare & Medicaid Services (CMS) Informational Bulletin, Payment of Medicare Cost Sharing for Qualified Medicare Beneficiaries (QMBs), dated June 7, 2013, Medicaid is legally obligated to reimburse providers for cost-sharing that is due for a Qualified Medicare Beneficiary (QMB) according to the state’s CMS-approved Medicare cost-sharing payment methodology.

Effective November 1, 2015, the “lesser of” logic is being applied to services covered by both Medicare and Medicaid that are rendered to QMBs. Specifically, claims for Medicare covered services that are also covered in the Medicaid State Plan are paid at the lesser of the:

  • Medicare cost-share (which is the sum of co-insurance, deductible and co-pay), or,
  • Difference between the amount paid by Medicare and the Medicaid State Plan rate (if any).


For services not covered under the N.C. Medicaid State Plan, the claims are paid the Medicare cost share amount. This rule applies to both crossovers and secondary filed claims for Q-class recipients. This methodology results in the provider receiving the Medicare or Medicaid allowable and the QMB recipient not being responsible for any additional monies for services covered by Medicaid and/or Medicare.

QMB claims last processed between March 1, 2015, and Oct. 31, 2015, will be reprocessed in batches over the course of this summer.

You are receiving this message because you have claims affected by this reprocessing. While some previously denied claims will now process for payment, the majority of claims will have a lower net reimbursement due to the CMS QMB rule. The final amount will be established when the actual claims are reprocessed.

If there are not sufficient funds from new claims paid in the checkwrite to cover the adjustment from reprocessing, an accounts receivable will be created. Funds from claims paid in subsequent checkwrites will be applied to the accounts receivable until the adjustment is fully recovered. To fully satisfy the recovery, NCTracks will look for available funds from any other NPI within the same corporate structure (shared Tax Identification Number). All amounts owed to the N.C. Division of Medical Assistance that are not satisfied within 30 days from the Systematic Payment Adjustment Begin Date will incur penalty and interest.

The reprocessed claims will appear in a separate section of the paper Remittance Advice (RA) with a unique Explanation of Benefits (EOB) code: EOB 06021 – “Medicare QMB Reprocessing of Claims Processed Between March 1, 2015 and October 31, 2015”.  The 835 electronic transactions will include all of the reprocessed claims along with other claims submitted for the checkwrite. (There is no separate 835.)

No action is required on the part of providers. If providers have any questions about the reprocessed Q-class claims, please contact the NCTracks Call Center at 1-800-688-6696 or


Thank you,

The NCTracks Team




Beaufort County North Carolina approves Colleton Software for billing contract

Colleton Software s pleaed to announce that Beaufort County, North Carolina has signed a billing contract with Colleton Software. The contract allows for the creation of a county wide billing service and for Colleton to manage the process.

Beaufort County EMS was established last year in order to provide the county ciitzens with the opportunity to receive county ALS service. John Fleming was chosen as the new EMS Director and started with the county in June of 2015.

Over the past year, the county has set up a first class operation and have worked to insure the best possible coverage and care for the citizens. Recently the county started providing care to the Belhaven Community in eastern Beaufort County.

Colleton Software is proud to work with Beaufort County and to have them as a client. We wish Director Fleming and his staff the very best in providing a top rate service.

Invitation to join Colleton Software for Dinner at Wilmington EMS Show

Colleton Software would like to invite all clients and other guest to join us for dinner during the North Carolina EMS Administrators Conference. We invite you to join us for a wonderful evening of fellowship and fun.

Details are listed below. Please RSVP to our office

Wild Wings and More
NC EMS Association Directors Meeting
Thursday, March 3rd, 2016

Meet at Hilton Lobby at 6:30 PM
or at Wild Wings at 7:00 PM

1331 Military Cutoff Rd,
Wilmington, NC 28405
RSVP to: Colleton Software

North Carolina Pre Approval Conference in Raleigh Nest Week

For all of the North Carolina clients.

Palmetto GBA will be holding a conference in Raleigh, NC on 12/07/201 5 at 11:00am to 1:00pm This conference will cover the upcoming changes and requirements for non emergent pre approval transports. . If you plan on attending this meeting,  please let us know in advance so we can have a representative there with you.

If you have any questions then please contact our office

Repetitive Scheduled Non-Emergent Ambulance Transportation Documentation Requirements (North Carolina)

Repetitive Scheduled Non-Emergent Ambulance Transportation Documentation
Requirements (North Carolina)

Palmetto GBA will hold Repetitive Scheduled Non-Emergent Ambulance
Transportation Prior Authorization Demonstration face-to-face workshops in
North Carolina for ambulance providers providing repetitive scheduled
non-emergent transports to familiarize them with The Centers for Medicare &
Medicaid Services (CMS) demonstration currently going on in South Carolina.

Two events have been scheduled:

Western/Asheville, NC on November 12, 2015,

Central/Charlotte, NC on November 20, 2015.

We hope you can attend to learn more about the ‘Repetitive Scheduled Non-Emergent Ambulance Transportation Prior Authorization Demonstration’ coming to North Carolina.

Colleton Software will be exhibiting next week at the North Carolina EMS Today Trade Show in Greensboro, North Carolina. Please stop our booth and say hello during the show.

We also would like for you to join us for dinner on Monday, October 6, 2014. We have arranged for a reservation at Arigatos Japanese Restaurant. This is the same location as we visited last year.

We will meet in the lobby at 6:15 PM at the Sheraton Hotel. Cocktails and Social Hour at the restaurant will be at 6:30 and we will have dinner at 7:00PM. If you wish you can meet us at the restaurant for dinner. The address is listed below. The location is less than 10 minutes from the hotel.


1200 S Holden Rd.
Greensboro, NC 27407

Please RSVP to Dave Pickren if you are going to attend or stop by the booth and let us know during the trade show.

Thank you and we look forward to seeing you at EMS Today.

Non payment days for Medicare / PBGA

Jurisdiction 11 Part B


From Friday, August 21, 2015 through Monday, August 24, 2015, Palmetto GBA will be performing a Financial System Transition of our J11 Part A, Part B and Home Health and Hospice workloads.

Due to this transition, there will be no payments issued with a payment date of August 25, 2015. All claims/payments scheduled to be paid August 25, 2015, will be paid one day early, on August 24, 2015.

Once the Financial System Transition is complete, payments will resume as normal starting August 26, 2015.

Medicare Access and CHIP Reauthorization Act of 2015

Attention Health Professionals: Information Regarding the

Medicare Access and CHIP Reauthorization Act of 2015

On April 14 , 2015, Congress passed the Medicare Access and CHIP Reauthorization Act of 2015; the President is expected to sign it shortly.  This law eliminates the negative update of 21% scheduled to take effect as of April 1, 2015, for the Medicare Physician Fee Schedule.   In addition, provisions allowing for exceptions to the therapy cap, add-on payments for ambulance services, payments for low volume hospitals, and payments for Medicare dependent hospitals that expired on April 1 have been extended.  CMS will immediately begin work to implement these provisions.

In an effort to minimize financial effects on providers, CMS previously instituted a 10-business day processing hold for all impacted claims with dates of service April 1, 2015, and later.  While the Medicare Administrative Contractors (MACs) have been instructed to implement the rates in the legislation, a small volume of claims will be processed at the reduced rate based on the negative update amount.   The MACs will automatically reprocess claims paid at the reduced rate with the new payment rate.

No action is necessary from providers who have already submitted claims for the impacted dates of service

Colleton Software signs partnership with EMS Charts

Colleton Software is pleased to announce that a partnership with EMS Charts has been signed between the 2 companies.

Effective immediately clients using EMS Charts for ePCR and Colleton Software for revenue management services can work with both companies. By providing EMS Charts as a ePCR option for Colleton clients, EMS providers can enjoy the benefits of both great companies.

The partnership will allow a seamless transaction between information from EMS Charts ePCR product to Colleton Software’s billing service. The partnership will also allow Colleton to offer the best available pricing for EMS Charts.

For more information, contact:

Dave Pickren

864 316 9966