Wednesday, April 8, 2015 / Hillside, NJ

In light of new healthcare regulations, it has become increasingly difficult for many healthcare businesses to operate efficiently. This certainly proved to be the case for Medical Express Ambulance, a medical transportation service operating in New Jersey. The company primarily provides medical transportation for patients who must travel to and from dialysis centers or who need to travel for chemotherapy or radiation treatments. Medical Express Ambulance also provides medical transportation for patients checking into or being discharged from rehab as well as transportation for patients who need to travel for PET scans, MRIs, or even to see a specialized doctor at the hospital.

Medical Express Ambulance

When we spoke with Marissa Fischer of Medical Express Ambulance recently, she explained the impact that recent regulations from Medicare have had on the business. In December of last year, Marissa explained, Medicare put in a new regulation that required the company to request prior authorization from any facility or nursing home to transport patients to dialysis centers. Since these are repetitive transports, it hit the business hard.

“In order to be reimbursed from Medicare, you must have a prior authorization number. In order to get that, you must have a physician medical necessity signed by the doctor and a very detailed one, a clinical assessment, a patient’s care plan, therapy plan from the nurse practitioner and all of the necessary medical records. And, you know how tedious that can be to obtain those documents,” she said. “So, we are operating without getting paid first until we receive a prior authorization. Since the majority of our business is Medicare, it hurt us on the cash flow system for not getting reimbursed immediately.”

Initially, Marissa considered applying for funding through a bank and said that the company was approved for a $250,000 line of credit from a bank based on its income from last year. While that might sound like good news, the sticking point was the length of time it would take to actually receive the funding. “It would take about 8-12 weeks to get the $250,000 credit line for paperwork. They needed an audited compiled financial and that costs money. That was going to cost me $5,800 to do that.”

Believing that there had to be a better solution, Marissa began to contact factoring companies and said that she noticed an immediate difference when she spoke with 48 Factoring. “When I first called 48 Factoring, the first person I spoke with, I spoke with them only a couple of minutes, it was like he knew what exactly what I needed so he referred me to someone who is familiar with the healthcare industry since we are a medical transportation company. When I explained everything that was happening with Medicare, he immediately knew what I needed and he understood what it took to get the reimbursement paid by entering the claims, and I was impressed. So, they started to tell me what they needed to get the process going and they were telling me exactly what I needed to get it processed.”

Marissa said she was actually speaking with three other factoring companies, and none of them worked as fast as 48 Factoring. “Here’s the best thing that I like about 48 Factoring,” Marissa said. “They referred me to a person who knew my industry immediately. The other factoring companies that I spoke with just know generalized business of when the money is coming in. The person I spoke with who they referred me to is number one, a doctor, and number two, he has had the experience of dealing with the government agencies with getting reimbursed so he knows how it works. So, I didn’t have to explain too much to make somebody understand our business. I like the concept of paying per day for that amount of money until you are paid up on your accounts receivable that you factored. It gives you drive to make more money.”

The funding she received from 48 Factoring proved to be tremendously helpful in terms of helping her keep the business afloat. “The Medicare change affected us really bad. I had to pay two months of unpaid rent for the office, two months of unpaid garaging for the vehicles, I had to pay back pay for some employees, even if we were not getting paid, we were still working,” she said. “We were able to get caught up with all our other bills. I didn’t know how we were going to do it. The landlord is not rude to me anymore,” she added with a laugh.

Rather than wait the 8 to 12 weeks other financial institutions had projected, Marissa was able to receive the funds she needed from 48 Factoring right away. “When he said you will have the money on Friday…, that brought tears to my eyes. And, I couldn’t believe it was for real. It was in my business checking account on Thursday night so that Friday morning I had what I needed. He told me exactly what I needed to get it done. Now, I can continue to operate without somebody yelling at me.”

“And the follow-up!” she added. “They followed up, like every other day. So important in my industry because of the changes in the healthcare with the reimbursements. I really want to thank 48 Factoring for helping me to push this through. And even the employees are very grateful and thankful.”