Wannabe

I'm speaking out of turn because I don't know how medicare works in the US, but doesn't it just make sense that services are allowed to bill more because it costs more to provide an ALS unit than a BLS unit, regardless of the level of care provided? I can kind of see the logic the other way, but if services were only allowed to bill based on the type of call, they could wind up in a pretty serious deficit at the end of the year if they don't get the budgeted number of ALS calls, but have been paying for Paramedics all along. It wouldn't be a big deal if Basics and Medics earned the same, but with the disparity you can bet if the billing dept. has to change their ways, they'll be looking to change the pay structure so that Paramedics only get paid the higher rate if they use the skills or some such BS like getting rid of Paramedics altogether because (as has been so often pointed out on this very board) 90/92/95/98/whatever % of calls are BLS calls anyway? Another way to try to pin down my thinking - if you go to the ER and are seen by a Doctor who doesn't do anything more for you than a nurse would have done (take your vitals (which, face it - the nurse does anyway), tell you do go home and get rest and fluids) does your plan not get billed for an MD contact? He/she didn't do anything doctorly so is that right? You are paying for the knowledge embodied in the people who arrive on the truck, not necessarily the procedures those people provide to you. Perhaps the rules are set up the way Rid suggests, but to me it doesn't make any sense at all... (FWIW - In Canada (Alberta anyway), you pay more for an ALS truck than a BLS truck, even if you just get a bandaid and a ride to the ER.)

LOL! The Fraggle Rock Blues - I hear that! An even earlier memory of the same blues was hearing Lorne Greene's New Wilderness music... that meant "bath time" before bed on Sunday... (I still cringe when I hear it, which fortunately isn't often).