emtI4now

From Something To Talk About:

Grace (Julia Roberts) stands up in the middle of the ladies' club meeting and says "I have a question. I'd like to know if anyone else here has F***ed my husband." Or something to that effect.

What the other posters don’t understand is that here in NJ there is something called the volunteer training fund. That is what enables you to get your free training/CEU's.

I'm not from NJ, but I sure hope there is more to the volunteer training fund than just free CEU's/training.

Because we achieved the same thing here by just sending an interested member to become a Training Officer. We pay for his training, and then he offers training to our members, as well as other service members in the county. We also partner with other Training Officers around the area to bring varied topics/instructors.

If we didn't bill we'd lose over $60,000 (yes, we're a rural volunteer service with a small call volume) in revenue just from Medicare, and to me that's not worth free training. We'd be inable to operate if we didn't bill. As it stands, we are in the hole about $50,000 yearly, and that's with some (albeit minimal) county funding as well as billing.

I would be curious to see the article that Ghurty mentioned on the details of billing vs. not billing etc.

Well, that would make my first name Tiffany......hmmm...I guess that's kinda stripper-ish. Now all I need is a pole....

When I give talks to kids, I always point out that when calling 911 on a cell phone, be sure to give them the phone number you're calling from if you know it and as much information as possible about your location, because if you are in a rural area like we are, we do not have enhanced 911 yet for cell phone capability.

I also ask them about seat belt usage, bicycle helmet usage, etc. to touch on personal safety issues. I show them the inside and outside, including compartments, and some of the equipment, and talk about how when they call 911 that we are coming to help them, and that they shouldn't be afraid.

Usually by the time I talk about all of that, and let them ask a few questions, that fills up about a half hour.

Always someone of equal or higher qualifications....

I, personally, won't release a patient to anyone but an RN or a doc.....and they have to sign.

Those were my thoughts as well. I don't think I got my point across very well. Another member stated that as long as the patient is released to the ER any staff member could sign because the hospital ER is the receiving facility and they are considered a higher level of care than we are. She said that if she were working in the hospital, as one of our members does work there as a CNA, then she should be allowed to accept and sign for the patient. My reply was that a CNA is not considered a higher level of care than we are so therefore they cannot accept the patient. We cannot give our radio report to a CNA, so I don't believe they should be allowed to accept the patient.

***sigh of frustration.....

Thanks.

Regarding transfer of patient care in the ER, who do you have sign your run forms as who you released the patient to? Any staff member or do you require it to be an RN?

We are a rural BLS service, and the main hospital we transport to most generally has one RN on duty at a time after 7 pm. They do sometimes have an LPN or two as well, and of course the CNA's.

A question has come up regarding other staff members working in the hospital and who is allowed to accept patient care on the run form.

How do you handle this issue?

Thanks for the answers. I actually spent yesterday looking in the Kansas Statutes, and haven't found the applicable law yet. Does anyone have any information on how the Kansas law on this issue works?

I am interested in speaking with others who do or have had experience in billing. I have some questions concerning patients who are guests at the iron bar motel.

If you have experience in this particular billing matter, please pm me.

Thanks.

We are a municipal-owned BLS service that does 911 response, and it's been my experience that just because someone dials 911 and gets transported to the ER doesn't mean that Medicare/Medicaid will pay for it. If the symptom/chief complaint doesn't indicate medical necessity of ambulance transport, the claim usually comes back patient responsibility. We are a BLS service, with no ALS available, other than the hospital, and sometimes, let's face it, it's just not truly classifiable as an emergency that is considered medically necessary.

I know this probably isn't helpful to you as we are not strictly a non-emergency transport service, as you are, although we do do non-emergency transports between facilities occasionally, but just thought I'd share my experiences.

10. "Got a full 6-pack, but lacks the plastic thingy to hold it all together."

I think I work with this one!!! LMAO! Thanks for the humor!

We're a little bit smaller than your service. We average about 400 calls per year. For FY '04, our expenses were approximately $180K. This includes salary and supplies. Our income generated from call volume was only $85K. My council was wondering why we cost more than we bring in and what could we do to increase our revenue. The only thing that we can do is to do our own in-house billing which will cost around $10K initially. Then we have to hire a couple new people just for billing and train them. I think all EMS services have this problem an, unfortunately, there is not really a way to increase revenue. Medicare has a cap on how much we can charge for services, so we're stuck with those rates. If you can think of any ways to increase the revenue, let me know because I am curious as well.

Woody,

Sounds like you've checked into the billing issue. Just curious why it would take 10K to start up the in-house billing? We do about half the amount of runs that you do, and I do all the billing.

Our expenses were around $110K for last year, and revenue approx. $80K. We are funded by the county to the tune of about $30K per year. The rest comes from run-generated revenue. The rest of our operating expenses were subsidized by the city.

I can't speak directly to the question asked. However, I can say that in the 48 hour basic refresher I just completed, HIPPA was not covered. Sure, the term came up frequently, just like it does here. But there was no formal coverage of the topic.

I would guess that would be because each service has to come up with their own policies and procedures on HIPAA. There are many required aspects, as well as many suggested and optional aspects of HIPAA, some of which do not apply to ALL services.

That's why it's each service's responsibility to train their employees, not one generic program or something like that.

I took Imitrex for my migraines, I thought I was gonna die. It made it so much worse, I truly thought I was going to stroke out.

Now I am on a maintenance preventative drug and a PRN pain med that works if I take it immediately when one is beginning.

but I sometimes have to laugh when I think about the quality of providers that we are allowing through. Just my 2 cents though

Sometimes I have to cry when I think about it.

40mg of expired Lasix in a really a hole medics coffee while he wasnt looking... had no idea why he was peeing all day long..

:shock: :shock: :shock:

BLS Emergency $450.00

BLS Non-emergency $350.00

$8.50/loaded mile

O2 $25.00

Supplies vary

Ours is a volunteer service, with one full-time EMT to provide day shift coverage. We average 150 calls per year, and do not make a profit. I did a cost study, and EVERY time we opened our doors last year, it cost us over $700.00. With the increase in fuel and supplies, it will only go up this year per projections.

I have a 99 Dodge Dakota SLT also. I love it!! Although it gets a little crowded with three kids in the back seat. I also have a chevy lumina that I just bought and I like it too.

I am just curious what size of an area that some of the rural EMS providers cover.

Our county is 900 square miles and we cover slightly less than half that. There are four other services in our county that split up the remaining portion. We also do mutual aid for each other when necessary.

Our volunteer fire department does our extrication/rescue stuff. We also have a county unit in a nearby town that we can call out also.

THANK GOD for fire fighters.

Wow, usaf. Thanks for sharing those stories. They certainly touched my heart. I can't imagine what both of those mothers must go through daily, and pray that I am never forced to make that decision. My prayers are with those families, as well as Mrs. Schiavo's family.

We had our attorney come in and give a class on legalities in EMS, i.e. the proper use of l/s, driving statutes, DNR's and how to handle them in the field. Also, the Good Sam act, injuries that must be reported, dealing with law enforcement and the requesting of information, that type of thing. Very informative. We have also had a class on handling a patient with osteogenesis imperfecta, aka brittle bone disease. That was informative as well.

EMT-I for a small rural service.