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Double patient transfer - HIPAA breech?


mobey

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  • 2 years later...
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I know this is an old post , but i have a question. One of my co workers said at his old company they would transport 2 dialysis patients at the same time. I asked how is that legal? He stated that since one pt was not being billed they would put him in the front seat and the other patient on the stretcher. I cant find any info on this subject online. This was the first i ever heard of this . Anyone else hear of transporting 2 non emergency pt's at the same time.

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It's not uncommon for us to do that here. This is a small system and when pts need to be transported, 'specially when they're doing so at the hospital because of an incoming blizzard or such, we do what we have to do. We simply can't staff an individual ambulance for each patient to run 180-400 mile circles.<div><br></div><div>I explain what I'd like to do to each patient and get their permission. These are often semi critical though non emergent patients. I've only once had a pt argue though have many times refused to haul the two pts that the hospital wanted taken. I once had a crushing chest pain that they wanted to pair with a forensics pt (a male that was found incompetent to stand trial for murder) that I, of course refused. And others like them. There are no HIPAA issues here that I can see.</div><div><br></div><div>Transferring can be a challenge at times if abandonment is going to be avoided. But I simply have the hospital make arrangements to have an RN meet us at the ambulance and take the first pt with my partner while I continue care of the one remaining. Or if the pt is BLS then do it the other way around. Not terribly complicated if the job really needs to be done.</div><div><br></div><div>I have no idea how the billing is handled. I've never been involved in that aspect of the business and intend to make a career our of avoiding it.</div><div><br></div><div>Dwayne</div><div><br></div><div><br></div>

Edited to try and straighten out the screwed up formatting. I was thwarted...

Edited by DwayneEMTP
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Let me add to this a slightly different situation...

You are on the scene of a minor/moderate patient and two blocks away another minor/moderate patient is sitting on scene with a First Responder crew as there are no more abulances avail. Do you save the system/offere to save the world and pick up both or continue on your assignment?

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<!--QuoteBegin-akroeze+--><div class='quotetop'>QUOTE (akroeze)</div><div class='quotemain'><!--QuoteEBegin-->I agree that getting them for transfer purposes is not appropriate. Also because there is no safe way for two people to use two stretchers and you can't leave a patient unattended.<!--QuoteEnd--></div><!--QuoteEEnd-->

Tell that to the transfer company I work for LOL

If they are billing for two transfers but it was the same trip then I would suspect it as fraud. You have a duty to report this. In the end.

If you do report it and the government gets money from fines I believe you are entitled to some of those fines based on the fraud reporting guidelines.

I know of a guy who reported a bunch of unauthorized accessing of he and his familie's medical record and it amounted to over 2300 times that his wifes boss and co-workers accessed their records. He filed suit and reported it and the fine was huge. He got something like 1.2 mil from the settlement. Whatever government group fined the hospital said that it was a pattern of behaviour that was rampant and flagrant and they fined the hospital huge. I think he got like 10% of the fine paid to him under whistleblower statute. His wife worked for the hospital at the time this happened.

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Well in BC we do transport more that one patient in our ambulances and in the aircraft. Im not sure on what the privacy laws would be but in the end if air ambulance has two patients to go north they will do both instead of 2 trips it saves money in the end.

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If these are stable BLS patients, I see no medical reason why 2 patients cannot be transported via IFT at the same time. If you have the capability to handle 2 stretchers, then great. The only way we can handle 2 recombent patients in our rig at the same time is one is tied to a backboard and strapped to the bench. Happens all the time. If they are able to sit up, then it seems to me that a medical transport van, equipped for wheelchairs is the way to go. Besides, most insurance carriers- including Medicare- will not reimburse for an ambulance unless it's deemed medically necessary and a doctor certifies this fact.

As for HIPAA issues, well, as was mentioned, in a crowded ER, those curtains are not sound proof, and if you are conscious and listening, you'll hear a person's entire medical history and far more than you ever wanted to know about them. It's the nature of the beast. In other words, asking medical questions in the presence of multiple patients is not optimum, but sometimes there is no other choice.

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yes , the way it was explained to me that both pts were stable. He said the one pt that sits up front was not being billed but does ( or did if still living) have a hx of HTN and has had b/p over 200 after treatment. the other pt would be on the stretcher since that pt was being billed. I just think God forbid something happen to the pt while sitting in the front seat ( vehicle accident, stroke)

Thanks everyone for all the input

ohh and yes bls pt.s

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  • 2 weeks later...

Just wondering if anyone knows the latest on this. Can we transfer 2 patients, unrelated in the same ambulance without breeching HIPAA?

I have researched it and cannot find much info.

We are buying a new ambulance and it "Must" be dual cot for double transfers, but I think that they are highly inapropriate.

For example, in an emergency if you are transporting 2 patients that were involved in an accident you shouldn't have a problem. But in a non-emergency if you transport 2 patients as you say in your question, I would ask either the patient or family members if they are ok with it. Remember that a violation of HIPAA is when you discuss a patient's condition, medical history, etc., that is not or will not be involved in the patient's current and/or continuation of care.

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