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Councilman Proposes Payment Before Ambulance Service


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...70% of the calls are NOT ALS. As I've had pointed out to me here on the forums many times, EMT B's are just trained first aid providers.

Keep reading, because what we have also clearly pointed out to you here is that 100% of all EMS patients are ALS until ALS evaluates them and determines otherwise. (content removed -admin) are incapable of making that evaluation or determination. Therefore, all EMS patients are ALS.

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you can aways make a bls patient into a als patient if you document creatively enough. Of course I would never ever ever ever advocate that.

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I guess it all depends on whether you're trying to hold onto your job at all costs, justify your existence and your salary or just trying to make yourself feel more important by referring to people as "(content removed - admin)". I've had patients transported in our ambulance that didn't trust that their little stubbed toe might not be critical, or the hair wrapped around the baby's toe wasn't a real emergency, or when they ran out of their prescription and needed a fast track through the ER.

I can't even how say how many para-gods have thrown a fit during an intercept because they patient wasn't "critical" enough for their skills to be used. Boo Hoo. Isn't this the heart of what's wrong with everything these days? People too high on themselves to be realistic? The fact is that if EMS gets budget axed, you would seem to be more willing to demand ALS on every call than to ration the best care for the most sick and perhaps deny the patient who really does need you.

We do the best we can with what we have and to transport people with paramedics when BLS will do is like demanding the brain surgeon see every headache that comes into the doctors' office. Maybe we should get rid of PA's, and all the nurse specialists too? I bet you could justify that too if you really tried. But it wouldn't make it right

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There is a simple alternative to this scenario, I know of a service that charged $50.00 directly to the water bill (after the fact). If the bill wasnt paid, water was turned off. $50 doesnt sound like alot, but by the time you bill medicaid 3 times and get denied, if you have a viable claim to start with, $50.00 in 30 days sounds pretty good. This makes the elected officials the "bad guys" when they turn that water off, instead of EMS at the time of the call.

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I don't thank that payment before service in whatever city or county that this would be in will happen, no matter how much a city council person wants it to happen, One the public would not put up with that and there is violation of federal law there, under EMTLA.

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I think this guy should come to the forums and read everything we've ever posted about denying 9-1-1 service to "non-emergent" situations. No offense spenac, that wasnt directed at you at all.

I'm offended. :roll: :lol:

But actually medicare used to provide a form that patients were to sign if they insisted on ambulance transport even though it was determined that ambulance transport was not required. In paraphrase the patient signed a statement that they would pay the full bill if in fact medicare did deny payment. This form actually became more of a financial contract that allowed services to use more serious bill collecting methods. Not sure that it is still out there or if something like that is still allowed. Now days I'm in charge of nothing but making sure my patient gets the best care I can provide.

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But actually medicare used to provide a form that patients were to sign if they insisted on ambulance transport even though it was determined that ambulance transport was not required. In paraphrase the patient signed a statement that they would pay the full bill if in fact medicare did deny payment. This form actually became more of a financial contract that allowed services to use more serious bill collecting methods. Not sure that it is still out there or if something like that is still allowed. Now days I'm in charge of nothing but making sure my patient gets the best care I can provide.

I remember thoes forms, and they are still used today. I see them mostly in instances now where a patient wants to be transfered to a hospital closer to home when the one they are currently in can provide the care they need. Generally what happens is the billing department would provided a (estimated) quote prior to picking up the patient, along with one of thoes forms. We give the form and quote to the patient and explain that medicare most likley will consider this transport unnessecarry and most likley will not pay for it. From there the patient can sign the form accepting financial responsability in case medicare will not pay or they can refuse transport and choose to stay where they are.

I have never seen this in the field... but since I was usually one to volunteer to do long distance transfers, Ive often used that form.

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