Advice on ways to ask a sensitive question.

[EMT6388]

Hi, I thought that this would be a good place to ask this question. I did a search and didn't find anything so here it is. At a recent staff meeting my employer asked us to start asking our patients if they are on supplemental health ( more commonly called welfare). His reason for this is because once he enters the PCR into the computer for billing as a normal call and then he finds out that it should be billed to supplemental health not the patient it is very hard to change it once it's sent off and usually ends up eating the cost for these trips. Well enough about the background of my question. I find it difficult to ask my patients "Hey are you on welfare?" without offending them. Any advice on a good way to word it without offending them? Any help would be greatly appreciated.

[Dsmittty911]

It's actually very simple. Number one even though MOST people do not want to be on government assistance if they had to call you they have other things on their minds. Just simply ask them if they have medical coverage that they would like to have this billed to. This leaves you the out if it is insurance or government assistance. I've been there and while I wasn't proud of it things would've been a lot worse without it. As long as you not acting like you looking down on them for it they should be okay with it.

[nwoparamedics]

I like that one Dsmittty911, well said....

[medic429]

If you HAVE to do it, then DSmitty's response is a good one....

I have a problem with having to ask anyone if they have insurance....we usually get a financial sheet from the hospitals once the patient is registered.....if we don't, and we bill the patient, we attach a card they fill out and send back with that info.

Maybe there is a better billing program out there.......

I don't know....just a pet peeve of mine....

good luck!

[akflightmedic]

Myabe its just me, but what is wronk with asking? I don't get it. You open your mouth, ask the question, get your answer and move on. They will not be insulted or offended, so why are you? Its simple, Do you have insurance for which we can bill for sevices rendered. If they say no, you then ask what about the 'caid?

Geez, we ask patients anything and everything about their deepest darkest medical secrets, yet we cant ask a simple do you have insurance question. You think a person is more likely to tell you about their veneral disease rather than what type of insurance they have. Get real!

Why is this a hassle? You go to the docs office and they ask for insurance, same for the dentists office. Are you offended? I'm not, and I wasnt even offended when I was on medicaid myself. Even in emergency situations, they ask you about insurance. Yes they treat you or stabilize as per the law, but as soon as you are concious or able to sign, the clerk is there getting a signature and asking about insurance. We need money people!! Why should EMS services be free when everything else is paid for? You want better salaries, newer equipment, paid staff??? Then bill for your services.

[medic429]

AK, I agree with what you're saying. Yes, we want to get paid, no we shouldn't be free. BUT, when you go to a hospital, doctor's office, etc. it's not the person treating you that's asking the insurance questions...it's the registrar or secretary or clerk whatever....that's where I have a problem....not even a 'problem' per se, I just don't do it.

[akflightmedic]

Who else is going to do it?

Do we need to hire billers for all our trucks?

Get real. Grow up..its a simple question and its one that is expected with any medical service that is provided.

[Ridryder 911]

Actually, I see a lot of physicians ask about insurance.. simple enough.. Am I going to place you on Levaquin ($5.00 a capsule) or Amoxicillin ($1.30 capsule) as well as some other procedures etc.

I ask about insurance .. not unusual if you don't dwell on it. It is pertinent information, depending upon the type some require notification prior to certain procedure if non-life threatening.

Be safe,

R/R 911

[Dustdevil]

Seriously, if you can't bring yourself to ask a simple question about insurance in a straightforward manner, then good luck asking patients about their vaginal discharge. There is no secret to it. I suppose the best way is to simply ask, "what sort of health insurance do you have?" They will either tell you or say, "none." In which case you can then ask specifically about supplemental. You have to just suck it up and do it.

But yeah, in a perfect world we wouldn't be expected to be admissions/billing clerks on top of being a medic. Unfortunately, with ambo services going bankrupt every day, even the FD systems are putting more focus on billing info these days. It's a necessary evil. Beats the hell out of socialised medicine though!

[hammerpcp]

OK.......see the problem here is that you posed this questing to a room full of Americans. In Canada it is absolutely not your role as a paramedic (or whatever you call yourselves out your way) to be inquiring in any way shape or form about the Pt's financial status. It brings up soooooo many nasty convoluted issues to do so. And if the only reason is to make your billing persons life easier, that's not a good reason. I would absolutely refuse to ask any pt this question.

If you are on social assistance here, then you don't get any bill. If you are employed/ earning your own money, then you pay 45$ per call. Some how they accomplish billing without us, as paramedics, ever inquiring about financial status. Why don't you find out how they manage to pull that off here (Ontario). Or better yet, tell your boss to do his job and figure it out himself.