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  1. AlphaButch

    ALS Billing vs BLS billing question

    Depends on what the chief complaint called in was.
  2. AlphaButch

    Feds ban new Medicare ambulance providers in Houston area due to fraud

    HB 3556 becomes effective Sept 1, 2013. It has a lot of similar restrictions.
  3. AlphaButch

    Medical Equipment differences between EMS and Hospital

    Our biggest issue and most frequent repairs needed are due to wear and tear to the cables and probes. A lot of this can be attributed to design (lack of specific cable storage area, covers that kink cables, etc). We don't even keep automatic NIBP cuffs attached anymore (they're put away to be...
  4. AlphaButch

    Community Paramedics revisited

    Our pilot is already doing all of these. The didactic training takes approximately 3 months for Medic/RNs and 6-8 months for Medics (more for certain specialty trained units). Along with clinical time before being approved by the MD staff. First stage of the pilot (18 days) allowed us to...
  5. AlphaButch

    EMT-B starting IVs

    Our EMTs get signed off on IVs after training. This allows for BLS transport of patient's who have IV access. It also speeds up scene times for those patients that may need access in the field (as they can do either the 12 lead placement or IV start while their partner does the other). The...
  6. AlphaButch

    EMTs writing ALS refusals

    At my service. A refusal should be either an AMA refusal or simply a refusal, and most agencies run that every refusal is AMA. There are no ALS/BLS determination on our refusal or on the refusals signed/accepted by our NP, PA, MDs. A refusal is a refusal. Care provided (including...
  7. AlphaButch

    How do you remove supine patients from their homes?

    Mega Mover is my personal preference. For hip fx, I bring in a scoop (even if it's just to move them to the stretcher).
  8. AlphaButch

    Nitronox Now Available...Again!

    Sending you a message now. I loved having these in the field and love seeing their return.
  9. AlphaButch

    Community Paramedics revisited

    Our pilot program (a version of community paramedicine) has actually been met with alot of resistance from hospitals because of the reduction in ER admissions. Hopefully, once they've sorted out the reimbursement issues for ACOs, this resistance will change as continuity of care and...
  10. AlphaButch

    EMS contracts

    Some are also set up so that the company bills the patient and/or insurance, then at the end of the year - they get reimbursed up to a contracted $ for transports done which were not paid by insurance/patient. Every contract is different.
  11. AlphaButch

    Acadian Amublance Service

    IFT, and although I'm a direct competitor - they're a solid outfit down here from outside observation.
  12. AlphaButch

    Do away with ambulance service

    With only 100 calls a month, the hospital is definately losing money (and not at a trickle). Like others said, volunteers, private service or a taxpayer subsidized service will step in. The public input at a board meeting of a private hospital will mean next to nothing, numbers speak more...
  13. AlphaButch

    Physician involvement

    Three physicians on board (One ER, one cardiac, one pediatric). Mostly involved with setting policy/protocol and heavily involved in our QA/QI. All of our transports are physician reviewed, so we know who is working due to the reasons our reports get kicked back or questioned. One's a...
  14. AlphaButch

    Life and death

    Private service 911, inter facility and CCT as well. Our service does approximately 10-15 direct ICUs a week. Not as many cath labs as I'd expect considering our demographics (95% of our patients >60). Most are respiratory arrests and septic shocks.
  15. AlphaButch

    Ask Billing Questions Here!

    We teach our providers to ask the important Why? question. Why are they a fall risk? Why do they need you to provide them oxygen? My grandpa had oxygen for awhile and he could work it himself. He'd probably curse someone out if they told him that he needed an ambulance.
  16. AlphaButch

    Medication Error Reporting Policy - no discipline

    If we self report and it wasn't an error due to malfeasance, it is addressed through reduction of skills until completion of in house retraining and sometimes being sent to outside courses. If it was an error that can be resolved system wise (such as different vials, etc), there is generally...
  17. AlphaButch

    IFT (Non-Emergency Transport) Questions

    Yes, things can go smoother with the Medicare/Medicaid process. Ours took about 6 weeks because it took 2 extra weeks for the inspector to come out, no Texas Medicaid number allowed until after you get the Medicare number, then about two months to get most of the HMOs completely registered. But...
  18. AlphaButch

    Starting at an IFT company

    Be extra polite to everyone. Including providers (nurses, aides, etc) who may have done something that makes you want to roll your eyes. Just be polite. Also, don't trust information just because it comes from the discharging nurse/aid/lvn. We do alot of IFT and roughly 60% were called in...
  19. AlphaButch

    IFT (Non-Emergency Transport) Questions

    The liability insurance, med control and licensing requirements should be questions for your state approving authority, call them and see if they'll do a consult with you (most are happy to since it can prevent issues later). Billing and reimbursement for medicare can be a headache, which is...
  20. AlphaButch

    update your opinion of ePCR, please

    We've been using ePCR and Ipads for almost two years now. There's a little transition time for folks to get used to the software, but from the management perspective - I wouldn't trade our ePCR system for paper ever. The biggest upside is the amount of data that can be collected and then...
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