Refuse ambo transport and you will pay

[akflightmedic]

Basically, if an ambulance comes and you refuse transport, they want to bill you.

How many of you have had patients who just wanted to be checked out and you were glad they did, you honestly did not mind and you said to them, "this is what we are here for, we rather you call and be examined than sit here and get worse"? I have said it many times and it is not false sentiment. Some of these very patients have turned out to be very sick indeed.

How many of these "maybe I should call and get checked out" patients will now fear they are wrong and worry about a potential charge and NOT make the call?

Even if it is determined that they do not need to go to the ER with me, should they be charged for it?

http://www.emsnetwor...cle_39113.shtml

Refuse ambulance ride and you'll get charged - Georgia


The Bryan County Board of Commissioners approved charging a $75 response fee to patients who refuse ambulance transport.

 

[Aidey]

The link doesn't work.

 

[reaper]

Our service charges for refusals, I have disagreed with it from the start!

 

[silver]

Our service charges for refusals, I have disagreed with it from the start!

even if a bystander or family member makes the decision to call (and calls), not the patient?

I agree, it doesnt seem right.

 

[akflightmedic]

http://www.emsnetwork.org/artman2/publish/article_39113.shtml

 

[Fox800]

We charge for refusals if the patient called for EMS or the patient's family called. If a third-party called and the patient didn't want EMS to begin with (i.e. low-speed MVC with no injuries), they do not get a bill.

There are good and bad aspects. One of the good things is that it helps cut down on unneccessary EMS utilization (to some extent), although we still have plenty of "frequent fliers". We have patients that will feign complaints in order to try and get EMS to do errands around the house like...bring them a glass of water, change the channel on the TV, turn the lights off. It's inappropriate to take an ALS resource out of service to check someone's blood pressure under the guise that it's free.

The bad thing is that it prevents some people who really do need us from calling us due to monetary considerations.

 

[subliminal1284]

Simple solution to this, Tell them you dont have an ID and give them a fake name. Cant charge someone who doesnt exist.

 

[DrParasite]

Simple solution to this, Tell them you dont have an ID and give them a fake name. Cant charge someone who doesnt exist.

I've wanted to do that every time i got seen in the ER for an on the job injury (both times). fake name, fake address, the hospital has to treat me, and I don't get the bill. unfortunately, most people in the ER know me, and I used to date one of the registration ladies, so I don't think I could get away with it.

Back to the topic at hand:

remember, every time the ambulance goes out the door, a cost is incurred. maybe it's in diesel fuel, maybe it's in the ekg stickies, or just a pair of gloves used to examine the patient. but there is a cost.

a person should have to pay for a service. "checking out" a patient is a service. if you call for the service, we come and check you out, should we not get compensated for our service?

I absolutely believe that every RMA post action (wake up diabetics, bleeding control, even a lift assist) should receive a bill. if you do something (provide a service) they should compensate you for said service, esp if they won't pay for it otherwise (which means tax-based services might not get to do this, because people pay for it through their taxes).

but every RMA? sounds a bit overkill. maybe the service should try to convince more people to go to the ER to get checked out?

oh, and for those who say a person can't afford the EMS bill? well, the hospital is going to bill them, if you have free BLS then ALS is going to bill, the ER docs are going to bill, as is the radiology people. so they are going to get a bill, and there are programs in place to handle how to pay for the service. you want a service, you should have to pay for it.

 

[bunkie]

Is it only for nonpaying frequent fliers or everyone? The article seemed conflicting.

 

[Achromatic]

Unless you were the person who called 911, this would not have a leg to stand on - third-party calls 911, and you don't want treatment or transport? Sorry, too bad, I'm not accepting the bill.

Our county has a BLS response from our FDs. For BLS calls, they also dispatch AMR / Olympic to do transport, unless intercept time is too high.

In the event that AMR / Olympic transport you, you're billed. If the BLS 911 FD unit transports you, or you get an ALS upgrade (and transport), no bill, covered by property tax.

If someone is refusing transport because of the cost, our standing orders are that if that's the only reason, BLS 911 FD will transport (and per the previous, without billing), on the grounds that the person has directly or indirectly paid for the service, and that the transport is a policy decision to maximize availability.

 

[reaper]

The problem with a lot of thinking, is property taxes for EMS or FD are not there to cover your free transport. The taxes are there to pay for equipment and personnel to be available and on site, when needed. Your taxes are like an insurance policy. You are paying for the "what if" times, when you may need them.

Looking at it from a companies stand. Even if a third party called 911, you can still be billed for services rendered. You had the right to refuse EMS services, when they show up. If you allow them to assess you, then you are accepting their services and they can bill you for said services.

I do not agree with it, on a pt care level, but services have to find ways to stay afloat. In the down economy, less and less people are paying the bills. So, a lot of services are having to find a way to make ends meet.

We may not like it, but I bet we like our jobs. This is what is needed to maintain large and small services.

 

[Achromatic]

Even if a third party called 911, you can still be billed for services rendered. You had the right to refuse EMS services, when they show up. If you allow them to assess you, then you are accepting their services and they can bill you for said services.

That I can agree with - if you allow assessment and/or treatment, then yes. In my example from our county, the only bill you would be presented with is one for transport via AMR/Olympic. Our property tax covers all operating expenses, equipment, supplies, personnel and services for the FD, ergo our FDs do not issue bills.

 

[Bloom-IUEMT]

Our service only bills if we do some kind or treatment or EKG. The problem with billing ppl who refuse transport is if that person wasn't the one who called 911. Family/friends often call for patients despite the patient's refusal. In addition, if a person is injured at a special event, the proprietors often call ambulances to cover their asses. Nothing discourages people from calling 911 more than a bill. Unless of course when those who knowingly can't pay call anyway because it won't affect them. Indeed, how do you bill a homeless person?

YOu know what, if you are so worried about reimbursement why don't tell your Congressman/Senator to vote for the public option! Jesus, nothing will curtail prices more and improve EMS reimbursement rates better!

 

[ZVNEMT]

my partner has been forced to collect as much as $300 from elderly people who's family calls us and then the Pt refuses. it's absolutely ridiculous. $300 is the flat rate for when we DO transport. that particular EMT is a family member or the company owners', so i imagine he gets his cut.

If I ever end up in that situation without said EMT, no way in hell am I collecting that much money. I'll probably get fired, but it's just unethical to do that to someone who didn't want us there in the first place.

 

[EMSLaw]

my partner has been forced to collect as much as $300 from elderly people who's family calls us and then the Pt refuses. it's absolutely ridiculous. $300 is the flat rate for when we DO transport. that particular EMT is a family member or the company owners', so i imagine he gets his cut.

If I ever end up in that situation without said EMT, no way in hell am I collecting that much money. I'll probably get fired, but it's just unethical to do that to someone who didn't want us there in the first place.

You collect cash up front from people who refuse transport?

 

[MrBrown]

We charge regardless of transport or not.

NZ does have universal healthcare but EMS is not (fully) included so we charge to make the difference up.

 

[Achromatic]

my partner has been forced to collect as much as $300 from elderly people who's family calls us and then the Pt refuses. it's absolutely ridiculous. $300 is the flat rate for when we DO transport. that particular EMT is a family member or the company owners', so i imagine he gets his cut.

If I ever end up in that situation without said EMT, no way in hell am I collecting that much money. I'll probably get fired, but it's just unethical to do that to someone who didn't want us there in the first place.

Wait, what? As much as you can say, where on earth is that EMS that requires their medical personnel to demand payment at time of (non-) treatment?!?

 

[ZVNEMT]

You collect cash up front from people who refuse transport?

like i said... I won't do it.... what my partner does is beyond my control.
i've only witnessed it 2 or 3 times.

 

[Dominion]

We charge nearly 100$ to patients who do not want to go. Regardless of if they called or not. The exceptions to the rule are MVC's or other similar things where a random bystander called and we show up and there are no injuries and they did not request EMS. But if grandma is feeling funny and their son/daughter/husband calls us and grandma doesnt' want to go, it's a charge and if they don't pay it gets sent to collections. I don't agree with it and I HATE explaining it.

 

[medicdan]

When I worked in Israel, as soon as we finished the PCR, we wrote the bill for the patient, and handed it to them or their family at the hospital. The prices were determined by the level of care, and distance of transportation, and every driver in the country carries a card with it listed. Most patients pay after the fact, but some ambulances in hte country carry credit card machines, and we are able to accept cash if the patient wants.

And no, we dont bill for refusals in Israel.