# EMS Unions in So cal



## SkiMaskWay (Aug 29, 2014)

What do you guys know about unionization here in LA Area it seems that it would be beneficial if the right union would proliferate industry wide...kinda like the Plumbers, Electricians Pipefitters etc. Those guys have Amazing wages and fringe benefits . What make this Industry so different. Also can anyone tell me their experience with EMS unions. Any info would greatly be appreciated. It seems like every industry has some kinda union.


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## LACoGurneyjockey (Aug 29, 2014)

I know AMR Riv Co unionized and from the guys I've talked to there it's actually been a step down, particularly compared to their non union division in San Bern.
Then again, AMR Ventura is under a completely different union and has the best pay across the board for private ambulances in a several hundred mile radius, low turnover, great equipment, and a stellar interagency relationship.
It can work, it can go bad, but I don't see anything comparable to the IAFF coming thru in my lifetime.


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## MrJones (Aug 29, 2014)

My experience with a major union was that it did nothing for me beyond taking a percentage of my paycheck every 2 weeks. But, boy, did the Union President drive a nice car.

Now the presence of a union would be enough to prevent me from applying with an ambulance service. I'm a medical professional, not a plumber, electrician or pipe-fitter. Or any other trade, for that matter.


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## SkiMaskWay (Aug 29, 2014)

MrJones said:


> My experience with a major union was that it did nothing for me beyond taking a percentage of my paycheck every 2 weeks. But, boy, did the Union President drive a nice car.
> 
> Now the presence of a union would be enough to prevent me from applying with an ambulance service. I'm a medical professional, not a plumber, electrician or pipe-fitter. Or any other trade, for that matter.


Right a medical professional! Not a Plumber, Electrician or pipe fitter? Its funny how the unionized Tradesman make around 40 dollars an hour... In fact first year apprentice with absolutely no training or skills makes About 22 hour ....not to mention Fringe benefits and Pension... Also firemen nurses and Cops are unionized.  So Mr Medical professional do your wages reflect that?, because I know for damn sure your not a Fireman otherwise you wouldn't be so proud of your medical inclination...
My brother in law is a Plumber his Journeyman wages are 44 an hour plus bennies and pension. My old EMT partner is now a Lineman making 56 an hour with IBEW ....besides Medical professionals don't make crappy wages bro


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## LACoGurneyjockey (Aug 29, 2014)

We don't make low wages because of the lack of a union, but because of the  overall standing of EMS, particularly in that godforsaken county you hail from. An over saturation of young, eager, qualified applicants willing to do the job for free. A lack of formal training (I went to EMT school for 5 weeks 8 hours a day), and I'll be done with medic school in under a year all together. What's an RN program look like next to that? Is there really such an over saturation of Plumbers that it drives down wages? I'd love to lay pipe for a living, just not like that.
On a different note, if you got into EMS to make 70k starting with a stellar pension and benefits, you're going to be sorely disappointed with the lack of patients actually found on fire. You can absolutely make a survivable living, particularly out of LA County, and there's even places with salaries equal or comparable to FD, but this is not the place to make yourself rich.


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## MrJones (Aug 29, 2014)

SkiMaskWay said:


> Right a medical professional! Not a Plumber, Electrician or pipe fitter? Its funny how the unionized Tradesman make around 40 dollars an hour... In fact first year apprentice with absolutely no training or skills makes About 22 hour ....not to mention Fringe benefits and Pension... Also firemen nurses and Cops are unionized.  So Mr Medical professional do your wages reflect that?, because I know for damn sure your not a Fireman otherwise you wouldn't be so proud of your medical inclination...
> My brother in law is a Plumber his Journeyman wages are 44 an hour plus bennies and pension. My old EMT partner is now a Lineman making 56 an hour with IBEW ....besides Medical professionals don't make crappy wages bro



Sounds to me like you picked the wrong profession.

Bro.


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## LACoGurneyjockey (Aug 29, 2014)

Whoa dude, who you callin bro?!?
I'm a medical professional, I took a 160hr class, and I demand respect! 

300 hours for a police academy
600 hours for a Fire academy
1200 hours for a medic program
And nursing programs are too classy to measure class in hours. 
If you want higher wages, broader scope, more respect, and a better job outlook, further your education or find a new career.


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## SkiMaskWay (Aug 29, 2014)

LACoGurneyjockey said:


> Whoa dude, who you callin bro?!?
> I'm a medical professional, I took a 160hr class, and I demand respect!
> 
> 300 hours for a police academy
> ...


Once again were going around in circles... I understand your point but excepting poor wages working,  conditions and crappy treatment is unexceptable. Regardless of the industry. Attitude such as yours breeds this type of conditions. And is exactly what these shady transport companies want. In fact I want to start my own ambulance company so I could pay minimum wage and exploit my medical professionals that think that how its supposed to be until land a Fire job


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## SkiMaskWay (Aug 29, 2014)

MrJones said:


> Sounds to me like you picked the wrong profession.
> 
> Bro.


Why? You picked the right one? Tell me about your profession...


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## SkiMaskWay (Aug 29, 2014)

LACoGurneyjockey said:


> We don't make low wages because of the lack of a union, but because of the  overall standing of EMS, particularly in that godforsaken county you hail from. An over saturation of young, eager, qualified applicants willing to do the job for free. A lack of formal training (I went to EMT school for 5 weeks 8 hours a day), and I'll be done with medic school in under a year all together. What's an RN program look like next to that? Is there really such an over saturation of Plumbers that it drives down wages? I'd love to lay pipe for a living, just not like that.
> On a different note, if you got into EMS to make 70k starting with a stellar pension and benefits, you're going to be sorely disappointed with the lack of patients actually found on fire. You can absolutely make a survivable living, particularly out of LA County, and there's even places with salaries equal or comparable to FD, but this is not the place to make yourself rich.


Other industries don't necessarily have a shortage or years of schooling yet manage to have descent pay and bennies. I know plumbing isn't very glamorous but neither is pushing  a gurney after medic school, Specially for minimum wage. But your right young EMTs willing to work for peanuts drive down the wages ....kinda like illegals that don't demand good wages or bennies...in fact illegals have it better they don't have to pay taxes or bs certs


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## SkiMaskWay (Aug 29, 2014)

SkiMaskWay said:


> Other industries don't necessarily have a shortage or years of schooling yet manage to have descent pay and bennies. I know plumbing isn't very glamorous but neither is pushing  a gurney after medic school, Specially for minimum wage. But your right young EMTs willing to work for peanuts drive down the wages ....kinda like illegals that don't demand good wages or bennies...in fact illegals have it better they don't have to pay taxes or bs certs


In fact there is an over saturation for most of the trades including Plumbers go to any union hall and look at the waiting list see how many guys they have in the books waiting for a spot to be dispatched there is absolutely no shortage....


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## DrParasite (Aug 29, 2014)

MrJones said:


> Now the presence of a union would be enough to prevent me from applying with an ambulance service. I'm a medical professional, not a plumber, electrician or pipe-fitter. Or any other trade, for that matter.


yeah, i can't think of any medical professional that belong to a union.  I mean, other than NURSES.

In EMS, you are paid what you are felt like you are worth.  If management thinks of you as replaceable, you will be paid poorly.  if people are willing to do the job for free in your area, they will pay you poorly.  if people are willing to do the job for free elsewhere, well, that's not here, so it shouldn't factor into wages (and any decent negotiator would say that, but we often don't have good negotiators doing the negotiations), and remember, if you get a good salary, good benefits, and a retirement plan, the city can just lay you all off and replace you with a private for profit entity whose people are willing to work for $9 an hour.  If beware of making a good living, because you run the risk of being outsourced to a cheaper provider.


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## epipusher (Aug 29, 2014)

I don't think plumbers and linesman bill the same as EMS. That may have something to do with our low pay as well.


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## DieselBolus (Aug 29, 2014)

SkiMaskWay said:


> . I know plumbing isn't very glamorous but neither is pushing  a gurney after medic school


 
I can see past the lack of communication skills, but.....wtf?

I have never met a medic who felt pushing a gurney was below them. Even flight medics who scored jobs with 500 applicants for a single opening. I have also never met a medic who failed to understand that the tools we have for moving people around are central in PREhospital care.

I suppose that could be hard to understand if you got into EMS to run around intubating patients and letting other people deal with the paltry transportation to definitive care.


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## SkiMaskWay (Aug 29, 2014)

epipusher said:


> I don't think plumbers and linesman bill the same as EMS. That may have something to do with our low pay as well.


I'm sure contractors make a killing on construction projects, but I'm sure the private ambulances also have a high profit margin...otherwise there wouldn't be so many Ambulance companies popping up in LA. There is so many of them its really big business. They have deep pockets but like another poster stated there is so many EMTs willing to work for bread crumbs. Like the the saying goes stand up for what you deserve or take what they give you. Look at the grocery store employees a few years back they went on strike demanding more pay and bennies despite the fact they have little education.


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## gonefishing (Aug 29, 2014)

SkiMaskWay said:


> I'm sure contractors make a killing on construction projects, but I'm sure the private ambulances also have a high profit margin...otherwise there wouldn't be so many Ambulance companies popping up in LA. There is so many of them its really big business. They have deep pockets but like another poster stated there is so many EMTs willing to work for bread crumbs. Like the the saying goes stand up for what you deserve or take what they give you. Look at the grocery store employees a few years back they went on strike demanding more pay and bennies despite the fact they have little education.


Listen, from experience with an ems union, it still goes in circles.  Nothing happens over night.  It can be a tug of war for years.   The reason why there are so many ambulance companys is alot of the owners wanna make a quick buck and pass on the little guy and alot do it the fraudulent way while others are honest but could give two cents about you.  What a union does is establishes a contract so there are no changes over night it has to be a voted issue.  Its fair but alot of owners see it as you cutting Into the profit or trying to tell them how to run the company.  Its been ATTEMPTED to bring in a large union for ems into L.A. failed by a small percentage and was mainly due to the people themselves not giving a damn because its all a "stepping stone" to a fire job or nurses job and my argument to that is why not have a union now and after your primary ems job?  As a business owner on the side of my ems job to make ends meat, I would welcome a union.  A proud happy well funded worker only helps you grow.


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## SkiMaskWay (Aug 30, 2014)

gonefishing said:


> Listen, from experience with an ems union, it still goes in circles.  Nothing happens over night.  It can be a tug of war for years.   The reason why there are so many ambulance companys is alot of the owners wanna make a quick buck and pass on the little guy and alot do it the fraudulent way while others are honest but could give two cents about you.  What a union does is establishes a contract so there are no changes over night it has to be a voted issue.  Its fair but alot of owners see it as you cutting Into the profit or trying to tell them how to run the company.  Its been ATTEMPTED to bring in a large union for ems into L.A. failed by a small percentage and was mainly due to the people themselves not giving a damn because its all a "stepping stone" to a fire job or nurses job and my argument to that is why not have a union now and after your primary ems job?  As a business owner on the side of my ems job to make ends meat, I would welcome a union.  A proud happy well funded worker only helps you grow.



Your absolutely right....


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## SkiMaskWay (Aug 30, 2014)

SkiMaskWay said:


> Your absolutely right....


Its time for a change


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## MrJones (Aug 30, 2014)

I'm curious as to whether any of those who have expressed the desire to unionize have ever been a dues-paying union member, EMS or otherwise. And please, no need for any long-winded responses; it's a simple yes or no question.


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## gonefishing (Aug 30, 2014)

MrJones said:


> I'm curious as to whether any of those who have expressed the desire to unionize have ever been a dues-paying union member, EMS or otherwise. And please, no need for any long-winded responses; it's a simple yes or no question.


Yes.


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## SkiMaskWay (Aug 30, 2014)

DieselBolus said:


> I can see past the lack of communication skills, but.....wtf?
> 
> I have never met a medic who felt pushing a gurney was below them. Even flight medics who scored jobs with 500 applicants for a single opening. I have also never met a medic who failed to understand that the tools we have for moving people around are central in PREhospital care.
> 
> I suppose that could be hard to understand if you got into EMS to run around intubating patients and letting other people deal with the paltry transportation to definitive care.


What I mean by " Pushing a gurney" is that's all you do, no patient care...ya know "slinging Gomers" its a joke for an ems worker doing bottom of the barrel type calls Dialysis, Doctors visits wait and returns hospital discharges.


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## gonefishing (Aug 30, 2014)

SkiMaskWay said:


> What I mean by " Pushing a gurney" is that's all you do, no patient care...ya know "slinging Gomers" its a joke for an ems worker doing bottom of the barrel type calls Dialysis, Doctors visits wait and returns hospital discharges.


LOL welcome to a part of ems.  Just like somebody has to fry the french frys.  I can get the point of some of those calls, not all the time do those patients have to go by Ambulance.  I've all seen people that seriously need an ambulance to dialysis and things go bad.  BP drops dramatically, shortness of breath.  Sorry its not all action and adventure.


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## terrible one (Aug 30, 2014)

I'm not found of the saying "you don't like it pick another career". This implies one should simply be grateful of the fact that have a job at all. Nothing will change when the brightest of EMS keep leaving because they fail to follow the status quo. 
It's obvious why so few EMS professionals retire as EMTs / paramedics. I for one would like to see changes and a push for making this a career instead of a stepping stone to a real career.


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## SkiMaskWay (Aug 30, 2014)

gonefishing said:


> LOL welcome to a part of ems.  Just like somebody has to fry the french frys.  I can get the point of some of those calls, not all the time do those patients have to go by Ambulance.  I've all seen people that seriously need an ambulance to dialysis and things go bad.  BP drops dramatically, shortness of breath.  Sorry its not all action and adventure.


I'm in no way implying that by not doing 911 calls, dropping tubes, popping lines, pushing meds.. Etc, I'm not happy being a Paramedic, but what I'm saying is that  just because we do calls that maybe warrant a wheelchair van... You cant say companies don't  charge an arm and a leg for those transports because they do. And the fact that they require a trained professional they should pay accordingly despite training involved ....they sure as hell charge accordingly. And the biggest problem is that EMTs are willing to work for so little and don't give themselves any value and buy in to the notion that its OK to put up with poor wages , bad working conditions, be treated like crap by their employers. And if it is a stepping stone fine you still should not allow an employer to mistreat you. I mean who does that? I started this discussion because I was wondering why EMS union were not as effective as other union in other industries... I've her of even our movie set medics consisting of EMTs and Paramedics those guys make great money and have bennies and even retirement...how are they different ? How come the over saturated EMT market doesn't effect them??


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## SkiMaskWay (Aug 30, 2014)

SkiMaskWay said:


> I'm in no way implying that by not doing 911 calls, dropping tubes, popping lines, pushing meds.. Etc, I'm not happy being a Paramedic, but what I'm saying is that  just because we do calls that maybe warrant a wheelchair van... You cant say companies don't  charge an arm and a leg for those transports because they do. And the fact that they require a trained professional they should pay accordingly despite training involved ....they sure as hell charge accordingly. And the biggest problem is that EMTs are willing to work for so little and don't give themselves any value and buy in to the notion that its OK to put up with poor wages , bad working conditions, be treated like crap by their employers. And if it is a stepping stone fine you still should not allow an employer to mistreat you. I mean who does that? I started this discussion because I was wondering why EMS union were not as effective as other union in other industries... I've her of even our movie set medics consisting of EMTs and Paramedics those guys make great money and have bennies and even retirement...how are they different ? How come the over saturated EMT market doesn't effect them??


Its like the Matrix, The status Quo, it's a system ...it shouldn't be that way. What LA county needs is a really good Union a legitimate one, One that can actually make a change and attempt to unionize all the private sector EMS workers and there is such a market for it.. That it  would work,  in fact that would really shake the tree for all the Ambulance companies that are under the impression they could exploit these young EMTs and make it quick buck. There is absolutely no representation for these workers. On the flip side any of the older ones do move on to either Fire were they become members of the Firefighters Association or Nursing were they have a Nurses association or union at the hospitals they work at  or any other industry that pays better and once again most likely has better pay due to some sort of represtation...


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## gonefishing (Aug 30, 2014)

SkiMaskWay said:


> Its like the Matrix, The status Quo, it's a system ...it shouldn't be that way. What LA county needs is a really good Union a legitimate one, One that can actually make a change and attempt to unionize all the private sector EMS workers and there is such a market for it.. That it  would work,  in fact that would really shake the tree for all the Ambulance companies that are under the impression they could exploit these young EMTs and make it quick buck. There is absolutely no representation for these workers. On the flip side any of the older ones do move on to either Fire were they become members of the Firefighters Association or Nursing were they have a Nurses association or union at the hospitals they work at  or any other industry that pays better and once again most likely has better pay due to some sort of represtation...


And as I said before it was attempted and the only people that didn't let it happen were the few that didn't care.  It all has to do with your peers.


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## SkiMaskWay (Aug 30, 2014)

MrJones said:


> Sounds to me like you picked the wrong profession.
> 
> Bro.


Nope your wrong.... I still recall my transcripts from RCC its ses the Units I got were all EMS and the title was Paramedic...so no your mistaken I did intend to be a Pre-hospital medical professional back in 2002 class 2...You mis perceived what I do.


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## SkiMaskWay (Aug 30, 2014)

gonefishing said:


> And as I said before it was attempted and the only people that didn't let it happen were the few that didn't care.  It all has to do with your peers.


That's true...I agree with you on that...


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## DieselBolus (Aug 30, 2014)

SkiMaskWay said:


> I'm in no way implying that by not doing 911 calls, dropping tubes, popping lines, pushing meds.. Etc, I'm not happy being a Paramedic, but what I'm saying is that  just because we do calls that maybe warrant a wheelchair van... You cant say companies don't  charge an arm and a leg for those transports because they do. And the fact that they require a trained professional they should pay accordingly despite training involved ....they sure as hell charge accordingly.


 
If you're running transports of dubious medical necessity, I hope you're delivering Advanced Beneficiary Notices and notifying the sending staff and your supervisor that you have a call you suspect Medicare will kick back on a technical denial. Otherwise you're not being an advocate for your patient, your employer, or your healthcare system.

Technical denials that get billed directly to the patient put a massive strain on private companies because the collection rate is horrible.
For the small number of IFT patients that could go by chair van or car and have insurance preauthorization for the Tx, I do agree its frustrating, but its job security.

I think the extra dollar an hour you'd get from unionizing will land in your lap anyway if you show your employer that you've done your homework in all aspects of patient advocacy. I'm not antiunion by any stretch of the imagination, but I think if we want to be treated and paid as professionals, we have much bigger fish to fry. Sorry to stray off topic..[/QUOTE]


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## gonefishing (Aug 30, 2014)

DieselBolus said:


> If you're running transports of dubious medical necessity, I hope you're delivering Advanced Beneficiary Notices and notifying the sending staff and your supervisor that you have a call you suspect Medicare will kick back on a technical denial. Otherwise you're not being an advocate for your patient, your employer, or your healthcare system.
> 
> Technical denials that get billed directly to the patient put a massive strain on private companies because the collection rate is horrible.
> For the small number of IFT patients that could go by chair van or car and have insurance preauthorization for the Tx, I do agree its frustrating, but its job security.
> ...


[/QUOTE]
EXACTLY.


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## SkiMaskWay (Aug 30, 2014)

DieselBolus said:


> If you're running transports of dubious medical necessity, I hope you're delivering Advanced Beneficiary Notices and notifying the sending staff and your supervisor that you have a call you suspect Medicare will kick back on a technical denial. Otherwise you're not being an advocate for your patient, your employer, or your healthcare system.
> 
> Technical denials that get billed directly to the patient put a massive strain on private companies because the collection rate is horrible.
> For the small number of IFT patients that could go by chair van or car and have insurance preauthorization for the Tx, I do agree its frustrating, but its job security.
> ...


[/QUOTE]
Billing is not my area of expertise... Sorry.. Patient care is. Also a dollar more?? That's not the kinda union I'm talking about .. How about medical, Dental , Vision, maybe retirement or some sort of 401k. Adherence to disciplinary policies, real job security, progressive pay scale,protection from termination for unjust causes simply because they can pay less to a new guy.etc....the fact that an ambulance company is slinging lots of Gs doesn't give me job security...then not being able to be reimbursed 100% of the time is also not my problem that's the way the business works. And most importantly providing good patient care for a pat in the back from my employer  is definitely not why I would do it... In this business EMS workers are very expendable and one thing is for sure even the company men or brown nosers aren't immune to being canned....Work Union Live better ...
I come from a family of skilled trades men( from Iron workers to Plumbers) and they all make  a descent living and all make over 100k a year always worked Union. And some 15 years ago I had the opportunity to get into the Union after the military since I have alot of connections and family but instead I chose to be an EMT and later a Paramedic because this is what I enjoyed doing and still do....but never expected it to have such a dark side, And be so degrading at times.


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## avdrummerboy (Aug 30, 2014)

Be careful what you wish for, very few unions that I know of that people actually like working under. Aside from the vast majority not caring (and wanting to just fly under the radar and not make waves), if you managed to band enough people together in the LA/ OC area who demand unionization and it comes off as desperate as it now feels, chances are you're going to get some shady union that will only be the slightest bit better than any given company down there.

As to a high profit/ big return company, you might want to talk to a few financial managers of companies. Even the unethical owners (and boy are there a lot down there) are going to have to play the same games with medicare/ medical/ other insurances. A good company is one that gets 30+% return on billed runs. 20-25% is common, if you've got a company making 35% or more, count your blessings as that is a rarity.


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## SkiMaskWay (Aug 30, 2014)

Billing is not my area of expertise... Sorry.. Patient care is. Also a dollar more?? That's not the kinda union I'm talking about .. How about medical, Dental , Vision, maybe retirement or some sort of 401k. Adherence to disciplinary policies, real job security, progressive pay scale,protection from termination for unjust causes simply because they can pay less to a new guy.etc....the fact that an ambulance company is slinging lots of Gs doesn't give me job security...then not being able to be reimbursed 100% of the time is also not my problem that's the way the business works. And most importantly providing good patient care for a pat in the back from my employer  is definitely not why I would do it... In this business EMS workers are very expendable and one thing is for sure even the company men or brown nosers aren't immune to being canned....Work Union Live better ...
I come from a family of skilled trades men( from Iron workers to Plumbers) and they all make  a descent living and all make over 100k a year always worked Union. And some 15 years ago I had the opportunity to get into the Union after the military since I have alot of connections and family but instead I chose to be an EMT and later a Paramedic because this is what I enjoyed doing and still do....but never expected it to have such a dark side, And be so degrading at times.[/QUOTE]
Maybe I will just hang up the driving gloves and just leave the industry and go work a Union job and lay pipe and make better wages instantly with no experience, And  play paramedic for an operation like morongo  or baker ambulance  maybe as a flight medic just part time for the love of the job.


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## drl (Aug 30, 2014)

SkiMaskWay said:


> Billing is not my area of expertise... Sorry.. Patient care is. Also a dollar more?? That's not the kinda union I'm talking about .. How about medical, Dental , Vision, maybe retirement or some sort of 401k. Adherence to disciplinary policies, real job security, progressive pay scale,protection from termination for unjust causes simply because they can pay less to a new guy.etc....the fact that an ambulance company is slinging lots of Gs doesn't give me job security...then not being able to be reimbursed 100% of the time is also not my problem that's the way the business works. And most importantly providing good patient care for a pat in the back from my employer  is definitely not why I would do it... In this business EMS workers are very expendable and one thing is for sure even the company men or brown nosers aren't immune to being canned....Work Union Live better ...



At least from what I've seen, unions in the EMS industry often don't provide huge wage increases. I have a friend who works in a unionized ambulance service in the same region as me, and the starting wage is less than a dollar more per hour, before union fee deductions. The benefits that my company provides are also on par with his, and begin after a shorter period of full-time employment.

One major area that his union does protect is job security; on the flip side, however, you get burned-out EMTs/medics who deliver sub-par care that the company can't easily let go. Bottom line, be careful what you wish for.

I agree with one of the earlier posters: if this EMS environment is to change, it needs to begin with raising the education, training, and certification bar. Once EMTs/medics are not so easily replaceable, like RNs, compensation will improve with or without unions.

And on the earlier note re. ambulatory patients who really don't need an ambulance: it's definitely in everyone's best interest to communicate that to the higher-ups. My company makes it pretty clear that they'll discontinue service for patients who don't need it, since insurance won't cover it.


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## DieselBolus (Aug 30, 2014)

SkiMaskWay said:


> Billing is not my area of expertise... Sorry.. Patient care is. Also a dollar more?? That's not the kinda union I'm talking about .. How about medical, Dental , Vision, maybe retirement or some sort of 401k. Adherence to disciplinary policies, real job security, progressive pay scale,protection from termination for unjust causes simply because they can pay less to a new guy.etc....the fact that an ambulance company is slinging lots of Gs doesn't give me job security...then not being able to be reimbursed 100% of the time is also not my problem that's the way the business works. And most importantly providing good patient care for a pat in the back from my employer  is definitely not why I would do it... In this business EMS workers are very expendable and one thing is for sure even the company men or brown nosers aren't immune to being canned....Work Union Live better ...
> I come from a family of skilled trades men( from Iron workers to Plumbers) and they all make  a descent living and all make over 100k a year always worked Union. And some 15 years ago I had the opportunity to get into the Union after the military since I have alot of connections and family but instead I chose to be an EMT and later a Paramedic because this is what I enjoyed doing and still do....but never expected it to have such a dark side, And be so degrading at times.


 
As an IFT EMT it is absolutely integral to patient care to understand how Medicare patients (your biggest demographic) are affected by your documentation and interaction with all parties involved.

For example, ERs want to clear out beds, and if an ambulance ETA beats a wheelchair van by a number of hours, you can bet your *** an MD will sign a bull **** Physician's Certification Statement for Medical Necessity form in a heartbeat. I had that happen last night, and I'm sure it'll happen again within a week. If there's no supporting evidence in the chart or your PCR, that's a technical denial on a Tx granny didn't need. Without your advocacy, she may never be told it won't be covered. Read: a surprise bill for thousands of dollars for someone's elderly family member because you didn't act as a patient advocate. Again, as an IFT EMT, preventing unnecessary financial hardship is absolutely patient care.

As for your employer not getting paid for a Tx, do you think that could possibly have an effect on your wages? It is absolutely your problem. That's the way business works.

EMS personnel not understanding the long term implications of their actions doesn't just apply to clinical decisions. You can screw up a patient medically and financially.

Remember those bigger fish to fry before worrying about unions?

I would hope anyone proclaiming to be a professional and discussing the financial aspects of EMS would have at least a working knowledge of how Medicare affects their industry and their patients.

By the way, as a  data point, I'm a Basic at an IFT only company and have the option of medical, vision, dental with decent premiums and 401(k) without a union. Also, I would say that for the 160 hours of education I have, as well as how easy, enjoyable, and low stress IFT is, and the glut of unemployed EMTs in my area, I have absolutely no gripes with being paid minimum wage. I'd pay me minimum wage too.


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## SkiMaskWay (Aug 30, 2014)

DieselBolus said:


> As an IFT EMT it is absolutely integral to patient care to understand how Medicare patients (your biggest demographic) are affected by your documentation and interaction with all parties involved.
> 
> For example, ERs want to clear out beds, and if an ambulance ETA beats a wheelchair van by a number of hours, you can bet your *** an MD will sign a bull **** Physician's Certification Statement for Medical Necessity form in a heartbeat. I had that happen last night, and I'm sure it'll happen again within a week. If there's no supporting evidence in the chart or your PCR, that's a technical denial on a Tx granny didn't need. Without your advocacy, she may never be told it won't be covered. Read: a surprise bill for thousands of dollars for someone's elderly family member because you didn't act as a patient advocate. Again, as an IFT EMT, preventing unnecessary financial hardship is absolutely patient care.
> 
> ...


We'll maybe they should include all of that good billing info in the next revision of the Brady's Paramedic and EMT textbook since according to you its patient care... Once again I'm a Paramedic with 12 years experience in the field and my expertise is on patient care not billing ....I formulate my treatment plan based on me exercising clinical judgment in the capacity of a Paramedic... I don't know about reimbursement or medical or medicare billing nor do I care, what I do care is that I provide the best possible care for the patient in my truck in the few minutes they will spend with me....as far as you being content with your pay thats your problem and the life style you want, but the fact that EMTs only have a 160 hours of training there is no excuse for low ball wages. There is a lot of other industries that an abundance of workers exists due to absolutely no training needed yet they make substantially better salaries with frindge benefits... So don't throw that myth about x amount of hours of schooling that's just a bs line ...in this day and age employers want specialized training ...a worker that can work. A skilled and experienced  person
At a job or trade. and good wages equals good moral and productivity and longevity. Cheap labor is cheap, poor quality , high turnaround. That's why most construction firms hire union workers because things are done right the first no needed for second inspection.
Go to home depot and hire an illegal to build you a house good luck passing inspection. Same idea. Cheap labor you pay for what you get...


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## SkiMaskWay (Aug 30, 2014)

DieselBolus said:


> As an IFT EMT it is absolutely integral to patient care to understand how Medicare patients (your biggest demographic) are affected by your documentation and interaction with all parties involved.
> 
> For example, ERs want to clear out beds, and if an ambulance ETA beats a wheelchair van by a number of hours, you can bet your *** an MD will sign a bull **** Physician's Certification Statement for Medical Necessity form in a heartbeat. I had that happen last night, and I'm sure it'll happen again within a week. If there's no supporting evidence in the chart or your PCR, that's a technical denial on a Tx granny didn't need. Without your advocacy, she may never be told it won't be covered. Read: a surprise bill for thousands of dollars for someone's elderly family member because you didn't act as a patient advocate. Again, as an IFT EMT, preventing unnecessary financial hardship is absolutely patient care.
> 
> ...


Also as far as pay being impacted by non reimbursement?? No I'm an hourly employee...I don't work on commission... I don't get paid anymore or less if xyz Ambulance reimburses..in fact if I was making minimum wage I treat that job as such: A minimum wage job!!!


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## SkiMaskWay (Aug 30, 2014)

DieselBolus said:


> As an IFT EMT it is absolutely integral to patient care to understand how Medicare patients (your biggest demographic) are affected by your documentation and interaction with all parties involved.
> 
> For example, ERs want to clear out beds, and if an ambulance ETA beats a wheelchair van by a number of hours, you can bet your *** an MD will sign a bull **** Physician's Certification Statement for Medical Necessity form in a heartbeat. I had that happen last night, and I'm sure it'll happen again within a week. If there's no supporting evidence in the chart or your PCR, that's a technical denial on a Tx granny didn't need. Without your advocacy, she may never be told it won't be covered. Read: a surprise bill for thousands of dollars for someone's elderly family member because you didn't act as a patient advocate. Again, as an IFT EMT, preventing unnecessary financial hardship is absolutely patient care.
> 
> ...



I would hope that any Ambulance service proclaiming to be a Professional Ambulance service that may be serving my community would atleast have the descentsie to provide their medical professionals with livable wages and access to healthcare in the form of medical insurance and benefits. I could I expect good patient care if you don't even take care of your own. And as far as being a Billing advocate for the patient??? Your delusional! You really are!


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## DieselBolus (Aug 30, 2014)

If the Brady book has every aspect of patient care covered, then why did you feel the need to post how long you've been in the field?

The fact of the matter is people are more than willing to work for the market rate. Most people dont intend on, or want to be "lifers" in private EMS. They move to fire, or move up from their vocational position as a medic to a professional position with more education.

I'm happy with my minimum wage because I need the hours for medic school. Its like a paid internship. It's also a hell of a lot more intellectually stimulating than my previous job doing drywall.

As far as me being delusional, probably. But CMS states that for a Medicare patient where the transporting staff suspects that there will be a technical denial, a good faith effort to deliver an Advanced Beneficiary Notice must be attempted. The patient, now informed that they will likely be fully responsible for the transport vs. the 20% copay they pay for a covered ride, then has the opportunity to refuse the transport and wait for the wheelchair van for ~$50+$5/mile vs thousands for an ambulance. The wheelchair van is usually the more popular choice for those who dont need an ambulance.

By the way, pay is usually impacted when your company has nothing to pay you with.


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## drl (Aug 30, 2014)

In the modern health care system, everyone has to deal with billing. Even a large part of doctors' work is dealing with insurance companies and MediCare. Like it or not, the days where healthcare providers could focus on just patient care are over.


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## SkiMaskWay (Aug 30, 2014)

DieselBolus said:


> If the Brady book has every aspect of patient care covered, then why did you feel the need to post how long you've been in the field?
> 
> The fact of the matter is people are more than willing to work for the market rate. Most people dont intend on, or want to be "lifers" in private EMS. They move to fire, or move up from their vocational position as a medic to a professional position with more education.
> 
> ...


I felt the need to emphasize on my experience because in the 12 years as a Medic and 4 years as an EMT I've always provided the best  patient care possible and to this day I haven't ever got a complaint nor have  I had an issue getting paid correctly or reprimanded. I never said the Brady covers every aspect of patient care but it sure isn't a medical billing text book. Once again that's not my job


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## SkiMaskWay (Aug 30, 2014)

DieselBolus said:


> If the Brady book has every aspect of patient care covered, then why did you feel the need to post how long you've been in the field?
> 
> The fact of the matter is people are more than willing to work for the market rate. Most people dont intend on, or want to be "lifers" in private EMS. They move to fire, or move up from their vocational position as a medic to a professional position with more education.
> 
> ...


Technical denial!Technical Denial... If you really intend on going to Paramedic school maybe you should worry about patient care and providing the best possible care . I want to see the look on your preceptors face if you spit some gibberish about technical denials or reimbursements... And no being an EMT is not an internship, its a job...they don't have interns running around getting certs  And LA city DOT cards for an ambulance company to conduct business. And if it were an internship billing would be the last thing to worry about.
By the way if the company can't bill  and they have no revenue they  should just shut down or hire billers. As far as an  impact on my pay it shouldn't its illegal. Pay is not contingent on reimbursement. Once again it ain't my problem specially for minimum wage.. Maybe the money they save on not paying adequately or benefits they could use to endure tough economical times associated with running a business.
Besides Ambulance companies are a dime a dozen... Specially ones that pay minimum wage.


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## SkiMaskWay (Aug 30, 2014)

drl said:


> In the modern health care system, everyone has to deal with billing. Even a large part of doctors' work is dealing with insurance companies and MediCare. Like it or not, the days where healthcare providers could focus on just patient care are over.


EMTs and Paramedics are not doctors and their role has nothing to do with billing....maybe grabbing demographics and a signature if the patients condition permits. And it has everything to do with patient care. Whether you like it or not billing is not of to much importance in the prehospital emergency setting...to think that is just absurd...


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## DieselBolus (Aug 30, 2014)

Solid advice. I definitely will refrain from talking about billing and technical denials when I'm working 911.

(There are no medicare technical denials in 911)

Speaking of spitting gibberish..


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## DieselBolus (Aug 30, 2014)

DieselBolus said:


> Solid advice. I definitely will refrain from talking about billing and technical denials when I'm working 911.
> 
> (There are no medicare technical denials in 911)
> 
> Speaking of spitting gibberish..



Actually I'm completely wrong, Medicare will still deny a 911 claim under certain conditions.

I think I confused it with state Medicaid programs.


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## DesertMedic66 (Aug 30, 2014)

SkiMaskWay said:


> EMTs and Paramedics are not doctors and their role has nothing to do with billing....maybe grabbing demographics and a signature if the patients condition permits. And it has everything to do with patient care. Whether you like it or not billing is not of to much importance in the prehospital emergency setting...to think that is just absurd...



If billing is not important at all how do you expect ambulance companies to pay employees? Or buy equipment? Or maintain equipment? Or operate at all? There is no money god that grants money to ambulance companies.


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## SkiMaskWay (Aug 30, 2014)

We completely got off the subject here...specially with the private Ambulance company Advocate/intern EMT guy...im over it Minimum wage for everyone! and no benefits! And let's specialize on Medical billing and coding! So that your company can maximize profits!!! Yay!!


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## DesertMedic66 (Aug 30, 2014)

SkiMaskWay said:


> We completely got off the subject here...specially with the private Ambulance company Advocate/intern EMT guy...im over it Minimum wage for everyone! and no benefits! And let's specialize on Medical billing and coding! So that your company can maximize profits!!! Yay!!


The more my company makes, the more they pay me. We have been doing really good with collecting info for billing and because of that we have been getting raises unlike other companies around us...


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## DieselBolus (Aug 30, 2014)

SkiMaskWay said:


> We completely got off the subject here...specially with the private Ambulance company Advocate/intern EMT guy...im over it Minimum wage for everyone! and no benefits! And let's specialize on Medical billing and coding! So that your company can maximize profits!!! Yay!!



I genuinely think you have absolutely no idea what went on in this thread.

FWIW, in case you missed it before, I do get benefits at my company.


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## SkiMaskWay (Aug 30, 2014)

DesertEMT66 said:


> If billing is not important at all how do you expect ambulance companies to pay employees? Or buy equipment? Or maintain equipment? Or operate at all? There is no money god that grants money to ambulance companies.


It did not say its not important AT ALL...I said its not my job as a Paramedic


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## DesertMedic66 (Aug 30, 2014)

SkiMaskWay said:


> It did not say its not important AT ALL...I said its not my job as a Paramedic


How are our companies supposed to bill patients without us making sure we have the proper paperwork and patient demographics?


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## SkiMaskWay (Aug 30, 2014)

DieselBolus said:


> I genuinely think you have absolutely no idea what went on in this thread.
> 
> FWIW, in case you missed it before, I do get benefits at my company.


I do recall you mentioning you receive...and thats really nice to know that some companies actually care about their employees. As far as not knowing what went on I simply chose to ignore it because I don't own an Ambulance company... I'm just a Paramedic with only about 1,300 of training


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## SkiMaskWay (Aug 31, 2014)

usafmedic45 said:


> It doesn't always work.  In fact, there have been studies done that says it has little if any effect in managing, controlling or preventing symptoms of PTSD or similar conditions.


My concern with my PCRs is the reflection of my adequate patient care billing is secondary


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## SkiMaskWay (Aug 31, 2014)

DesertEMT66 said:


> If billing is not important at all how do you expect ambulance companies to pay employees? Or buy equipment? Or maintain equipment? Or operate at all? There is no money god that grants money to ambulance companies.


Oh I damn well know about the money Gods not existing shoot ask most of the EMTs on pay day...


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## DrParasite (Aug 31, 2014)

DesertEMT66 said:


> The more my company makes, the more they pay me. We have been doing really good with collecting info for billing and because of that we have been getting raises unlike other companies around us...


HAHAHAHA LMAO!!!! That might work for your company but with the VAST VAST majority of companies out there, the more the company makes, the employees make exactly the same amount.  The owners get rich, the staff get run into the ground, the ambulances barely meet state regulations, and as long as the billing keeps generating more money, the owners are happy. 

BTW, I just left a union EMS job for a non-union one.... I would take a union job over a non-union any time where the staff is overworked, the equipment is unsafe, and management doesn't care enough about the staff to listen to their concerns, and mistreats them and threatens unfair discipline for BS reasons.


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## avdrummerboy (Aug 31, 2014)

Wow, this thread went to S*** fast lol

As to pay, can you argue why SkiMaskWay this professions' employees need to make above minimum wage? Not saying I disagree with you, hell, I'd love to start at 12 or so an hour 24/24 on a 72 hour shift, but what is your reasoning? The way I see it, if you're paid minimum wage, it realistically means that your employer believes that they should be able to pay you less, the running question I'd like to know, how much less would these companies like to see us get paid (I'm sure most would overzealously answer FREE!) My personal opinion, even though it is only a 200 or so hour course, it is still a speciality; you can't just wake up one morning and go apply to be an EMT and get hired somewhere the same day, like you could at say fast food. So, yes we probably have enough justification in my mind right there to be at least some bit over minimum wage.

As to billing, no we are not billing/ coding experts, however, the business side of an ambulance company, be it BLS/ ALS/ 911 whatever is driven by billing and bringing in money, that's how they pay you your 'low' wages, that's how they buy rigs and gear (in theory) and whatever else the company needs. Yes there are owners making large salaries and yes it is not perfect, but welcome to the business world I guess. 

Patient care is absolutely the number one priority, however, getting billing info is also of great secondary importance if you want to get paid at all let alone have a job to come into the next week. As I said above, 'good' ambulance companies receive 25-30% of what they bill out, for example the company I work for runs on a around a 3M dollar budget but we bill out over 7M dollars worth of services, so it kind of leaves the honest companies' (like the one I work for) hands tied in terms of great wages, outstanding bennies giving raises, acquiring new gear, fixing old gear, etc.


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## Jon (Sep 1, 2014)

SkiMaskWay said:


> Also as far as pay being impacted by non reimbursement?? No I'm an hourly employee...I don't work on commission... I don't get paid anymore or less if xyz Ambulance reimburses..in fact if I was making minimum wage I treat that job as such: A minimum wage job!!!



Here's the root of the issue that you seem to be missing:

For EMS providers to get paid more, that money needs to come from somewhere. Unions don't BRING money, they actually take it out of your pocket. They just try to get the employers to give you more money, so you don't notice the union taking their share.

In most for-profit systems, the hourly wage is dictated, among other things, by what Medicare and other insurers will pay. So long as Medicare continues to reimburse, on average, 12% LESS than the cost of the transport, we will continue to be paid chump change. 

The systems that pay more are, by and large, taxpayer funded (FD/3rd service government jobs). 


In short - stop expecting something for nothing. Open your eyes, look at the current limiting factors. Money doesn't grow on trees. Further, if you want to be paid more, you have to provide a service that's worthwhile.


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## SkiMaskWay (Sep 1, 2014)

Jon said:


> Here's the root of the issue that you seem to be missing:
> 
> For EMS providers to get paid more, that money needs to come from somewhere. Unions don't BRING money, they actually take it out of your pocket. They just try to get the employers to give you more money, so you don't notice the union taking their share.
> 
> ...



I strongly disagree that unions just take money from workers with nothing in return...Unions are there to protect workers from not just illegal and unfair treatment but also guarantee constant raises and descent pay...benefits etc. Like u said money doesn't grow on trees there is costs associated with Attorney fees and logistical and administrative work of the union. Now the fact that there is loss revenue with running an ambulance company that's the business theyre in. Welcome to EMS.
Like I said as far as my role?  its not billing nor do I care if they collect or not... I will just do the bare minimum because my pay is not contingent on billing.specially if the wages are low. Only thing I really care about is that I provide excellent patient care and that my hours are correct for the the time im on the clock providing my paramedic services. And really don't think that's expecting something for nothing. And as far as  limited training or me only deserving minimum wage because I only received 1200 hours or so of training that just a BS excuse not to pay. Its Sleazy business practices because at the end of the day as a Paramedic you play a very important role and its definitely not worth minimum wage... I'm sure there is good companies out there and I would bend over backwards for a good employee. But 90% of LA companies are sleaze balls. And I treat them as such. Bottom line.


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## DesertMedic66 (Sep 1, 2014)

SkiMaskWay said:


> *guarantee constant raises and descent pay*


Hahahahahahahahaha. Ooh man that is funny. I know plenty of unionized companies that don't get constant raises and descent pay.

And here I am sitting in my corner with a non union company who gets the same pay (actually if I pick up shifts it's much more) and constant raises.

Do you really not get that your job is dependent on the company receiving payment from transports? If they don't get paid then their cost of operation exceeds the money they are bringing in. When that happens the company will normally downsize. Downsizing means you may get laid off.


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## SkiMaskWay (Sep 1, 2014)

DesertEMT66 said:


> Hahahahahahahahaha. Ooh man that is funny. I know plenty of unionized companies that don't get constant raises and descent pay.
> 
> And here I am sitting in my corner with a non union company who gets the same pay (actually if I pick up shifts it's much more) and constant raises.
> 
> Do you really not get that your job is dependent on the company receiving payment from transports? If they don't get paid then their cost of operation exceeds the money they are bringing in. When that happens the company will normally downsize. Downsizing means you may get laid off.



Who the hell turned this into a Budget, balance sheet, profit margin blah blah discussion.... I understand the the basic concept of budgeting and, accounts receivable and accounts payable. Once again I don't give a rats A** if they bill or not even if it means I would possibly be laid off. I don't get paid to worry about that. I understand that money in the privates comes from the hiked up prices and at times fraudulent billing. Specially when it doesn't make a difference on my check if I run one call or twenty calls all that matters is how many hours I work. Its just reality. Now once again the unions u speak of are probably those fake EMS unions that scam employees and usually are in bed with management.
IF we had a real EMS union we would not have EMTs and Medics making poverty level wages, 
UA250 LA county Plumbers and Pipefitters and service techs: straight from there web site


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## avdrummerboy (Sep 1, 2014)

Yes you understand the basics of budgets, but you seem not to get that if there is not money in there for you, you're gone! And if everyone has your attitude about it, then there will be no money at all and the company is done. You have to remember that privates are not subsidized and you do need to give at least a passing thought to doing billing right. I understand that we're in the field as patient care givers, but since rigs aren't staffed with two EMS personal and a billing agent, it is up to the crew to get billing and insurance info.


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## DesertMedic66 (Sep 1, 2014)

SkiMaskWay said:


> Who the hell turned this into a Budget, balance sheet, profit margin blah blah discussion.... I understand the the basic concept of budgeting and, accounts receivable and accounts payable. Once again I don't give a rats A** if they bill or not even if it means I would possibly be laid off. I don't get paid to worry about that. I understand that money in the privates comes from the hiked up prices and at times fraudulent billing. Specially when it doesn't make a difference on my check if I run one call or twenty calls all that matters is how many hours I work. Its just reality. Now once again the unions u speak of are probably those fake EMS unions that scam employees and usually are in bed with management.
> IF we had a real EMS union we would not have EMTs and Medics making poverty level wages,
> UA250 LA county Plumbers and Pipefitters and service techs: straight from there web site
> 
> ...



Last time I checked plumbers do care about billing and make sure all of their customers are billed. They bill for $500 and they get paid $500. EMS may bill for $1,500 and only receive $100. 

If you know of any plumbers who don't care about billing because "it doesn't concern them" please provide me with their contact information as I would love some free work done


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## SkiMaskWay (Sep 1, 2014)

avdrummerboy said:


> Yes you understand the basics of budgets, but you seem not to get that if there is not money in there for you, you're gone! And if everyone has your attitude about it, then there will be no money at all and the company is done. You have to remember that privates are not subsidized and you do need to give at least a passing thought to doing billing right. I understand that we're in the field as patient care givers, but since rigs aren't staffed with two EMS personal and a billing agent, it is up to the crew to get billing and insurance info.


Right, I do if my patients condition permits I get a signature and demographics...but that's not my priority. Getting the patient to the hospital safely is...as far as me being gone guess what  I could be gone for any little thing. So I'm not worried about job security because there isn't specially in the privates.


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## SkiMaskWay (Sep 1, 2014)

DesertEMT66 said:


> Last time I checked plumbers do care about billing and make sure all of their customers are billed. They bill for $500 and they get paid $500. EMS may bill for $1,500 and only receive $100.
> 
> If you know of any plumbers who don't care about billing because "it doesn't concern them" please provide me with their contact information as I would love some free work done


Free work? Your crazy! I know lots of plumbers commercial and industrial they make $44 an hour plus frindge benefits and a pension all union employees Too
Total package is $78 an hour. Last thing they do is bill...the Contractors due that and they have professional billers.the funny thing none of them went to a formal school. Just a few evening work shops during apprenticeship. And that goes for other Union trades too. Maybe your thinking of Plumbing techs that work for Roto rooter. You I really dought that Ambulance companies only receive a measly 100 bucks man you truly are a company man...well good luck with that.
Besides a plumbing service and repair call is not the same thing as a Medical call. In fact roto rooter plumbing tech  does make more than a EMT in LA county. Damn you just sympathize so much with these Ambulance companies.


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## SkiMaskWay (Sep 1, 2014)

Work Union Live better!


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## MrJones (Sep 1, 2014)

SkiMaskWay said:


> ...IF we had a real EMS union we would not have EMTs and Medics making poverty level wages,









You just keep telling yourself that. Meanwhile, the rest of us will work on the things that will actually result in improved wages and working conditions.


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## SkiMaskWay (Sep 1, 2014)

MrJones said:


> You just keep telling yourself that. Meanwhile, the rest of us will work on the things that will actually result in improved wages and working conditions.


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## SkiMaskWay (Sep 1, 2014)

MrJones said:


> You just keep telling yourself that. Meanwhile, the rest of us will work on the things that will actually result in improved wages and working conditions.


Like what Mr Jones? 100% compliance on your billing info? No! You wrong. That won't improve your working conditions or wages. Its politics and greed you can't fix that. Even the best employees aren't immune to unjust termination. Brown nosing or being a poster child for your company won't spare you...its business.
Anyways to more important things Angels just swept the As.  30 games above .500 83-53 best record in MLB yay! We may just have a freeway world series here in LA.


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## MrJones (Sep 1, 2014)

SkiMaskWay said:


> Like what Mr Jones? 100% compliance on your billing info? No! You wrong. That won't improve your working conditions or wages. Its politics and greed you can't fix that. Even the best employees aren't immune to unjust termination. Brown nosing or being a poster child for your company won't spare you...its business.
> Anyways to more important things Angels just swept the As.  30 games above .500 83-53 best record in MLB yay! We may just have a freeway world series here in LA.



That's strange - I don't recall writing anything about billing info, brown nosing or being a poster child. But, hey, if it makes you feel better to think that I did then you just get down with your bad self. Meanwhile, I'll continue working toward real change - change that will result in actual improvements, both for our profession and for those who are a part of it.

Even you.


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## SkiMaskWay (Sep 1, 2014)

MrJones said:


> That's strange - I don't recall writing anything about billing info, brown nosing or being a poster child. But, hey, if it makes you feel better to think that I did then you just get down with your bad self. Meanwhile, I'll continue working toward real change - change that will result in actual improvements, both for our profession and for those who are a part of it.
> 
> Even you.


Sorry wrong poster...well Thank you for all your efforts.


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## DesertMedic66 (Sep 1, 2014)

SkiMaskWay said:


> Free work? Your crazy! I know lots of plumbers commercial and industrial they make $44 an hour plus frindge benefits and a pension all union employees Too
> Total package is $78 an hour. Last thing they do is bill...the Contractors due that and they have professional billers.the funny thing none of them went to a formal school. Just a few evening work shops during apprenticeship. And that goes for other Union trades too. Maybe your thinking of Plumbing techs that work for Roto rooter. You I really dought that Ambulance companies only receive a measly 100 bucks man you truly are a company man...well good luck with that.
> Besides a plumbing service and repair call is not the same thing as a Medical call. In fact roto rooter plumbing tech  does make more than a EMT in LA county. Damn you just sympathize so much with these Ambulance companies.


I don't sympathize with them, I just have realistic views. 

While this link is from 2011 it is still accurate about Medi-Cal reimbursement rates: http://www.californiahealthline.org...-providers-struggle-with-low-medical-payments


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## SkiMaskWay (Sep 1, 2014)

DesertEMT66 said:


> I don't sympathize with them, I just have realistic views.
> 
> While this link is from 2011 it is still accurate about Medi-Cal reimbursement rates: http://www.californiahealthline.org...-providers-struggle-with-low-medical-payments


For bringing Medi-Cal patients to a hospital, the state pays ambulance providers about $118 plus $3 per mile, or about one-quarter of the cost of the ambulance trip. In comparison, the federal government pays ambulance providers about $420 plus $6.80 per mile -- or about 75% of the cost of the ambulance trip -- for bringing Medicare beneficiaries to the hospital.

So let's just say $130 with mileage per transport 8 runs a day is 
$379,600 per rig in a year and not all transport are med-ical some are private insurance some maybe they don't collect. Out of that EMT salary maybe 30kx2 . Their making a killing. Insurance and licensing and overhead, maintenance on vehicles most companies barely maintain there rigs? 
Add 14 more rigs that's 5.4 million. Wow there is a profit margin for sure I don't feel sorry them one bit. Its big business.
Man I want a piece of that pie. Add ALS runs and CCT to that equation.


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## drl (Sep 1, 2014)

Ignoring other logical fallacies, you definitely can't compute the revenue per rig using those insurance figures, for several reasons:

1.- Many large private insurers pay as little as 80% of Medicare rates. I believe Blue Cross is notorious for this.
2.- Medicare is extraordinarily good at rejecting payment or paying less than the quoted figures, based on their assessments of patient "need" for ambulance transport (even with regular patients). Some of that is also due to EMTs being less than diligent with their PCR/PCS/other documentation (so you better believe billing is key).
3.- Open any book on businesses and you'll find that overhead costs are significantly more than you estimate.

For those and other reasons, I'm quite willing to bet most companies are not "making a killing." And as long as that's true, EMT/medic pay will continue to be relatively low.


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## DesertMedic66 (Sep 1, 2014)

SkiMaskWay said:


> For bringing Medi-Cal patients to a hospital, the state pays ambulance providers about $118 plus $3 per mile, or about one-quarter of the cost of the ambulance trip. In comparison, the federal government pays ambulance providers about $420 plus $6.80 per mile -- or about 75% of the cost of the ambulance trip -- for bringing Medicare beneficiaries to the hospital.
> 
> So let's just say $130 with mileage per transport 8 runs a day is
> $379,600 per rig in a year and not all transport are med-ical some are private insurance some maybe they don't collect. Out of that EMT salary maybe 30kx2 . Their making a killing. Insurance and licensing and overhead, maintenance on vehicles most companies barely maintain there rigs?
> ...


You forgot a **** load of extra costs. Extra staff aside from EMTs/Medics, training, late call deductions, county contract fees (huge sum of money), facility rent, all the medication costs (including O2), contracts with tow companies, contracts with medical facilities for flu shots (and the like), phone lines, radio channel costs (it's not free), and soo much more. 

If your going to try to calculate how much they actually make then you should know how much is actually costs to maintain a company. There are some companies that make a killing in revenue but there are many others that don't. 

8 runs in a day is a very very busy system.


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## avdrummerboy (Sep 1, 2014)

Let's use your 5.4M dollar estimate in billing alone,  a GREAT ambulance company will see a mere 30% of that or 1.62 million! You're 'whopping' budget just got sliced 70% instantly. Add to that other factors, like actual overhead costs, what little maintenance is done (for some of the crappier companies) among others and the killing that you think these companies isn't happening.


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## SkiMaskWay (Sep 1, 2014)

drl said:


> Ignoring other logical fallacies, you definitely can't compute the revenue per rig using those insurance figures, for several reasons:
> 
> 1.- Many large private insurers pay as little as 80% of Medicare rates. I believe Blue Cross is notorious for this.
> 2.- Medicare is extraordinarily good at rejecting payment or paying less than the quoted figures, based on their assessments of patient "need" for ambulance transport (even with regular patients). Some of that is also due to EMTs being less than diligent with their PCR/PCS/other documentation (so you better believe billing is key).
> ...


Well then why do they do it? If its not for the money? You think they do it because their moral compass points them to help fellow man? No man...you better believe their making money... Greed is what drives most of them indicative of how they nickel and dime their employees. Do you realize how many new companies operate in LA owned by Armenians and Russians that barely speak English to offense to anyone but its the truth. Given we have a hand full of descent companies such as Hall Ambulance and others that primarily do 911 but those are in whole different category and county for that matter. But even  in LA even the companies that do 911 only do it to attract bright eyed EMTs looking for experience but get stuck doing dialysis and discharges. Don't be so naive its the reality. The pay will always be low because the workers they target usually live at home and its probably their first real job and they really don't care about money or mortgages or benefits and most likely it is a stepping stone so they allow themselves to be exploited. Just like McDonalds or other low paying jobs in fact those jobs offer room for advancement to shift leader or manager and they even provide medical and dental.... Its greed plain and simple


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## SkiMaskWay (Sep 1, 2014)

SkiMaskWay said:


> Well then why do they do it? If its not for the money? You think they do it because their moral compass points them to help fellow man? No man...you better believe their making money... Greed is what drives most of them indicative of how they nickel and dime their employees. Do you realize how many new companies operate in LA owned by Armenians and Russians that barely speak English to offense to anyone but its the truth. Given we have a hand full of descent companies such as Hall Ambulance and others that primarily do 911 but those are in whole different category and county for that matter. But even  in LA even the companies that do 911 only do it to attract bright eyed EMTs looking for experience but get stuck doing dialysis and discharges. Don't be so naive its the reality. The pay will always be low because the workers they target usually live at home and its probably their first real job and they really don't care about money or mortgages or benefits and most likely it is a stepping stone so they allow themselves to be exploited. Just like McDonalds or other low paying jobs in fact those jobs offer room for advancement to shift leader or manager and they even provide medical and dental.... Its greed plain and simple


Since AMR got downsized here in LA there are sooo many companies that have popped up over night..just look at the county web site. 8 calls is actually low balling that's only 4 dialysis patients and besides if they use O2 meds or any additional treatments they charge they even charge for night calls why?? Is fuel more expensive at night? Do they pay the EMTs night differential ? No ...their scammers.. EMS should not be privatized we should have a 3rd service EMS system kinda like A/TCEMS. And their should be a limitation on how many Ambulance companies should be in business to filter out all the crooks...


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## DrParasite (Sep 1, 2014)

SkiMaskWay said:


> Free work? Your crazy! I know lots of plumbers commercial and industrial they make $44 an hour plus frindge benefits and a pension all union employees Too
> Total package is $78 an hour. Last thing they do is bill...the Contractors due that and they have professional billers.the funny thing none of them went to a formal school. Just a few evening work shops during apprenticeship. And that goes for other Union trades too. Maybe your thinking of Plumbing techs that work for Roto rooter. You I really dought that Ambulance companies only receive a measly 100 bucks man you truly are a company man...well good luck with that.
> Besides a plumbing service and repair call is not the same thing as a Medical call. In fact roto rooter plumbing tech  does make more than a EMT in LA county. Damn you just sympathize so much with these Ambulance companies.


You know what? your right.

you should quit EMS, ad become a plumber... or a contractor.... After all, if you want to make $78 an hour...

BTW, I totally support unions in EMS (because we have crappy supervisors who need to be kept in check to prevent abuses of power), but I also know there is only so much money to go around, and if you work for a private for-profit company, they are going to make you fight tooth and nail for everything in your contract, and even then, you still only have so much money.  

This is why I won't ever work full time for a for-profit EMS agency, because even with a union, you won't be making much money.  If you want a livable wage, work for a taxpayer subsidized EMS agency; that's how the PD and FD get paid livable wages, not by relying on tickets or fines.


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## SkiMaskWay (Sep 1, 2014)

SkiMaskWay said:


> Since AMR got downsized here in LA there are sooo many companies that have popped up over night..just look at the county web site. 8 calls is actually low balling that's only 4 dialysis patients and besides if they use O2 meds or any additional treatments they charge they even charge for night calls why?? Is fuel more expensive at night? Do they pay the EMTs night differential ? No ...their scammers.. EMS should not be privatized we should have a 3rd service EMS system kinda like A/TCEMS. And their should be a limitation on how many Ambulance companies should be in business to filter out all the crooks...


I've been in EMS for a long time I've  worked for awesome companies outside of LA and really bad ones in LA... I love being a Paramedic. After The Marines I took an EMT class and I fell in love with the work but I never imagined it had such a dark side and it was such a business like everything else. I couldn't afford to do this full time... Its just a Part time thing now but I'm so bitter because if I would have wanted to do this full time I was destined for a life of Poverty. Pretty pathetic huh or I would have to leave southern California. The money I make as a Paramedic is just beer money now...
In fact I'm gonna try to get a Flight Paramedic spot somewhere to supplement my income. And never step in to a privately owned ambulance again specially in LA county I despise them all.


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## LACoGurneyjockey (Sep 1, 2014)

"


SkiMaskWay said:


> I've been in EMS for a long time I've  worked for awesome companies outside of LA and really bad ones in LA... I love being a Paramedic. After The Marines I took an EMT class and I fell in love with the work but I never imagined it had such a dark side and it was such a business like everything else. I couldn't afford to do this full time... Its just a Part time thing now but I'm so bitter because if I would have wanted to do this full time I was destined for a life of Poverty. Pretty pathetic huh or I would have to leave southern California. The money I make as a Paramedic is just beer money now...
> In fact I'm gonna try to get a Flight Paramedic spot somewhere to supplement my income. And never step in to a privately owned ambulance again specially in LA county I despise them all.



Yes, you might have to leave LA, whoopdie ****ing doo. You think no one has ever moved for a job. You want to make LA into this utopian EMS system, just pick up Austin Travis County and drop it over here? It doesn't work like that. LA is what it is, if it's not to your liking, it's really not that difficult to move elsewhere. 
But I do agree with you on one point, you are bitter. Why keep doing it if it makes you so bitter? Do you really think that doesn't filter thru to your partners, to your patients, to hospital staff? Anyway, plumbers make such great wages, if that's all it's about why not take some night workshops and thrive on that? Private companies need to make money, or county services can take your money thru taxes, either way the funds come from somewhere. You brag about doing the bare minimum, like it's a good thing. It's a sign you're done here, and you need to find something else to fulfill you. 
And I think I speak for everyone in this thread when I say you would be perfectly suited for a flight job, those aren't dependent on billing at all, and someone with such an enthusiasm and passion for the job would be perfect. 
Let me now firmly press the sarcasm button.


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## LACoGurneyjockey (Sep 1, 2014)

Then there's this matter that I just can't let go:
It's there, not their. They're, not their. Several times. Then just for ****s and giggles you threw in a there's that really would have been happier as a their's. Doubt, not dought (wow, autocorrect just about lost it *there*). Decent, not descent (at least I don't think you meant descent pay, seems counterproductive). Do, not due.
Maybe you have been diligently completing all necessary billing paperwork for Medi Star Super Medi Ambu Trans Care Ambulance Service, but no one in billing can decipher *your* grammar. 
DesertEMT, I wonder if this is just one very skilled troll that has sucked in even the best of us... After reading this whole thread I just have a hard time believing this is genuine.


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## gonefishing (Sep 1, 2014)

Well to any concern, the L.A. mayors talking about raising the minimum wage so why not sign the petition to see it through?


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## LACoGurneyjockey (Sep 1, 2014)

I propose we all make $15 an hour across the board. Much like fast food workers, we are over worked and under paid and I demand an immediate, dramatic pay increase because it would really make my life a lot easier. I will not further my education however, and I will continue to do the bare minimum. 
Because in the same way the nice man who makes my delicious burger is only responsible for cooking such delicious burgers and not cleaning the kitchen, I am responsible for patient care only and I absolutely refuse to do more than one thing at a time. 
And I want a pony with ATCEMS painted down the side.


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## gonefishing (Sep 1, 2014)

LACoGurneyjockey said:


> I propose we all make $15 an hour across the board. Much like fast food workers, we are over worked and under paid and I demand an immediate, dramatic pay increase because it would really make my life a lot easier. I will not further my education however, and I will continue to do the bare minimum.
> And I want a pony with ATCEMS painted down the side.


Now see I thought the same thing lol if the McDonald's staff gets $15 an hour im quitting I can say "want frys with that?" LOL


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## SkiMaskWay (Sep 1, 2014)

LACoGurneyjockey said:


> Then there's this matter that I just can't let go:
> It's there, not their. They're, not their. Several times. Then just for ****s and giggles you threw in a there's that really would have been happier as a their's. Doubt, not dought (wow, autocorrect just about lost it *there*). Decent, not descent (at least I don't think you meant descent pay, seems counterproductive). Do, not due.
> Maybe you have been diligently completing all necessary billing paperwork for Medi Star Super Medi Ambu Trans Care Ambulance Service, but no one in billing can decipher *your* grammar.
> DesertEMT, I wonder if this is just one very skilled troll that has sucked in even the best of us... After reading this whole thread I just have a hard time believing this is genuine.


Yeah thanks for the Auto correct...my text to speech isn't very good. You attempt to insult me? Why? the truth hurts and you know it. It just seems that some how you are offended or have taken it personal, you want to call me a troll? your probably some brown noser EMT that thinks being a tampon for a private ambulance company is the status quo....in fact you probably live in your mom's basement content with your piss poor wages. If I'm a troll what are you? Better? You're no better than a baggage handler. As far as me being done in this field? And my bitterness rubbing off on anyone? I'm well liked and respected in this field, EMTs, Paramedics Nurses and Firefighters alike have always enjoyed working with me, and most importantly my patients have always been treated with the utmost respect and have gotten the best possible care I could provided as a Paramedic. Your statements and attacks are unfounded and pathetic.


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## SkiMaskWay (Sep 2, 2014)

LACoGurneyjockey said:


> I propose we all make $15 an hour across the board. Much like fast food workers, we are over worked and under paid and I demand an immediate, dramatic pay increase because it would really make my life a lot easier. I will not further my education however, and I will continue to do the bare minimum.
> Because in the same way the nice man who makes my delicious burger is only responsible for cooking such delicious burgers and not cleaning the kitchen, I am responsible for patient care only and I absolutely refuse to do more than one thing at a time.
> And I want a pony with ATCEMS painted down the side.


In fact your right...I will go above and beyond. I will take a medical billing and coding class just to insure my ambulance company collects every possible penny owed to them, and then maybe I could get my 25 cent raise I deserve. And I'll go back to school because I'm tired of being an LA county gurney jockey. your name suits you well too. At least you know your place.


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## LACoGurneyjockey (Sep 2, 2014)

SkiMaskWay said:


> Yeah thanks for the Auto correct...my text to speech isn't very good. You attempt to insult me? Why? the truth hurts and you know it. It just seems that some how you are offended or have taken it personal, you want to call me a troll? your probably some brown noser EMT that thinks being a tampon for a private ambulance company is the status quo....in fact you probably live in your mom's basement content with your piss poor wages. If I'm a troll what are you? Better? You're no better than a baggage handler. As far as me being done in this field? And my bitterness rubbing off on anyone? I'm well liked and respected in this field, EMTs, Paramedics Nurses and Firefighters alike have always enjoyed working with me, and most importantly my patients have always been treated with the utmost respect and have gotten the best possible care I could provided as a Paramedic. Your statements and attacks are unfounded and pathetic.



I like the "the truth hurts, your attacks are unfounded" so seamlessly combined with, well, just about everything else in your post.  
I left LA because I was tired of the conditions, and I get just as tired of hearing (not necessarily just) you complain about it and continue to work in a place you despise. No one did this to you. You made a conscious decision to work in this field in the city you're in.


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## SkiMaskWay (Sep 2, 2014)

gonefishing said:


> Now see I thought the same thing lol if the McDonald's staff gets $15 an hour im quitting I can say "want frys with that?" LOL


In n Out employees probably already got you beat. Lol


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## DieselBolus (Sep 2, 2014)

SkiMaskWay said:


> In fact your right...I will go above and beyond. I will take a medical billing and coding class just to insure my ambulance company collects every possible penny owed to them, and then maybe I could get my 25 cent raise I deserve. And I'll go back to school because I'm tired of being an LA county gurney jockey. your name suits you well too. At least you know your place.



Bro, do you even bill and code?

Medical billing and coding has nothing to do with any of this.


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## SkiMaskWay (Sep 2, 2014)

LACoGurneyjockey said:


> I like the "the truth hurts, your attacks are unfounded" so seamlessly combined with, well, just about everything else in your post.
> I left LA because I was tired of the conditions, and I get just as tired of hearing (not necessarily just) you complain about it and continue to work in a place you despise. No one did this to you. You made a conscious decision to work in this field in the city you're in.


That's just it... That's not the field I chose. Privates in LA that's not EMS. So passion and enthusiasm for that I don't have your right.


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## LACoGurneyjockey (Sep 2, 2014)

SkiMaskWay said:


> That's just it... That's not the field I chose. Privates in LA that's not EMS. So passion and enthusiasm for that I don't have your right.



On a serious note, then why continue to work in LA? I know it's a bad system. You know it's a bad system. Anyone on this forum for 8-ish minutes knows it's a bad system. There's plenty within a reasonable commute. You've got all this experience. Why wouldn't you work somewhere that doesn't treat you like ****?


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## Jon (Sep 2, 2014)

SkiMaskWay said:


> It did not say its not important AT ALL...I said its not my job as a Paramedic



Then who's job is it? How much effort would it take you to get the correct demographics, and speak up and say "hey, this run doesn't appear to need Medicare eligibility requirements?"

If someone else is doing that, they need to be paid too. And remember, I just said that the average EMS provider is reimbursed BELOW cost on Medicare runs.

No one is saying you need to be a coder, but you should have some concept of what information needs to be gathered and documented so that your employer can bill the call correctly and promptly.


I love how you keep insisting that a union would make everything better. I'm not convinced.

How much do your plumber friends pay in union dues, insurance, and any other costs that come out of their hourly wage? Do they provide their own equipment and tools? Do you (aside from a stethoscope?)

Plumbers are able to be paid "X" because their employer/general contractor is able to charge X+Y for the service provided. There are often vast differences in rates paid for union vs. Non-union plumbers (or other skilled trades).

There's no multi-tiered Medicare rate depending on if your a union shop. They say they will pay Z-dollars, that's all your employer will ever get.


As for the idea of one union to rule the all- that was supposed to be NEMSA, except that ship sailed about 8 years ago.


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## Jon (Sep 2, 2014)

Alright people.

I like the overall idea here, but it's got to be done NICELY, ok? Otherwise the dancing lock will be the last post, and folks may get vacations.


So play nice, and don't make me remove posts again, OK? Thanks.


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## gonefishing (Sep 2, 2014)

Jon said:


> Then who's job is it? How much effort would it take you to get the correct demographics, and speak up and say "hey, this run doesn't appear to need Medicare eligibility requirements?"
> 
> If someone else is doing that, they need to be paid too. And remember, I just said that the average EMS provider is reimbursed BELOW cost on Medicare runs.
> 
> ...


I was waiting for someone to bring up NEMSA...... (shivers) nasty union.


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## SkiMaskWay (Sep 2, 2014)

Jon said:


> Then who's job is it? How much effort would it take you to get the correct demographics, and speak up and say "hey, this run doesn't appear to need Medicare eligibility requirements?"
> 
> If someone else is doing that, they need to be paid too. And remember, I just said that the average EMS provider is reimbursed BELOW cost on Medicare runs.
> 
> ...


They make about $78 an hour when you include the benefits package.Journeyman wage Hourly is $44  Medical, dental, Vision, Pension. Check UA250 in LA county.


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## SkiMaskWay (Sep 2, 2014)

SkiMaskWay said:


> They make about $78 an hour when you include the benefits package.Journeyman wage Hourly is $44  Medical, dental, Vision, Pension. Check UA250 in LA county.



No one is saying I should be a coder? Then why do people (inexperienced people) keep insisting I have to go above and beyond to ascertain billing info? I clearly posted I would not go beyond basic demographic data and signatures anything beyond that is just not my god damn job, Besides I don't get paid enough to care about the over all financial status of a company. I speak for about 80 percent of the EMTs and Paramedics. That's just how it is.
Can you elaborate in NEMSA?


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## gonefishing (Sep 2, 2014)

SkiMaskWay said:


> No one is saying I should be a coder? Then why do people (inexperienced people) keep insisting I have to go above and beyond to ascertain billing info? I clearly posted I would not go beyond basic demographic data and signatures anything beyond that is just not my god damn job, Besides I don't get paid enough to care about the over all financial status of a company. I speak for about 80 percent of the EMTs and Paramedics. That's just how it is.
> Can you elaborate in NEMSA?


Do a Google search I don't wanna upset the mods.


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## DesertMedic66 (Sep 2, 2014)

SkiMaskWay said:


> No one is saying I should be a coder? Then why do people (inexperienced people) keep insisting I have to go above and beyond to ascertain billing info? I clearly posted I would not go beyond basic demographic data and signatures anything beyond that is just not my god damn job, Besides I don't get paid enough to care about the over all financial status of a company. I speak for about 80 percent of the EMTs and Paramedics. That's just how it is.
> Can you elaborate in NEMSA?


No one is saying you should be a coder (as stated again). You should however attempt to get the information required to correctly bill a patient (you keep changing your story from "I do it" to "I don't care about it"). 

If you speak for 80% of the EMTs and Medics then why are you the only one so far on this thread to have your view point? Time for you to step off your high horse and realize you are in the small percent of providers who don't care.


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## LACoGurneyjockey (Sep 2, 2014)

gonefishing said:


> Do a Google search I don't wanna upset the mods.



This. I refrain from further comment at the threat of a very firm slap on the wrist.


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## SkiMaskWay (Sep 2, 2014)

DesertEMT66 said:


> No one is saying you should be a coder (as stated again). You should however attempt to get the information required to correctly bill a patient (you keep changing your story from "I do it" to "I don't care about it").
> 
> If you speak for 80% of the EMTs and Medics then why are you the only one so far on this thread to have your view point? Time for you to step off your high horse and realize you are in the small percent of providers who don't care.


Not caring is one thing, and not getting the info is another. I maintain 100% compliance on my PCRs but since I don't care I don't go out of my way to get it... And most importantly patient care comes first, in fact that's what they use to preach back in EMT and Paramedic school. As far as me not realizing? Only thing I've realized is that according to a handful of individuals on this forum billing is more important. Whatever its a mute point....All I wanted was everyone's experience or observations on EMS unions and instead I got gang banged by the crusading ambulance company billing expert lynch mob. Ha ha ha ha ha


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## DesertMedic66 (Sep 2, 2014)

SkiMaskWay said:


> Not caring is one thing, and not getting the info is another. I maintain 100% compliance on my PCRs but since I don't care I don't go out of my way to get it... And most importantly patient care comes first, in fact that's what they use to preach back in EMT and Paramedic school. As far as me not realizing? Only thing I've realized is that according to a handful of individuals on this forum billing is more important. Whatever its a mute point....All I wanted was everyone's experience or observations on EMS unions and instead I got gang banged by the crusading ambulance company billing expert lynch mob. Ha ha ha ha ha


You posted a thread about how every company should have a union and how it will help everyone (which is clearly false). Then made clearly false statements about unions and what they do. You failed to realize that we should care about billing because without patients being billed all private ambulance companies would fail as a service. 

You got everyone's experience with unions and to the most part they aren't very helpful. Feel free at any time to go into the other fields of work which you posted about several times.


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## SkiMaskWay (Sep 2, 2014)

DesertEMT66 said:


> You posted a thread about how every company should have a union and how it will help everyone (which is clearly false). Then made clearly false statements about unions and what they do. You failed to realize that we should care about billing because without patients being billed all private ambulance companies would fail as a service.
> 
> You got everyone's experience with unions and to the most part they aren't very helpful. Feel free at any time to go into the other fields of work which you posted about several times.


I did already go work in a different field and I do make substantially better wages with no experience and I have Frindge benefits. And that's why I was wondering what is so different about this field that even at entry level requires specialized training. I'm a Paramedic still part time only, I show up to see old medic and EMT friends only I get paid some extra beer money while I'm at it and to keep my License current. Now what False information have I posted? You seem biased towards unions. Firefighters, Nurses, even grocery store workers have them and they all seem to have better paying positions compared to Private EMS workers, how is that false?


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## MrJones (Sep 2, 2014)

SkiMaskWay said:


> I did already go work in a different field and I do make substantially better wages with no experience and I have Frindge benefits. And that's why I was wondering what is so different about this field that even at entry level requires specialized training. I'm a Paramedic still part time only, I show up to see old medic and EMT friends only I get paid some extra beer money while I'm at it and to keep my License current. Now what False information have I posted? You seem biased towards unions. Firefighters, Nurses, even grocery store workers have them and they all seem to have better paying positions compared to Private EMS workers, how is that false?



Please - put down the shovel.


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## Jon (Sep 2, 2014)

SkiMaskWay said:


> Not caring is one thing, and not getting the info is another. I maintain 100% compliance on my PCRs but since I don't care I don't go out of my way to get it... And most importantly patient care comes first, in fact that's what they use to preach back in EMT and Paramedic school. As far as me not realizing? Only thing I've realized is that according to a handful of individuals on this forum billing is more important. Whatever its a mute point....All I wanted was everyone's experience or observations on EMS unions and instead I got gang banged by the crusading ambulance company billing expert lynch mob. Ha ha ha ha ha



Billing is secondary to patient care... But it does need to get done. And if you're NOT gathering the information, the company is paying someone ELSE to do it.... With money that you could perhaps be getting paid. It's often far easier to gather the information at the time of service than down the road (capturing signatures, copies of insurance cards, copies of ID's or face sheets).


Nurses get paid more because their industry organization (ANA) pushed for most RN jobs to require a BSN. I know of far more nurses that are NON union than are union, and they all get paid MUCH more because of education.

You claim to be a highly educated prehospital provider, yet your spelling and grammar are indicative of someone who's never graduated high school. Image matters. Oh, and if you're spelling like that in your chart, it's making it harder to bill and more likely to be rejected.

Personally, I think the way to improve our industry's pay practices is to follow nursing. Increase education requirements, and eventually the money (and respect) will follow. Unions can't make a difference when the payors won't pay more.



Oh, and NEMSA was (I guess still is) a union that had an ambitious goal. They were going to be one EMS union to rule them all, starting with AMR. Their idea was to have one union negotiating for multiple AMR divisions all at once. Wasn't a bad idea, in theory. They appeared to start well, but I think the most charitable way to put it is that they got too big to quickly, and when they needed to negotiate in multiple locations at once, they sold some operations down the river while focusing on others.


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## iftmedic (Sep 2, 2014)

Jon said:


> Billing is secondary to patient care... But it does need to get done. And if you're NOT gathering the information, the company is paying someone ELSE to do it.... With money that you could perhaps be getting paid. It's often far easier to gather the information at the time of service than down the road (capturing signatures, copies of insurance cards, copies of ID's or face sheets).
> 
> 
> Nurses get paid more because their industry organization (ANA) pushed for most RN jobs to require a BSN. I know of far more nurses that are NON union than are union, and they all get paid MUCH more because of education.
> ...


UOTE]
Thanks for the union information... Finally someone shed some light. It's nice to see you jumped on the band wagon and decided to display your excellent editorial abilities as well and insult SkiMask... NEMSA sounds like they had a good plan, I just spoke to the Director in charge of that union out of Modesto I think, He sounded like he was very knowledgeable and informed. 
I think that education is important for the industry specially with Barriers to entry, but I also think union can play an important role as well, specially with companies that absolutely disregard employees rights, unfair treatment, unjustified disciplinary actions, pay and benefits. I also work in LA and I know how bad companies treat EMTs
 I think the Nursing field has prevailing wages throughout the industry set forth by the nurses association regardless of BSN or ASN. Most nurses won't work for crappy pay because most of them work for hospitals that have Unions that fight for the rights of all nurses, I mean Firefighters and Police officers have unions too recently I watched hundreds of LAPD officers at city hall rallying and demanding more pay and benefits spearheaded by the LAPD officers association. I do get signatures and PCS forms signed if my patient's condition permits, but normally in a busy 911 system if you can't get it? oh well! You clear and go to the next run, that's been my experience at least in places like ICEMA and REMS.


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## DesertMedic66 (Sep 2, 2014)

iftmedic said:


> UOTE]
> Thanks for the union information... Finally someone shed some light. It's nice to see you jumped on the band wagon and decided to display your excellent editorial abilities as well and insult SkiMask... NEMSA sounds like they had a good plan, I just spoke to the Director in charge of that union out of Modesto I think, He sounded like he was very knowledgeable and informed.
> I think that education is important for the industry specially with Barriers to entry, but I also think union can play an important role as well, specially with companies that absolutely disregard employees rights, unfair treatment, unjustified disciplinary actions, pay and benefits. I also work in LA and I know how bad companies treat EMTs
> I think the Nursing field has prevailing wages throughout the industry set forth by the nurses association regardless of BSN or ASN. Most nurses won't work for crappy pay because most of them work for hospitals that have Unions that fight for the rights of all nurses, I mean Firefighters and Police officers have unions too recently I watched hundreds of LAPD officers at city hall rallying and demanding more pay and benefits spearheaded by the LAPD officers association. I do get signatures and PCS forms signed if my patient's condition permits, but normally in a busy 911 system if you can't get it? *oh well! You clear and go to the next run, that's been my experience at least in places like ICEMA and REMS.*


 Not really in REMS anymore. We are required to get a face sheet from the hospital and have the patient/family/or a nurse to sign before we are able to respond to another 911 call


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## DieselBolus (Sep 2, 2014)

SkiMaskWay said:


> Not caring is one thing, and not getting the info is another. I maintain 100% compliance on my PCRs but since I don't care I don't go out of my way to get it... And most importantly patient care comes first, in fact that's what they use to preach back in EMT and Paramedic school. As far as me not realizing? Only thing I've realized is that according to a handful of individuals on this forum billing is more important. Whatever its a mute point....All I wanted was everyone's experience or observations on EMS unions and instead I got gang banged by the crusading ambulance company billing expert lynch mob. Ha ha ha ha ha


 
A huge contributory factory to how much you get paid is the slim margin ambulance companies operate on.

A larger proportion of billable calls is what creates the money you want. Not a magical union that quadruples your pay.

If you think we are all wrong, ask your supervisor what would happen to your company if his labor costs went up by 20%, let alone what you expect for your "professional" position.

To go full circle, fish to fry..


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## Mufasa556 (Sep 3, 2014)

I really love this forum.

The employees at the company I work for have tried to unionize twice. The first time didn't get much traction. The second time, people from the union started showing up at employees homes asking a bunch of questions. Management flipped. Employees rabble roused. Then we voted and it didn't get enough votes. A couple companies in the area tried to unionize also and it never gathered enough votes. That seems to be the story everytime. Lots of noise. No action.

I had two buddies leave my company for another union company. I remember how excited one was. He was dancing a little jig through the back parking lot. Wagging his finger with glee. Talking how green the grass will be. Sure he started at $10.60hr. A whopping 50cents more than we were making. It was the same rodeo. Broke off rigs. Dilapidated stations. The crews were making some decent money working a 72/96 schedule. The union dropped them down to only 2 48s a week.

There's a lot of good information in this thread, if you choose to absorb it. I'm sure companies could pay their employees more, but why should they? If you join the plumbers union, you spend your career working as a plumber. Most EMTs I've met are on the move. They're spending as few moments as they can in the rig before they're a fireman or get burnt and choose a new career. I've seen so many great medical professionals, with a deep passion for caring for others, who went above and beyond with the most sincere acts of kindness, get burnt by the business and go back to waiting tables or construction.

A union is not going to make people stay longer. The union won't fix busted rigs or blown out stations. I talked at great lengths with the union folks. One question they asked was, "Don't you want to make it better for those in the future?" I do, but I don't think the union is the way to do it. I'd rather see the mentality of those coming in change.


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## Aprz (Sep 4, 2014)

At the first place I worked at that had a union, I didn't know much about unions then. All I remember is people complaining that they negotiated a terrible contract, and the contract stilled passed.

At the second place I worked at that had a union, I was initially anti union. I didn't know much about unions then, but I was convinced through my company that unions were bad. After working a while at the company, I saw organizers and my co-workers participating in the union doing their best to fight for us to have a higher wage and better working conditions. Why would you hate a group that wants to increase your wage, improve your working condition, and protect your job? I joined that fight, and I am hoping to become shop steward soon.

I think one of the biggest problems with unions is that people will become unionized and automatically expect magic to happen. People will say things like "I am waiting for the union to..." and that is the problem. If you don't participate like not going to union meetings, not willing to talk to co-workers about the union, turn your head ahead from your co-workers who talk union, ignore union organizers, not pick up phone calls, not read your e-mails, not participate in actions like wear a button or sticker, and you're willing to accept low wage, not strike, etc. then yeh, your union will probably not be successful at negotiating things in your favor. It makes me sad to see people complain about pay, but then say it is OK, and blame the union for low pay after ignoring the union by literally turning your head away ignoring anybody that tries to communicate with you about the union. It is also extremely hard in EMS due to high attrition. You are constantly having to convince people to even join in the first place.


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## iftmedic (Sep 4, 2014)

Aprz said:


> At the first place I worked at that had a union, I didn't know much about unions then. All I remember is people complaining that they negotiated a terrible contract, and the contract stilled passed.
> 
> At the second place I worked at that had a union, I was initially anti union. I didn't know much about unions then, but I was convinced through my company that unions were bad. After working a while at the company, I saw organizers and my co-workers participating in the union doing their best to fight for us to have a higher wage and better working conditions. Why would you hate a group that wants to increase your wage, improve your working condition, and protect your job? I joined that fight, and I am hoping to become shop steward soon.
> 
> I think one of the biggest problems with unions is that people will become unionized and automatically expect magic to happen. People will say things like "I am waiting for the union to..." and that is the problem. If you don't participate like not going to union meetings, not willing to talk to co-workers about the union, turn your head ahead from your co-workers who talk union, ignore union organizers, not pick up phone calls, not read your e-mails, not participate in actions like wear a button or sticker, and you're willing to accept low wage, not strike, etc. then yeh, your union will probably not be successful at negotiating things in your favor. It makes me sad to see people complain about pay, but then say it is OK, and blame the union for low pay after ignoring the union by literally turning your head away ignoring anybody that tries to communicate with you about the union. It is also extremely hard in EMS due to high attrition. You are constantly having to convince people to even join in the first place.


Extremely helpful info. This is the kinda response we needed on this thread. Thank you.


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