# Ambulance Operations in CA



## Danielsperry (Apr 15, 2013)

I work on a Inter-facility BLS ambulance serving Santa Clara County. Does anyone know if its legal to transport patients that don't qualify for BLS (the kind of patients that would normally go by a wheelchair/gurney van) on the ambulance? 

Heres some other details; The Ambulance is staffed with 2 EMTs, if we transport non-BLS patients - then my company doesn't allow us to assess our patients (taking our own vital signs, doing any interventions beyond the scope granted by a CPR card) even though we are EMTs on a fully equipped ambulance. 

From what I've read and asked, this seems illegal and forms liability. I'd like to know your opinion on the matter and reasons why you think it could be fine or not fine to do this. 

Thanks!


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## Aidey (Apr 15, 2013)

It is legal depending on how they bill. From what I've been told Medicare/Medicaid does allow the use of ambulances in place of wheelchair vans as long as the transport is still treated as a wheelchair transport and billed as such. We've done this before when the weather doesn't permit the wheelchair vans to run. We don't asses the pt at all and we use the wheelchair documentation form, not our normal PCR software.


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## Danielsperry (Apr 16, 2013)

Good to know. What do you do if the patient has their own wheelchair? For us, sometimes we have to take patients out of their wheelchair and put them on the gurney. When we arrive, we put them back in the wheelchair.


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## DesertMedic66 (Apr 16, 2013)

It all depends on how it is billed. For my company we will just bill it as a wheelchair transport. We still asses the patient and do anything we want/need to in our scope. We use the same ePCR form. The only thing that we have to change in the ePCR is to state somewhere that the patient could have gone by a wheelchair van. 

The patient gets transferred from the wheelchair to the gurney and then transported. If its the patients personal wheelchair then it also gets folded and transported. 

Our billing department will go through the ePCR to get the billing info and determine how it should be billed.


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## Danielsperry (Apr 16, 2013)

DesertEMT66 said:


> It all depends on how it is billed. For my company we will just bill it as a wheelchair transport. We still asses the patient and do anything we want/need to in our scope. We use the same ePCR form. The only thing that we have to change in the ePCR is to state somewhere that the patient could have gone by a wheelchair van.
> 
> The patient gets transferred from the wheelchair to the gurney and then transported. If its the patients personal wheelchair then it also gets folded and transported.
> 
> Our billing department will go through the ePCR to get the billing info and determine how it should be billed.



Interesting. I will have to investigate the reason why my company or county doesn't allow for assessment on non-BLS. I'd much rather do the way your service does it if I have the choice.


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## wanderingmedic (Apr 16, 2013)

saying this might be :deadhorse: but if not doing something could cause harm....you should probably do it......

yes, i understand that not every wheelchair patient is going to die on you, however I would always err on the side of treatment, especially if the patient began to deteriorate..... 

maybe I'm just crazy though......

"Do no harm"


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## Danielsperry (Apr 16, 2013)

azemtb255 said:


> saying this might be :deadhorse: but if not doing something could cause harm....you should probably do it......
> 
> yes, i understand that not every wheelchair patient is going to die on you, however I would always err on the side of treatment, especially if the patient began to deteriorate.....
> 
> ...



I agree. I'd rather explain why I tried to help then why I did nothing especially in a grey area as this.


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## Tigger (Apr 16, 2013)

DesertEMT66 said:


> It all depends on how it is billed. For my company we will just bill it as a wheelchair transport. We still asses the patient and do anything we want/need to in our scope. We use the same ePCR form. The only thing that we have to change in the ePCR is to state somewhere that the patient could have gone by a wheelchair van.
> 
> The patient gets transferred from the wheelchair to the gurney and then transported. If its the patients personal wheelchair then it also gets folded and transported.
> 
> Our billing department will go through the ePCR to get the billing info and determine how it should be billed.



This how we did it to, though not everyone assessed the patient as it wasn't technically required. 

Many patients hated it as they had to be transferred twice and ride backwards, so we tried to minimize it.


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## DrParasite (Apr 16, 2013)

when i did my stint with private transport that had a wheelchair division, we did it this way too.  if no vans were available we would do the transport in an ambulance.  same paperwork as we would for an ambulance run. the patient will just get a bill for a wheelchair transport.

think of it this way.  lets say you picked up a sick patient, who was only supposed to go by wheelchair, and they died during the transport.  how would you governing body look at it?  what would the family say?


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## CodeBru1984 (Apr 17, 2013)

I'm curious as to the name of the company. OP, you can PM me the name if you'd like too.


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## sid8 (May 9, 2013)

These services are really good...


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