# Grady EMS Bill Help Please



## Joseph1991 (Jan 12, 2010)

I got a bill from Grady EMS (Atlanta, GA) for $2279

I had a seirzure and I did not ask for an ambulance to come but once they got to the MARTA bus Station, where I had the seizure, I asked them if it was going to be free, they said no so I refused to go with them but they said that they could not leave me where I was... Again, I told them that I did not want to go, but they end up putting me on the stretcher anyways. And then again, once I was inside the ambulance, they asked me what hospital I wanted to go to, I asked if it was going to be free, they said no, so I told them I wanted out now, again they said we cant let you out. They asked me for my social security number, I gave it to them, and to sign something and I did.

Once I arrived at the hospital, I was placed to the side of the hall (my legs still jerking) for over an hour, completely ignored. While I was in the hallway I texted my mother to come to the hospital. They finally took me to a room put sticky things all over my body and drew my blood. 20 Minutes, if that, later my mother arrived at the hospital and I called a nurse in the room and she said I was going to be there for at least another 4 hours and that I could not leave. I then told my mother that I was leaving regardless of what the hospital was telling me, So I got up took everything off of me and out of me and left without telling them.

I am 18 years old, never had a job, dont have any money, dont have medical insurance and I have no idea what to do.


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## MMiz (Jan 12, 2010)

Hello,

As you know, this forum is for EMS providers, and you most likely will not receive the answer you're looking for.

First, it's going to be their word vs. yours.  There are few conditions where an ambulance can take you somewhere without your consent, and this isn't one of them.  You should have stated "I refuse to be treated or transported by ambulance" and ask that they document it.  As an alert person, by allowing them to transport you, it appears as though you consented to the treatment.

I've had countless patients say that they don't want to pay the bill, or say they don't want to go when they hear that the ambulance isn't free, but they expect me to continue with treatment and transport.

As far as the hospital goes, I can't make an excuses.  That's a personal beef you're going to have to take up with the hospital.  Unfortunately what a patient deems an emergency isn't always what a busy ER feels in an emergency.  What you see on TV and expect rarely corresponds with how an ER actually operates.

If I were in your situation, I'd contact both the ambulance and the hospital and plead your case.  Ambulance services hear hardship cases all of the time.  Almost all will allow you to pay on a payment plan or significantly reduce the cost.  The same goes for the hospital visit.

When it comes down to it, you used the services, and you're responsible for paying for them.  Fortunately you're in a position where you can negotiate costs with both the EMS provider and the hospital.

Good luck!


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## Tincanfireman (Jan 12, 2010)

Joseph1991 said:


> I got a bill from Grady EMS (Atlanta, GA) for $2279


 
$2300 for one response? I'm not sure how ATL's service charges compare to services charges for my (much smaller) agency, but that still seems kind of steep...


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## s4l (Jan 12, 2010)

I'm surprised you didn't get to sign an AMA.


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## 18G (Jan 12, 2010)

Wow... an ambulance bill for $2,279, That is an extreme amount. A little bit more and you could have went by helicopter 

Sometimes with seizures, as Im sure you know all to well, patients are not fully coherent immediately afterwards and perhaps based on the Paramedic's assessment and impression of you, you were not capable of making a decision at that point in time. This is where implied consent comes into play. Implied consent is a law that assumes you would want transport and full medical care for your situation if you were fully conscious, alert, and oriented and able to make an informed decision. Maybe the EMS crew felt you were not able to make the decision prior to transport. 

What was it exactly you signed? Most EMS companies get patients to sign acknowledgment of HIPAA (federal privacy laws) and a statement of financial responsibility. If you signed a form accepting financial responsibility than you really dont have any recourse. The best you will be able to do is setup payments. 

It sounds like this:

If you were not fully alert and oriented and able to make a rationale and informed decision at the time transport was initiated, than you were treated and transported under implied consent. To the best of my knowledge your stuck. The EMS crew was looking out for your best interest and wanted to make sure you were safe. 

If you were able to make a rationale decision to refuse and they transported you anyway, then that opens up a whole 'nother area. But if you signed a form, that looks as though you were consenting to transport especially if it was a form pertaining to billing. I'm no attorney so I cant say for sure but based on my experience I am confident in what Im telling you. 

There is an attorney who posts on the forum so perhaps he could shed some light for you.  

My advice to you is to call the EMS company that transported you and request a copy of the patient care report to see how the Paramedic documented the call - particularly your mental status and actions after the seizure. Perhaps your not recalling events as accurately as you believe? Im not insinuating just throwing that out there as a possibility and basis for getting a copy of the patient care report. By law they have to give you a copy.  

Hope this helps ya at least a little.


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## Veneficus (Jan 12, 2010)

Welcome to modern medicne, For what you received that sounds very near the going rate. 

I suggest contacting a lawyer. Nobody here can make that bill go away and even by some miracle you are absolved, it may be reported as non payment to credit agencies.

Most likely the lawyer will charge you a fee also. It will probably be less than the $2K but it will not be cheap either.


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## JPINFV (Jan 12, 2010)

18G said:


> What was it exactly you signed? Most EMS companies get patients to sign acknowledgment of HIPAA (federal privacy laws) and a statement of financial responsibility. If you signed a form accepting financial responsibility than you really dont have any recourse. The best you will be able to do is setup payments.



Here's a sticking point. If he was under implied consent, why have him sign anything? If he's competent to sign HIPAA and billing forms then he's competent to sign AMA. 

*To the original poster, *I don't think it's fair to comment either way without being their and/or knowing you personally. There's a medical gray zone for people with chronic disorder (is this your first seizure?) when it comes to letting them sign AMA. Regardless, MARTA officials and/or the passengers did the correct thing by requesting an ambulance for a passenger having a seizure. 

If this was your first seizure, I completely agree that you needed to be checked out at the hospital. While, yes, you have the ability to refuse services, a serious question is 'how long after a seizure does a patient become competent again?' This is going to be different for every case. For someone with a known condition, a decision that the patient is competent to make their own decisions is easier to make since the patient knows, and to an extent expected (in the sense of 'it's going to happen sooner or later'), what happened and why. Without being there, I don't think anyone can really comment on the appropriateness of how the call was run.


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## 18G (Jan 12, 2010)

> Here's a sticking point. If he was under implied consent, why have him sign anything? If he's competent to sign HIPAA and billing forms then he's competent to sign AMA.



If he was altered throughout the entire transport than yes, it makes no sense to have him sign forms that he cannot not understand. Not to mention the signature would not be binding, right? I have seen providers have patients sign their paperwork just because its easier to get a signature than to have their superiors get on them for not. 

I have had many seizure patients who were altered to the point they could not refuse transport or care only to regain their normal mental status and become CAOx4 enroute to the hospital. We don't know how long the transport was so this is always a possibility. 

Another thing, many providers would jump on getting a refusal if at all possible


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