Dependable care ambulance shutdown-Los Angeles

looker

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Dependable care ambulance base in Los Angeles with 5 or 7 unit have shutdown. Rumor is that Medicare ruled that many of their transport were not medically justified and demanded money back. Basically bankrupting the company and forcing it to close.
 

RedAirplane

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I'm not quite sure how IFT works, but what happens to the hospital calling for these transports when their ambulance disappears overnight?
 

luke_31

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I'm not quite sure how IFT works, but what happens to the hospital calling for these transports when their ambulance disappears overnight?
Call the next company down the list. In Los Angeles county the hospitals and nursing facilities typically have a list of multiple companies they use.
 

Mufasa556

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So even more ambulances will be available at the next auction?
 
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looker

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So even more ambulances will be available at the next auction?
Yes and this is probably beginning of the end of IFT as we know today. Basically since 07/8 a lot of ambulance companies been pooping up left and right and medicare been paying out all of those claims without much of hassle.This in the last few years have ended and they are cracking down hard.Basically you will have mostly those that have 911 contract left and they will also do real ift that do not have questions on justification.Rest of those patients will go by gurney vans which frankly today are at very short supply. This for sure will change in the next few years. Regulation regarding gurney vans also have to change.Anyone that is thinking of becoming emt should really make sure that is what they want to do as there will an extreme over supply of emt compare to available positions.
 
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looker

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I'm not quite sure how IFT works, but what happens to the hospital calling for these transports when their ambulance disappears overnight?
You keep going down the list until you find the one is available/still in business.
 

triemal04

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Yes and this is probably beginning of the end of IFT as we know today.
You mean that southern california might actually have to follow the rules?

You mean that southern californian EMS might actually take a step forward?

You mean that people that defraud the gov't will be held accountable?

You mean that people that defraud the public and customers will be held accountable?

You mean that EMT's and "ambulances" will be used more for their intended purpose?

These are all GOOD things...don't you agree?
 
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looker

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You mean that southern california might actually have to follow the rules?

You mean that southern californian EMS might actually take a step forward?

You mean that people that defraud the gov't will be held accountable?

You mean that people that defraud the public and customers will be held accountable?

You mean that EMT's and "ambulances" will be used more for their intended purpose?

These are all GOOD things...don't you agree?
I don't agree that a lot if it was fraud. Just because someone can walk today do not mean they can walk tomorrow.I had patient that could sit in wheelchair on the way to the dialysis center but couldn't on the way back. Is it fraud if we transported him both way on ambulance? Ambulance are used what they are designed for as they might only available options for people being lessor level such as gurney van not available/ not covered by medicare insurance.
 

johnrsemt

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I had quite a few patients that could sit in a wheelchair; but needed oxygen on the way back from Dialysis (Never saw a WC van carry their own supply or O2).
Or the ones that like Looker said could drive or ride in a van/WC on the way to Dialysis but not on the way back.

How about the ones that tell the Nurses at the ED that they can't sit or stand? but then at home they get up and walk away from the cot? Who is at fault for that? The nurse that trusted the patient or the crew that let him walk away from the cot.

And it is going to get worse: Medicare stops paying for more ambulance transports: Already they won't pay for a patient to go to the doctor by cot (the ones that can't sit or walk on their own). So if a patient can't go to the doctor every 90-180 days for checkups or mild problems. All of a sudden they end up at the ED for problems that could have been taken care of at the doctors office if they could have gotten there.
A friend is fighting Medicare for his mother who lives at home, but is bed bound due to MS; Medicare is refusing to pay for a 5 day hospital stay for pnuemonia because she didn't go to the doctor before it got too bad (but Medicare won't pay for an ambulance transport to the doctor). So who is at fault for that?
 

gonefishing

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I had quite a few patients that could sit in a wheelchair; but needed oxygen on the way back from Dialysis (Never saw a WC van carry their own supply or O2).
Or the ones that like Looker said could drive or ride in a van/WC on the way to Dialysis but not on the way back.

How about the ones that tell the Nurses at the ED that they can't sit or stand? but then at home they get up and walk away from the cot? Who is at fault for that? The nurse that trusted the patient or the crew that let him walk away from the cot.

And it is going to get worse: Medicare stops paying for more ambulance transports: Already they won't pay for a patient to go to the doctor by cot (the ones that can't sit or walk on their own). So if a patient can't go to the doctor every 90-180 days for checkups or mild problems. All of a sudden they end up at the ED for problems that could have been taken care of at the doctors office if they could have gotten there.
A friend is fighting Medicare for his mother who lives at home, but is bed bound due to MS; Medicare is refusing to pay for a 5 day hospital stay for pnuemonia because she didn't go to the doctor before it got too bad (but Medicare won't pay for an ambulance transport to the doctor). So who is at fault for that?
This is where community Paramedicine is going to really shine. With the Obama rates you can always carry a secondary private insurance for as low as $20 a month.
Also alot of Doctors still do home visits same with NP's. Theres alot of patients that don't necessarily need to go to a doctors office. They can be taken care of at home.
 

johnrsemt

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When I looked at ACA it said that you didn't qualify if you had Medicare or Medicaid; so maybe that changed since the beginning
 
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looker

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This is where community Paramedicine is going to really shine. With the Obama rates you can always carry a secondary private insurance for as low as $20 a month.
Also alot of Doctors still do home visits same with NP's. Theres alot of patients that don't necessarily need to go to a doctors office. They can be taken care of at home.
What really needs to happen is for medicare to start paying for gurney vans.They can pay half as much and there will be plenty of providers. Otherwise we will have 911 getting all of this calls because grandmother wasn't able to see her doctor and instead now must be admitted to the hospital instead.
 

triemal04

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I don't agree that a lot if it was fraud. Just because someone can walk today do not mean they can walk tomorrow.I had patient that could sit in wheelchair on the way to the dialysis center but couldn't on the way back. Is it fraud if we transported him both way on ambulance?
Why actually, yes, as a matter of fact if you billed medicare or their insurance for both ends of the trip requiring an ambulance then IT IS fraud. If you adjusted the documentation so that it appeared the person required an ambulance for both ends of the trip when they really didn't then IT IS fraud. Thank you for admitting that you run a fraudulent buisness with illegal billing practices.

You can attempt to justify your actions however you want and try to make yourself out to be the good guy, but the plain truth of the matter is that you, and all those who follow similar practices to you are defrauding the government, insurance companies, and individual people to line your pockets.

Good buisness plan if you can get away with it.
 

Akulahawk

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Why actually, yes, as a matter of fact if you billed medicare or their insurance for both ends of the trip requiring an ambulance then IT IS fraud. If you adjusted the documentation so that it appeared the person required an ambulance for both ends of the trip when they really didn't then IT IS fraud. Thank you for admitting that you run a fraudulent buisness with illegal billing practices.

You can attempt to justify your actions however you want and try to make yourself out to be the good guy, but the plain truth of the matter is that you, and all those who follow similar practices to you are defrauding the government, insurance companies, and individual people to line your pockets.

Good buisness plan if you can get away with it.
It's only fraud if the initial trip is billed as requiring an ambulance (in that particular instance). If the initial run is billed as a gurney trip or wheelchair trip, and on the return trip the patient is evaluated/documented truthfully as requiring at least BLS monitoring, then the return trip would be OK to bill as an ambulance trip. However, doing that will invite extra scrutiny as the insurance company may question why the patient was OK for one type of trip before and another after a given appointment.

I have done many, many trips in the ambulance where the patient was "only" a wheelchair trip and was billed as a wheelchair trip, even though the ride itself was provided in an ambulance. This was done only in instances where our wheelchair vans were too overbooked to accommodate a given trip.
 

CALEMT

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It's only fraud if the initial trip is billed as requiring an ambulance (in that particular instance). If the initial run is billed as a gurney trip or wheelchair trip, and on the return trip the patient is evaluated/documented truthfully as requiring at least BLS monitoring, then the return trip would be OK to bill as an ambulance trip. However, doing that will invite extra scrutiny as the insurance company may question why the patient was OK for one type of trip before and another after a given appointment.

I have done many, many trips in the ambulance where the patient was "only" a wheelchair trip and was billed as a wheelchair trip, even though the ride itself was provided in an ambulance. This was done only in instances where our wheelchair vans were too overbooked to accommodate a given trip.

This. While working BLS IFT (at a different company) we would get "gurney runs" or "wheelchair runs" all the time. I was in a BLS ambulance and the gurney or wheelchair pt would get transported by ambulance. But heres the "catch" if you so desire to call it that, we wouldn't do a assessment, vitals or anything pertaining to a billable ambulance transport. The only documentation done for these types of calls was a little sheet of paper (I'm trying for the life of me to remember what was on it) with the persons name, where we picked them up and where we dropped them off. If I remember correctly, we would get a signature for ex. the nurse at the dialysis center or the nurse at the SNF. There was no PCR created because this isn't a billable call for the ambulance side of things.

Now for instance lets just say a gurney (non BLS pt) goes to dialysis and requires an ambulance back to wherever it is they came from, then yes we would bill for a ambulance ride. We had to state why they were returning by ambulance instead of a gurney van so we could justify billing insurance for ambulance transport.
 
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