EMS Unions in So cal

[SkiMaskWay]

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.

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

 

[SkiMaskWay]

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.

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.

 

[SkiMaskWay]

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...

 

[DieselBolus]

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..

 

[DieselBolus]

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.

 

[DesertMedic66]

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.

 

[SkiMaskWay]

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!!

 

[DesertMedic66]

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...

 

[DieselBolus]

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.

 

[SkiMaskWay]

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

 

[DesertMedic66]

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?

 

[SkiMaskWay]

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

 

[SkiMaskWay]

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

 

[SkiMaskWay]

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...

 

[DrParasite]

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.

 

[avdrummerboy]

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.

 

[Jon]

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.

 

[SkiMaskWay]

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.

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.

 

[DesertMedic66]

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.

 

[SkiMaskWay]

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