EMS Unions in So cal

[avdrummerboy]

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.

 

[DesertMedic66]

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 siteView attachment 1520

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

 

[SkiMaskWay]

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.

 

[SkiMaskWay]

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.

 

[SkiMaskWay]

Work Union Live better!

 

[MrJones]

...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.

 

[SkiMaskWay]

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.

 

[SkiMaskWay]

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.

 

[MrJones]

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.

 

[SkiMaskWay]

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.

 

[DesertMedic66]

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

 

[SkiMaskWay]

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.

 

[drl]

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.

 

[DesertMedic66]

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.

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.

 

[avdrummerboy]

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.

 

[SkiMaskWay]

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.

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

 

[SkiMaskWay]

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...

 

[DrParasite]

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.

 

[SkiMaskWay]

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.

 

[LACoGurneyjockey]

"

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.