La County protocol question

A question reagrding policy 502

Can anyone elaborate on 'principle 3' of policy 502, specifically in regards to EMTALA. Principle 3 states that "The most appropriate receiving facility for a patient may be the health facility which is affiliated with their health plan." I'm very new to EMS having just been certified by the state and awaiting my first interview so my knowledge is limited, but wouldn't this be somewhat of an EMTALA violation as it's suggesting choosing a receiving hospital based on a patient's health coverage? I understand that if a patient has a regular hospital they go to and they specifically request to be transported there it's up to them but where do we draw the line in order to avoid getting in trouble? Any help is appreciated, I may just be reading this incorrectly.
 
Patients are able to choose the hospital they want to be transported to (within reason). We have one hospital in my area that does not accept Kaiser insurance. If the patient is stable then we will transport them to a hospital that accepts it. If the patient is critical then we will transport to the closest facility.
 
I thought all Er's were required to accept any insurance for er visits.
 
DesertEMT66 said:
Patients are able to choose the hospital they want to be transported to (within reason). We have one hospital in my area that does not accept Kaiser insurance. If the patient is stable then we will transport them to a hospital that accepts it. If the patient is critical then we will transport to the closest facility.
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This is exactly what's confusing me. Isn't it illegal to choose a hospital based on insurance, whether or not the patients stable? Unless of course the patient requests a certain hospital
 
Why would it be illegal?* If somebody made a law that prohibited a stable patient from being transported to a hospital so that insurance would cover it, thereby putting the patient under unnecessary financial strain, that lawmaker should be hung.

*I have no idea if it is or is not illegal in CA.
 
FireWA1 said:
I thought all Er's were required to accept any insurance for er visits.
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Our hospital will transfer out all Kaiser patients and all kaiser patients know to not go to that hospital.
 
sean818 said:
This is exactly what's confusing me. Isn't it illegal to choose a hospital based on insurance, whether or not the patients stable? Unless of course the patient requests a certain hospital
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Not to my knowledge. It is in the patients best interest to transport them to that hospital.
 
FireWA1 said:
I thought all Er's were required to accept any insurance for er visits.
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A hospital is required by law to treat and stabilize within the abilities of their facilities and staff any life threatening condition regardless of ability to pay or insurance affiliations.

Its no stretch of the imagination to see how a kaiser patient can benefit from a kaiser network hospital.. (To continue the example) access to records, no billing issues, etc. A non kaiser facility may bill for services kaiser may not approve, or cover the same as an in network facility.

When reasonable we should honor patient requests for where to go especially if it means their insurance will cover visits and won't leave them broke.

In my county we ask every patient where they want to go and hardly ever override their request unless its a case specific issue and they requested a facility not equipped for the condition, and this doesnt happen often.
 
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NPO said:
A hospital is required by law to treat and stabilize within the abilities of their facilities and staff any life threatening condition regardless of ability to pay or insurance affiliations.

Its no stretch of the imagination to see how a kaiser patient can benefit from a kaiser network hospital.. (Go continue the example) Access to records, no billing issues, etc. A non kaiser facility may bill for services kaiser may not approve, or cover the same as an in network facility.

When reasonable we should honor patient requests for where to go especially if it means their insurance will cover visits and won't leave them broke.

In my county we ask every patient where they want to go and hardly ever override their request unless its a case specific issue and they requested a facility not equipped for the condition, and this doesnt happen often.
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This exact wording. We also ask every single patient.
 
We have a similar hospital system here. They don't have an "er" that is classified as an urgent care so legally they don't have to anyone except people in their system. I must have misunderstood what someone said. So yeah. Unless they will die by not going there it makes sense to go to the place that will care for them the best.
 
Thank you for clarifying everybody that makes alot more sense than what I was thinking. My teacher made it very clear to never choose a hospital based on insurance and definitely never to mention the insurance to the hospital that you plan on transporting to but I guess that would mainly apply to true emergencies. Glad I found this forum before I start working :)
 
STXmedic said:
Why would it be illegal?* If somebody made a law that prohibited a stable patient from being transported to a hospital so that insurance would cover it, thereby putting the patient under unnecessary financial strain, that lawmaker should be hung.

*I have no idea if it is or is not illegal in CA.
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Lol, I honestly wouldn't expect much more from california. Seems to be the most ***-backwards state in existence
 
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