No Transport = No Fee?

MMiz

MMiz

I put the M in EMTLife
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When I first started working in EMS for a private company, we didn't charge for treatment if we didn't transport. That changed, and we soon charged for services rendered on scene with no transport (commonly 12 lead, O2, blood sugar check, etc.).

Do you charge if you don't transport?
 
The services that I am affiliated with only charge for loaded miles. The flight services that we call only charge if they are loaded when they lift off.
 
My last service only charged for transport. The service I am at now, charges if we assess a pt. I do not agree with it, sometimes.

I have found that it can hinder my care. We get an elderly person has a fall and a neighbor will call an ambulance. A lot of the Pt's will not let you examine them, because they do not want a bill for it.

If we provide treatment or transport, then I can see billing. I don't agree with billing for assessments!
 
nope, no charges if theres no transport and i agree. think of how many calls you run that are originated by a third party call in. i lost count hundreds of mva where i either on sighted them or they were called in by someone not involved in the incident. they shouldnt be responsible for somebody else calling an ambulance when they dont want one.
 
We charge for refusals on first party calls only. I believe our fee is around $150.
 
No fee for call outs at my 911 service, but we will charge for certain interventions on scene, like oral glucose. This leads to a fair amount of creative documentation. The private I work for charges for all calls in their small 911 area, which I don't happen to agree with.
 
Our 911 contracts state there will be no charge for any services unless the patient is transported.
 
I believe we only charge for transports, but not completely sure. We may charge for things such as diabetics that we wake up but refuse to go to the ER since we have actually used some supplies with those runs.
 
We charge for refusals if we do anything beyond a good ALS assessment. PuseOx and 12 lead are not charged as they are considered to be required to make a good assessment. Say you go hypo-glyc and once we get your sugar up, the event is explainable, and you eat you dont want to go, then it's a $50 fee i believe, as well as any supplies used (IV, D50, thiamine, etc...)
 
Grady_emt said:
We charge for refusals if we do anything beyond a good ALS assessment. PuseOx and 12 lead are not charged as they are considered to be required to make a good assessment. Say you go hypo-glyc and once we get your sugar up, the event is explainable, and you eat you dont want to go, then it's a $50 fee i believe, as well as any supplies used (IV, D50, thiamine, etc...)
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That's how ours works. The assessment is free if you don't want to go but if we do any interventions we charge a $75 fee plus the supplies.
 
How about patients you treat/stabilize on scene, then turn over to another authority? HEMS? Treat and release with police?
What about if ALS jumps onto a BLS rig? Does ALS bill the BLS service then the BLS bills the patient?
 
emt-student said:
How about patients you treat/stabilize on scene, then turn over to another authority? HEMS? Treat and release with police?
What about if ALS jumps onto a BLS rig? Does ALS bill the BLS service then the BLS bills the patient?
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Annoyingly, they don't get charged, period. :wacko: And I know of one frequent flyer that likes to call us, have us treat him, and then hitch a ride to the ER. Really, really irritates me a 3 in the morning. Of course, he's also tried to break my fingers before, so I'd rather see him...move to Oregon or something.

On my new service, I don't know of the policy. At my service on which I stand on LOA, we don't have ALS except for LifeFlight. There are some procedures that get billed at an ALS rate, but we have no Ps.
 
We charge for everything.

I do and I don't agree with it. I agree with it because it cuts down on abuse of the EMS system, but I don't agree with it because those with out insurance who REALLY need to go to the hospital are hesitant or reluctant to call when they could really use EMS or at least an EMS assesment to urge them to the ER by POV.

I think the bad outweighs the good. I wish we had a system where they only charged for interventions on scene, en-route, and transport. Assesments should be of no charge.
 
Sasha said:
I wish we had a system where they only charged for interventions on scene, en-route, and transport. Assesments should be of no charge.
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The problem is, especially for a private service, you have to pay fuel and disposables (gloves, EKG pads, BGL strips and lancets, etc), plus the opportunity cost of tying up one of your units which could otherwise be transporting a paying customer. I'm not a fan either, but from a business standpoint it makes sense to stop as much loss as possible.
 
rmellish said:
The problem is, especially for a private service, you have to pay fuel and disposables (gloves, EKG pads, BGL strips and lancets, etc), plus the opportunity cost of tying up one of your units which could otherwise be transporting a paying customer. I'm not a fan either, but from a business standpoint it makes sense to stop as much loss as possible.
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But from a patient advocate standpoint, I would rather waste money and cut some excess somewhere then to charge for an assesment and discourage a patient who may really need EMS from calling because he doesn't want a bill, figures his heart burn will go away eventually, and dies 3 hours later. When does a human life become less important than making money?
 
Sasha said:
But from a patient advocate standpoint, I would rather waste money and cut some excess somewhere then to charge for an assesment and discourage a patient who may really need EMS from calling because he doesn't want a bill, figures his heart burn will go away eventually, and dies 3 hours later. When does a human life become less important than making money?
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Easy now, I'm agreeing with you. Maybe this points to a larger problem of for profit EMS handling 911 contracts...
 
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rmellish said:
Easy now, I'm agreeing with you. Maybe this points to a larger problem of for profit EMS handling 911 contracts...
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It does. Although I work for a private service, I would love to see all EMS as government funded, which is why I love fire service EMS so much. I think it's better for the patient.
 
Sasha said:
It does. Although I work for a private service, I would love to see all EMS as government funded, which is why I love fire service EMS so much. I think it's better for the patient.
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I'm not a fan of fire based EMS per se, but that's another discussion.
 
Why not county third service? It is gov. funded and strictly EMS!
 
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