Prices + Charges of Your Company to Patients

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Hi all,

Where I live (in Canada), there are very little fees associated with calling an ambulance. Less than $100 if you are a permanent resident/citizen, and a few other requirements to not be charged the big rate (around $500.)

**As was told to me, please don't quote!

I'm wondering, what sort of fees are generally charged to your patients for a traditional asses, treat, and transport? What can cause the price to increase? What would it increase up to? Ever had patients who worried about financial costs?

This will be interesting to compare!
 
South Texas, a 911 transport (without including any treatment, will range from $800-$1200. IFT transports tend to be a little less. My old IFT system started at $300 for a BLS transfer.
 
SoCal it's about $1,500 just for the ambulance to respond. There is a night charge, O2 charge, milage charge, and some other charges.
 
NM is a per mile charge. First mile is a bunch (I think ALS 1 rate first mile at my old service was 700+) and then each mile is a much lower price (3-10)
 
I make it a point not to care what the prices are. Couldn't care less whether my pt could pay or not. So I try to not know so it won't effect my care.
 
Dependent on the dispatch code (AlS assessment or not) the base rate changes. Then there is an ALS 2 charge for 3+ med administrations, defib, intubation, etc. Oxygen charge, bariatric charge, CCT charge, mileage etc etc.

I dont know what the prices are, nor do I want to know.
 
Emergency ambulance part charge for medical is $88.

For accidents it's free because of universal accident insurance (ACC).

It is said the actual cost of a callout to the service is about $600.
 
Canadian said:
Hi all,

Where I live (in Canada), there are very little fees associated with calling an ambulance. Less than $100 if you are a permanent resident/citizen, and a few other requirements to not be charged the big rate (around $500.)

**As was told to me, please don't quote!

I'm wondering, what sort of fees are generally charged to your patients for a traditional asses, treat, and transport? What can cause the price to increase? What would it increase up to? Ever had patients who worried about financial costs?

This will be interesting to compare!
Click to expand...

in New Brunswick if you have insurance they are billed. If you don't have any or your insurance doesn't cover all of it...the fee is waved.... so for nb residents the ambulance is free. non residents it is 650 for a 911 and a lot more for ift.

some charge a flat rate i have seen 80-400.

when I worked in the US they billed for mileage, items used plus there was a minimum charge for different call types. bls vs als1 vs als2.

where I work industrial, we don't bill pts. the oil company picks up the tab for workers, locals and anyone we treat.
 
Our average cost of transport including mileage was around 1900 dollars last year.

We are a special tax district and have a mill levy to support our operations. The property tax surcharge works out to be about 100 dollars a year per 100k proper value. District residents get a break on ambulance bills, on average they pay 6-800 dollars.
 
What is billed or charged is often entirely different than what is reimbursed. Often medicare or medicaid reimbursement is 10% of the billed price, somewhere on the order of $250 for BLS, $290 for ALS in some areas around me.

CMS (Medicare/Medicaid) can pay whatever they want, and in many cases, the ambulance services cannot go after patients for the rest (unless an ABN was signed at time of service). Private insurance companies strong arm services into signing "preferred provider" agreements, for negotiated rates. If the services don't sign, the insurance companies just address payments to the patients, who are under no responsibility to turn over to the ambulance services (or it is often cheaper to write off than chase the patients down).

Reimbursements from CMS have been slashed recently, and services used to making 60-80% of what is billed are being forced to make due with 20-30%.

In fact, you can look up how much ambulance services actually get paid by CMS, there's a cool new tool on their website. https://data.cms.gov/utilization-and-payment-explorer
I will note, this tool is not the entire picture-- it's only Part B, fee-for-service, but you can look up how much individual services bill and receive compared to the national average.

Paging BillingSpecialist, for some more insight?!?
 
Wow! Those prices are crazy! Over $1000 for most likely less than two hours of actual contact? And some EMT's are living below the poverty line? Shame.
 
BLS- $500 + $12/mile

ALS- $750 + 12/ mile

Then we charge for...

ALS Assessment
Neurologic Assessment
BGL check
EKG
12-lead
Medication admin
IV access
Oxygen

And a million other things. How much of that actually gets paid.. I have no idea. I know we write off quite a bit.
 
My mother's 911 charge was about $1,100, give or take. I don't know what the CCT ambulance charged for her. As was mentioned, the insurance companies pay what they want, and if no agreement is made, they just pay the beneficiary or estate, and it's their job to distribute the checks.

Also, here's the county wide set rates for Orange County, CA.

http://healthdisasteroc.org/civicax/filebank/blobdload.aspx?BlobID=12248
 
TransportJockey said:
NM is a per mile charge. First mile is a bunch (I think ALS 1 rate first mile at my old service was 700+) and then each mile is a much lower price (3-10)
Click to expand...

The standard NM Tariff rate schedule can be found here: http://www.nmprc.state.nm.us/transportation/docs/ambulancetarrif09.pdf

Quick reference:

First mile is always included.

BLS non-emergency: 289 +10.40/mile

BLS emergency: 417 +10/40/mile

ALS-1 non-emergency: 313 10.40/mile

ALS-1 Emergency: 494 + 10.40/mile

ALS-2: 715 + 10.40/mile

SCT: 846 + 10.40/mile

That being said, individual services can file for a non-standard tariff rate, either higher or lower, depending on individual circumstances. I believe that most, if not all of them have, those can be found here: http://www.nmprc.state.nm.us/consumer-relations/company-directory/ambulances/index.html

I have been told, though I have not independently verified, that the service I work for has the highest tariff rate in the state.

As noted elsewhere, what we bill and what we get paid are vastly disparate numbers.
 
UnkiEMT said:
The standard NM Tariff rate schedule can be found here: http://www.nmprc.state.nm.us/transportation/docs/ambulancetarrif09.pdf

Quick reference:

First mile is always included.

BLS non-emergency: 289 +10.40/mile

BLS emergency: 417 +10/40/mile

ALS-1 non-emergency: 313 10.40/mile

ALS-1 Emergency: 494 + 10.40/mile

ALS-2: 715 + 10.40/mile

SCT: 846 + 10.40/mile

That being said, individual services can file for a non-standard tariff rate, either higher or lower, depending on individual circumstances. I believe that most, if not all of them have, those can be found here: http://www.nmprc.state.nm.us/consumer-relations/company-directory/ambulances/index.html

I have been told, though I have not independently verified, that the service I work for has the highest tariff rate in the state.

As noted elsewhere, what we bill and what we get paid are vastly disparate numbers.
Click to expand...

Thank you for posting that. I wasn't about to go digging in the PRC website on my phone lol
 
I would be curious to know how much of those transport fee's are reinvested in "plant and property," and go back to shareholders; or if "non-profit", upper echelon salaries.
 
I'm just in awe at these prices... I think it's terrible to charge people in this manner for health services. It would put me in a conflict of interest. Example: What if that patient didn't "need" oxygen?
 
Canadian said:
It would put me in a conflict of interest. Example: What if that patient didn't "need" oxygen?
Click to expand...

I see no particular conflict of interest. For one, my pay doesn't depend on what services I provide, for two, healthcare billing is unlike any other kind of billing.

If the patient is insured, then the insurance company will pay exactly as little as they feel like they can get away with, and there isn't a damn thing we can do about it.

If the patient isn't insured, then there's a well over 80% chance we'll be writing off the bill, In fact, except in rare circumstances, my service won't even seriously attempt to bill the pt beyond the pro-forma attempts we're legally obligated to perform. Not to mention that even if the patient can/does pay, there'll be a self-pay discount and the possibility that even after making payment arrangements, we'll get part way through them, the pts circumstances will change, and we'll write off the rest of the bill.

I absolutely do wish that the US had some form of socialized medicine that prevented my patients from ever seeing my bill (or me from seeing my surgeons bill, to be honest.), but it's not as bad as it seems.
 
Canadian said:
I'm just in awe at these prices... I think it's terrible to charge people in this manner for health services. It would put me in a conflict of interest. Example: What if that patient didn't "need" oxygen?
Click to expand...

Why?

We know how much it costs to operate out service. We know what we can get in taxpayer revenue, county contributions, and grants. The rest needs to be made up somehow, or service will suffer.
 
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