pt has no complaints....

TTLWHKR

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Originally posted by asys007@Jul 28 2005, 02:13 AM

Also, for people so against 'personal attacks', you were pretty quick to call me a 'nazi-emser'....thanks ever so much.
What the heck is that supposed to mean?

I don't see any personal attacks against you? Obviously there is something about you that is out of public view.

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Jon

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Originally posted by asys007@Jul 28 2005, 03:13 AM
As far as documentation goes, I agree that a refusal is only as good as the documentation that supports it. ALL of my charts, including refusals, include documentation of what did/did not happen. Everything is written there, down to the patient's belongings.

And yes, I do get signatures from all patients who are able to sign. And yes, this does include refusals...who do by the way sign billing cards because they are billed for our services.
you can bill for refusals? how??? I need to get in on this racket... tap the un-accessed funds my squad has been missing ;)

There is NOTHING wrong with good charting... it can save you SOOO many headaches later.....

Jon
 

TTLWHKR

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Originally posted by MedicStudentJon+Jul 28 2005, 05:30 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (MedicStudentJon @ Jul 28 2005, 05:30 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-asys007@Jul 28 2005, 03:13 AM
As far as documentation goes, I agree that a refusal is only as good as the documentation that supports it. ALL of my charts, including refusals, include documentation of what did/did not happen. Everything is written there, down to the patient's belongings.

And yes, I do get signatures from all patients who are able to sign. And yes, this does include refusals...who do by the way sign billing cards because they are billed for our services.
you can bill for refusals? how??? I need to get in on this racket... tap the un-accessed funds my squad has been missing ;)

There is NOTHING wrong with good charting... it can save you SOOO many headaches later.....

Jon [/b][/quote]
Thats how the Ambulances in South East PA got in legal troubles, billing insurance companies full transport rate for refusals. That's how the protocol got changed.

The federal law is, if the patient did not initiate 911 for themselves, and they refuse - you cannot bill them. You can, however, bill the person who called 911 - IF THEY ARE A PATIENT SIGNING A REFUSAL upto $100.00. With current fuel prices, I'd have no problem with that. But I do not believe that someone who did not request an ambulance, and who does not want our help should be held accountable for a bill. In that case, we should also bill all the rubberneckers who call 911 just so they can feel better about themselves. Including the ones who call at 3am for a deer along the road, and someone burning trash.
 

Jon

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Originally posted by TTLWHKR+Jul 28 2005, 01:31 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (TTLWHKR @ Jul 28 2005, 01:31 PM)</td></tr><tr><td id='QUOTE'>
Originally posted by MedicStudentJon@Jul 28 2005, 05:30 AM
<!--QuoteBegin-asys007
@Jul 28 2005, 03:13 AM
As far as documentation goes, I agree that a refusal is only as good as the documentation that supports it. ALL of my charts, including refusals, include documentation of what did/did not happen. Everything is written there, down to the patient's belongings.

And yes, I do get signatures from all patients who are able to sign. And yes, this does include refusals...who do by the way sign billing cards because they are billed for our services.

you can bill for refusals? how??? I need to get in on this racket... tap the un-accessed funds my squad has been missing ;)

There is NOTHING wrong with good charting... it can save you SOOO many headaches later.....

Jon
Thats how the Ambulances in South East PA got in legal troubles, billing insurance companies full transport rate for refusals. That's how the protocol got changed.

The federal law is, if the patient did not initiate 911 for themselves, and they refuse - you cannot bill them. You can, however, bill the person who called 911 - IF THEY ARE A PATIENT SIGNING A REFUSAL upto $100.00. With current fuel prices, I'd have no problem with that. But I do not believe that someone who did not request an ambulance, and who does not want our help should be held accountable for a bill. In that case, we should also bill all the rubberneckers who call 911 just so they can feel better about themselves. Including the ones who call at 3am for a deer along the road, and someone burning trash. [/b][/quote]
Really?

I'd always been told that you flat-out "COULD NOT BILL FOR A REFUSAL" - it was on the 3rd tablet of commandments Moses brought down from the mount.....
 

TTLWHKR

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Originally posted by MedicStudentJon+Jul 30 2005, 02:07 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (MedicStudentJon @ Jul 30 2005, 02:07 AM)</td></tr><tr><td id='QUOTE'>
Originally posted by TTLWHKR@Jul 28 2005, 01:31 PM
Originally posted by MedicStudentJon@Jul 28 2005, 05:30 AM
<!--QuoteBegin-asys007
@Jul 28 2005, 03:13 AM
As far as documentation goes, I agree that a refusal is only as good as the documentation that supports it. ALL of my charts, including refusals, include documentation of what did/did not happen. Everything is written there, down to the patient's belongings.

And yes, I do get signatures from all patients who are able to sign. And yes, this does include refusals...who do by the way sign billing cards because they are billed for our services.

you can bill for refusals? how??? I need to get in on this racket... tap the un-accessed funds my squad has been missing ;)

There is NOTHING wrong with good charting... it can save you SOOO many headaches later.....

Jon

Thats how the Ambulances in South East PA got in legal troubles, billing insurance companies full transport rate for refusals. That's how the protocol got changed.

The federal law is, if the patient did not initiate 911 for themselves, and they refuse - you cannot bill them. You can, however, bill the person who called 911 - IF THEY ARE A PATIENT SIGNING A REFUSAL upto $100.00. With current fuel prices, I'd have no problem with that. But I do not believe that someone who did not request an ambulance, and who does not want our help should be held accountable for a bill. In that case, we should also bill all the rubberneckers who call 911 just so they can feel better about themselves. Including the ones who call at 3am for a deer along the road, and someone burning trash.
Really?

I'd always been told that you flat-out "COULD NOT BILL FOR A REFUSAL" - it was on the 3rd tablet of commandments Moses brought down from the mount..... [/b][/quote]
Most of the time the patients in an MVA, etc, did not call 911 when they are refusing. If they don't want help, they won't be calling you. The caller is most likely a passerby with all the cell phone technology. Of course I'm sure some people do call, hoping to get just PD. Touchy subject. We never billed, 100 bucks isn'tn worth a rumor of medicare fraud.
 

asys007

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Just a clarification:

We DO NOT bill insurance companies under the pretense that the patient was treated and transported...

A patient is billed for a 'refusal', pretty much we just say "hey, we responded, you owe us this pathetically low fee..." (NOT to be confused with the hefty fee we charge for an actual transport)
As far as extra money, we operate entirely on subscription drive money. There is no tax money or government input for us. In fact, 2004 was the first year where we actually made money on operations alone. We work our @$$es off on hospice transports and CORE trips, just to keep the doors open and our trucks running...


***Many of the refusals we take are for people who are subscribers, meaning they pay us a yearly fee ('donation' - $45/family) and the service picks up the tab for anything your insurance doesnt cover
 

Flight-LP

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Originally posted by asys007@Aug 1 2005, 12:02 AM
Just a clarification:

We DO NOT bill insurance companies under the pretense that the patient was treated and transported...

A patient is billed for a 'refusal', pretty much we just say "hey, we responded, you owe us this pathetically low fee..." (NOT to be confused with the hefty fee we charge for an actual transport)
As far as extra money, we operate entirely on subscription drive money. There is no tax money or government input for us. In fact, 2004 was the first year where we actually made money on operations alone. We work our @$$es off on hospice transports and CORE trips, just to keep the doors open and our trucks running...


***Many of the refusals we take are for people who are subscribers, meaning they pay us a yearly fee ('donation' - $45/family) and the service picks up the tab for anything your insurance doesnt cover
But again, you cannot bill an individual that did not initiate the 911 system and then refuses care. Another area that you cannot bill is the "no patient / no injuries" catagory. If you show up and no one is injured, you can't send a "hey, we responded, you owe us this pathetically low fee..." bill.

Memberships are nice ideas in theory, except when private air services use them, but the fee is just that; a fee. It is not a donation!!!!!
 

Jon

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Originally posted by Flight-LP+Aug 1 2005, 08:59 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (Flight-LP @ Aug 1 2005, 08:59 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-asys007@Aug 1 2005, 12:02 AM
Just a clarification:

We DO NOT bill insurance companies under the pretense that the patient was treated and transported...

A patient is billed for a 'refusal', pretty much we just say "hey, we responded, you owe us this pathetically low fee..." (NOT to be confused with the hefty fee we charge for an actual transport)
As far as extra money, we operate entirely on subscription drive money. There is no tax money or government input for us. In fact, 2004 was the first year where we actually made money on operations alone. We work our @$$es off on hospice transports and CORE trips, just to keep the doors open and our trucks running...


***Many of the refusals we take are for people who are subscribers, meaning they pay us a yearly fee ('donation' - $45/family) and the service picks up the tab for anything your insurance doesnt cover
But again, you cannot bill an individual that did not initiate the 911 system and then refuses care. Another area that you cannot bill is the "no patient / no injuries" catagory. If you show up and no one is injured, you can't send a "hey, we responded, you owe us this pathetically low fee..." bill.

Memberships are nice ideas in theory, except when private air services use them, but the fee is just that; a fee. It is not a donation!!!!! [/b][/quote]
Well, you can bill, but they can fight it, and not pay.... and you can be in very deep doo-doo...

Around here, most Co's are part paid, part volunteer... They always make some money. At my FD, the Ambulance makes enough to buy a brand new E450 Horton every 3 years, and have some extra money left over for the Fire. Co. to "have"

The ambulance Co. isn't rich, but they seem get by... we needed to do a significant fund drive to build our pretty new building....


Anyone else do memberships? At the FD, the company "pays" the ambulance bill of any volunteer member if insurance fails to.

At the squad, we have had an off again / on again community membership program. you ask for "X" amount of money per household, and the company waives any bills left over after insurance. The program has had several incarnations over the last 50 years, and we recently started it again after it was proven somewhere lese that it was legal.

I've heard of Acadian and others doing "membership" programs in the Louisiana Bayou or other remote uninhabited places... you call, and they send a helocopter out for you.... but you pay XX a year.... Probably not a bad deal.

Jon
 

Flight-LP

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Actually Jon, its a very bad idea. Acadian is a remote exception due to their geographic location and their areas inaccessable by a ground unit. As I stated in a previous thread, air memberships introduce the generally uneducated public to the option of calling a helicopter instead of 911. Outside of the obvious financial burden of flying to a BLS call, it also promotes a negative reputable image of air services as a whole and creates a multi faceted safety risk for all involved. A helicopter should not be used for a non-emergent transport, plain and simple. Just my .$02 worth...............
 

Jon

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Originally posted by Flight-LP@Aug 1 2005, 01:21 PM
Actually Jon, its a very bad idea. Acadian is a remote exception due to their geographic location and their areas inaccessable by a ground unit. As I stated in a previous thread, air memberships introduce the generally uneducated public to the option of calling a helicopter instead of 911. Outside of the obvious financial burden of flying to a BLS call, it also promotes a negative reputable image of air services as a whole and creates a multi faceted safety risk for all involved. A helicopter should not be used for a non-emergent transport, plain and simple. Just my .$02 worth...............
Great points. I was meaning to say that some of Acadian's area or other REALLY REALLY REALLY rural areas (I'm sure you have some in Texas) are better served by aeromedical response then ground ambulance. I know in Arizona and other places, it isn't odd for Aeromedical to be the first arriving unit.

Jon
 
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