SD BLS = dialysis - 3 questions

[Jon]

Gurney transports are payed for by hmo's or individuals. I often collect payment on the spot taking checks, credit card info or cash.

I understand a typical bls transport costs medicare around $550.(no O2) The "gruneys" I run, bill out at $100 plus milage.

We aren't UPS or Public Transit - Why do we collect fares?

 

[JPINFV]

I think I've taken payment once or twice, but it was exceedingly rare and for non-essential transports with this arrangement set up ahead of time. I've never given anyone a surprise bill following a transport. As far as physician certificate of necessities, I get them signed and the staff can put down what ever they want. If they're not fully sure, I'll help them out a bit [e.g. orthopedic device preventing wheelchair van transport], but I'm not going to lie in my run sheet to cover for hospital staff. If the patient wants to go to a wheel chair at the destination, thus making the patient not 'bed confined,' then so be it. My honor isn't for sale at $12-13/hr. If the staff can't/won't sign the certificate of necessity, then I punt it to dispatch. In the few times I've had this problem, they generally say to transport anyways. It's generally better to eat a few transports than lose a contract.

We aren't UPS or Public Transit - Why do we collect fares?

You do cash your pay checks, right? I bet, if you offered this to your company, that instead of collecting payment for services, you offered to let the company take it out of your check that they'd be willing to drop the charge against the patient.

 

[daedalus]

No. I come from a system where EMS is staffed with providers with a 2 years of education for BLS and 3 for ALS and where stable IFT exists in the private sector staffed by drivers with first aid or perhaps First Responder and where their vehicles are not considered Ambulances under the law. What I meant was that those without the inclination to professionally practice prehospital care are unlikely to go through two years of school. There are of course exceptions (as there is with anything), but education seems to keep the whacker and wannabes numbers low in EMS.

The criteria I referred to was directed largely to the concept of forging documents to pad bills and otherwise operating in a way that was no providing professional patient centered care.

Where is this magical land!?

 

[TransportJockey]

I do IFTs in NY and NJ and have no idea what a gurney transport is. Every call we are required to assess our patients.

My IFT company has many contracts with nursing homes for their emergencies. Patients are usually coveren by medicare so the company gets paid and they are legitimate emergencies and no so legit emergencies that come in.

We do many dialysis runs, psych transfers, ed and hospital discharges and CCTs.

Sounds like the IFT company I worked for here in ABQ

 

[SanDiegoEmt7]

My honor isn't for sale at $12-13/hr. If the staff can't/won't sign the certificate of necessity, then I punt it to dispatch.

Amen, Most of our contracts here never fill these out and always call for BLS instead of w/c. Since most of the transferring nurses only sign the form and don't fill it out I fill them out honestly regardless of the affects on the billed amount. My billing and management can take it up with the calling nurses when we don't get the expected money"

Most nurses and patients truly don't care if they go BLS because medicare/medi-Cal pay for everything. They wouldn't care if they got a CCT to a dialysis call.

 

[JPINFV]

...and for those outside of California, Medi-Cal is the state of California's medicaid program.

 

[vquintessence]

My honor isn't for sale at $12-13/hr. If the staff can't/won't sign the certificate of necessity, then I punt it to dispatch. In the few times I've had this problem, they generally say to transport anyways. It's generally better to eat a few transports than lose a contract.

Ah, well put. Chair car transports are a waste of resources when it's being done routinely by an ambulance. But like you said, if it keeps the contract intact then it's worth eating dollars sometimes.

We lost a transport contract with a facility about six weeks ago because crews were refusing to take pts BLS without med necessity. That is all fine and good but they refused to transport the pt via "chair car status" as instructed by the supervisor... Well that happened about half a dozen times... pts missed appointments... the contract is gone... one BLS truck has lost 10hrs a week... and the offending crew members are out a job!