Recent events in our area have brought about taking two patients at a time. Our billing clerk has said that since she spoke to an attorney and it doesn't violate hippa than we will do it. Does anyone have any arguments for or against this practice? They are medical patients that are from a certain doctor and or nursing home. Who would, in the end, be responsible if one patient ends up dying and the family sues because we had extra patients to take up our time and attention. Also when billing insurance or medicare can we bill both patients for the mileage and time or do we split it, and would a faimly be correct in not paying for something that has been paid for by the other patients insurance. <_<
Taking extra patients??
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Jeffrey_169
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I have never heard of this being the preferred method of transport. I have done it in a pinch, but I have never seen it recommended outside of being absolutely necessary.
As too being sued, well this a little out of my scope as I know little of the laws of your location. I can not see it being a big deal, but then again I don't understand how someone can sue when they are hurt breaking into someone's house either. Laws are funny sometimes.
Just curious, but why is that the policy? Cheaper or what? Its a surprise to see it being common place.
As too being sued, well this a little out of my scope as I know little of the laws of your location. I can not see it being a big deal, but then again I don't understand how someone can sue when they are hurt breaking into someone's house either. Laws are funny sometimes.
Just curious, but why is that the policy? Cheaper or what? Its a surprise to see it being common place.
we did training for Mass Cal situations, and in that case I have transported 7 patients, for mass casualty training only
transported 6 3 different times on ECF evacuations; tornados, that damaged them, not enough ambulances and busses to transport, so you do what you can, everyone but tech was seatbelted.
transported 6 3 different times on ECF evacuations; tornados, that damaged them, not enough ambulances and busses to transport, so you do what you can, everyone but tech was seatbelted.
EMTinNEPA
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If you have two patients and one happens to overhear your conversation with another, it is not a hipaa violation... otherwise hospitals would be getting shut down all the time because the patient in the next bed overheard what a doctor was saying to their "neighbor", so to speak...
themuffin101
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its not toooo bad if they are family or friends in the same car...granted neither are seriously injured and you have enough manpower. I would NEVER take two patients from separate vehicles as someone mentioned above. You have to play these situations by ear. you have to look at MOI, how many total patients, how many rigs are available, and how much manpower you have.
Are you asking about taking 2 interfacility non emergent patients and then billing them as if it were a seperate trip?
I am not a legal expert, but I have never even heard of anyone doing that. I certainly wouldn't want to be the first to test it.
fire_911medic
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We did this one time and it was a mother/daughter burn patient being transferred to a burn center from basically a free standing clinic. Both were stable but needed to be transferred for additional care. Due to the situation, we found it completely appropriate and I don't believe anyone would argue with that. I have taken 2 patients several times on emergency transports (though not IFT) that were either a minor and critical or two minor patients. NEVER two critical patients. And if I do, someone comes along with me and gets the CPR seat and I get captain's chair. Two non related IFT's or two criticals is a definite no no in my book and most others I can think of !
I can understand two family members. I have transported 5 patients at one time during an emergency. But 2 unrelated nursing home patients to doctors offices or dialysis and billing both might not even be legal, much less ethical.
I certainly have transported multiple patients in certain emergency situations before, but as long as I make it clear to my billing department, I am not going to worry about the legality of it. I trust them to make the decision, and ultimately, billing and medicare law isnt my expertise, or my responsibility.
I first learned the art of the multiple-transport while working in Israel, where we routinely transported one stretcher bound, and often more ambulatory patients from multiple patient accidents (especially MVCs). There we write the bill as soon as we finish the PCR, and have a formula for calculating cost, based on the number of patients transported, and the necessities of care.
If I recall correctly, as long as a full assessment was performed, with any necessary treatments and ongoing assessments, the patient with highest acuity (on the stretcher) paid 70% what they would if alone. If two patients loaded, it was 70%, and 50%, if three, 50%, 30%, 30%, etc.
As with many discussions here, the best practice would be to ask your managers or field supervisors at work, or if you are really curious about the procedure, ask the billing department what their policies are. The answers we give you here should not be undertaken without discussions with your bosses at work.
I first learned the art of the multiple-transport while working in Israel, where we routinely transported one stretcher bound, and often more ambulatory patients from multiple patient accidents (especially MVCs). There we write the bill as soon as we finish the PCR, and have a formula for calculating cost, based on the number of patients transported, and the necessities of care.
If I recall correctly, as long as a full assessment was performed, with any necessary treatments and ongoing assessments, the patient with highest acuity (on the stretcher) paid 70% what they would if alone. If two patients loaded, it was 70%, and 50%, if three, 50%, 30%, 30%, etc.
As with many discussions here, the best practice would be to ask your managers or field supervisors at work, or if you are really curious about the procedure, ask the billing department what their policies are. The answers we give you here should not be undertaken without discussions with your bosses at work.
clarified
Sorry I was slightly sleeo deprived on the original posting. These are NOT emergency situations. Always Nursing Home Transfers or direct admits. I cant understand why they wouldn't want the additional revenue from a second trip unless just billing as two different trips. Just wondering if any one else has seen this.
Sorry I was slightly sleeo deprived on the original posting. These are NOT emergency situations. Always Nursing Home Transfers or direct admits. I cant understand why they wouldn't want the additional revenue from a second trip unless just billing as two different trips. Just wondering if any one else has seen this.
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From a nursing home, most likely you'll need a PCS form of some sort that is used for your billing to determine a patient's medical necessity to be transported by ambulance. Transporting two at a time because of convienance does not seem appropriate to me. This isn't about HIPAA, but about your ability to appropriately monitor a patient's condition. A patient also has the right to privacy, and ethically I'm not sure I can agree with that one.
I once transported nine people in an ambulance, which surely wasn't appropriate, but it was making the best of what he had. During actual emergency calls I've transported two. Sometimes you're the only unit available in the county.
Taking two patients on routine calls doesn't seem ethically permissible.
I once transported nine people in an ambulance, which surely wasn't appropriate, but it was making the best of what he had. During actual emergency calls I've transported two. Sometimes you're the only unit available in the county.
Taking two patients on routine calls doesn't seem ethically permissible.
JPINFV
Gadfly
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Probably because people who were in seperate sides of a collision have a differing thoughts as to who's at fault and tend to hold a gruge over it.
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I caution all that transporting folks from separate cars at a MVA works occasionally... it all depends on the totality of the circumstances.
I really wonder why any IFT company would be transporting 2 patients in an ambulance. There are a lot of questions:
How do you get both patients to the truck? You probably only have one stretcher, other would go on the bench seat, right? How do you do get both into and out of the truck without abandoning the other?
How do you monitor both patients during transport? How do you do it while secured in a seatbelt?
The KKK-1822-E specs call for the ambulance to be able to transport a second patient so that we can in case of extenuating circumstances. That said, it is NOT the standard of care in this country.
I really wonder why any IFT company would be transporting 2 patients in an ambulance. There are a lot of questions:
How do you get both patients to the truck? You probably only have one stretcher, other would go on the bench seat, right? How do you do get both into and out of the truck without abandoning the other?
How do you monitor both patients during transport? How do you do it while secured in a seatbelt?
The KKK-1822-E specs call for the ambulance to be able to transport a second patient so that we can in case of extenuating circumstances. That said, it is NOT the standard of care in this country.
reaper
Working Bum
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On an MVA, I transport more then one pt freqently. Unless they are a major trauma, there is no problem in it.
IFT- I would never allow two pt's. If they are going by ambulance, they should be on the stretcher. If they are able to sit on a bench seat, then they do not need an ambulance and that is considered fraud!
IFT- I would never allow two pt's. If they are going by ambulance, they should be on the stretcher. If they are able to sit on a bench seat, then they do not need an ambulance and that is considered fraud!
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JPINFV
Gadfly
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Once upon a time I suggested a giant vacuum tube between nursing homes and facilities but couldn't get anyone to go along.
That's MY idea!
We have the 10 or 12 seater vans that do that sometimes