EMTinNEPA
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I never said they all did. I only asked how many didn't recieve payment because of subpar documentation and billing practices.
What does your department do?
- Thread starter tracyloo32
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I never said they all did. I only asked how many didn't recieve payment because of subpar documentation and billing practices.
enjoynz
Lady Enjoynz
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I thought this thread was meant to be about fund raising....hence the original post.
Not all services have the luxury of having all the funding they want handed to them on a plate. Or have heaps of calls, to cover their transport charges!
The thread is not a vollie bashing. Or my paper is better than your paper work thread.
Gosh folks, take it too another thread of your own!-_-
Enjoynz
Not all services have the luxury of having all the funding they want handed to them on a plate. Or have heaps of calls, to cover their transport charges!
The thread is not a vollie bashing. Or my paper is better than your paper work thread.
Gosh folks, take it too another thread of your own!-_-
Enjoynz
Of course your service takes proper documentation very seriously. You work for a private IFT company, whose very survival is contingent on proper billing. I'm sure that proper documentation for billing purposes is a top priority there, and understandably so. A volly organization doesn't enjoy the nearly 100% rate of clientele having some form of insurance, or a reimbursement guarantee from the sending facility. The volly service is subject to the same scourge of uncompensated cases that any paid 911 service does. The pt may have no insurance, give a false name, the crew may not be able to secure proper demographics due to a language barrier, etc. etc. Many vollies will also do third party billing only, so as not to cause any financial insult to the pts in their community. I'd imagine that the typical volly agency doesn't have a fully staffed billing dept, nor can they afford to go to ePCR's to avoid claim denials due to illegible handwriting.
Door to door solicitation for donations is an option. Here, the local volly house offers a free professional family photo at the house on a certain day for all that gave donations.
Legalized gambling for fundraising purposes would be a good cash cow, but the potential for embezzlement and other forms of curruption would be too great, I would think.
EMTinNEPA
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Who also happens to be the primary 911 ALS provider for 75% of the county and in turn tens of thousands of people... we do just as much 911 as we do IFT... if not more. We average 6 or 7 IFTs a day and 8 to 10 911s.
If they don't have insurance, we charge them directly. If they don't pay their bill, we destroy their credit. If they give a false name, I guess we have to take the hit, but so does the hospital.
And how is billing "financial insult"? It's insulting to charge for services rendered?
Boot drives and baked potato stands are fine, but they won't come anywhere close to the funds obtained through billing for services.
usafmedic45
Forum Deputy Chief
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Excuse me? Three words: audit and review. We regularly got dinged for poor documentation, regardless of volunteer or paid status. Continuous quality improvement involves a lot more than just direct patient care issues and protocol modifications.
What she said.
As someone who used to review ~10,000 call reports a year (an educated guess based on an average of about 30 cases reviewed per day)- both paid and volunteer- as part of his work as the quality control "officer" for a medical director that oversaw most of the services in a six-county area, I would have to disagree with you there. The grammar for a lot of the paid EMS professionals was just as bad, if not worse than their volunteer counterparts. Of course, this could also have something to do with the fact that our volunteers tended to have more college education than the paid personnel (we tracked this) and spent more time at the hospital (or scene for the case of non-transport agencies) on average before marking back into service (we used this as a way to judge who had more time to write their reports).
We had a scale for documentation violations that depended upon the severity of the issue at hand:
-Minor issue: poor spelling, handwriting, grammar, syntax, typos, etc.
-Moderate issue: unclear documentation of procedures, failure to include patient information on the run report (or other things likely to screw up billing), medication administration, etc
-Major issue: failure to turn in reports (first and second offenses), etc
-Critical issue: failure to turn in reports (recidivist); failure to document administration and/or disposal of controlled substances;
Usually, the minor and moderate issues would get the person a verbal warning ("Hey Bob, learn how to freaking spell 'amiodarone' will you please?") or one of my infamous sticky notes (I had specially made post-it notes that had common problems on it so that I didn't have to write out each issue....I just checked off what was an issue). If the problem did not cease, then they were usually called in to have a little chat and then a written warning was given along with suggestions on how to fix the problem. If you still could not learn, you often would find yourself without a job unless you had a dang good mitigating circumstance. Note: I am not trying to imply that we fired people simply for not being able to spell or write....it had to be pretty severe, usually to the point where you could not figure out what they were trying to convey. Major or critical issues were usually treated with suspension and, if severe enough, termination on the first offense.
Our cases were about a 60/40 split for volunteer and paid respectively, yet we found that ~70% of the non-minor issues (based on the above description) went out to paid personnel. If you looked at the minor issues, it was something like 60/40 so it was about evenly divided between the two groups.
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We collect money from property taxes, from billing our patients, and fundraisers like the Fireman's Ball and an annual golf tournament. In addition, we receive donations from our community on a pretty regular basis.
My mistake, I could've sworn that somewhere else you said that your agency was 100% IFT.
If I was a citizen in your coverage area, and I was made aware that the local private EMS agency was pursuing those in financial difficulty up to the point of ruining their credit, I'd make sure that I'd advise others, and work with local politicians to have your service cease that practice, or otherwise not renew the contract, and put a municipal agency in place instead.
By "financial insult" I mean requiring the pt to pay out of pocket for txp copays. A volly service is there for the community 100%. Many won't ask citizens to pay anything out of pocket, let alone go after someone's credit.
What happens if you fail to pay a credit card bill? You get reminders, it goes to collections, and eventually is reported on your credit. You received goods or services and are expected to pay for them.
Why should EMS services be any different? If I provide my professional services and care to you, I expect compensation, as does my company. Therefore, you need to pay. It really is simple as that. Just like the credit cards, hospitals, and other creditors out there, a payment plan can be set up on an individual basis. But to simply ignore the bill is a strong part of why these expenses are needed.
I get a warm fuzzy feeling when I hear that vollie services do not bill and are there for the community. But since they don't bill, they run crap equipment, have nil for a trining budget and therefore usually run the bare minimum staffing, and usually are not the cream of the crop. Based on this, I personally am quite happy to pay for professional MICU level services from one of the nations best EMS services. Most reasonable citizens are.
As has been stated numerous times prior in other posts, vollie EMS may be the only option for many rural areas. The tax base isn't able to support a paid service, and rural areas are typically lower income, on average, compared to surrounding cities. What do you want them to do?
The community squad isn't going to go after someone's home or possessions due to inability to pay. Bad PR for them, and they could expect a drop in donations. Many will do third party billing so that only the insurance company is billed.
Level1pedstech
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In my area our transport agency has the following billing options, with the passage of the recent levy we are good to go for 10 years. Residents pay nothing for service and transport but an attempt to bill insurance will be made, if you have no coverage services are written off. Non residents and we always have many in the area enjoying the outdoors pay full fare and every attempt will be made to collect for all services rendered. Life flight I believe has the same policy which I am sure is an agreement reached between our transport agency and life flight. This system seems to work and I think part of the reason is that people who tend to travel to the area fit into an upper level financial demographic not rich but employed and probably covered under an insurance plan. Visitors make up a large share of our call volume. On the other hand our local population has its fair share of people that fall into the lower levels of the financial demographic. I guess in a way the two even each other out,and judging by the recent levy results I think the taxpayers are very happy with the system and want it to continue.
On the subject of charting I can definitely stand to improve my documentation skills. When I chart in the ER I have a tough time when the team starts really moving fast on assessments,my medical terminology is not at the level of the MD's and RN's. I always have a sheet of paper that I can write stuff down that I hear and then complete my chart when everyone is finished. I also keep a cheat sheet for meds and thier proper spelling. Like everything else there is always the need to continue perfecting skills like documentation whether you are paid or volunteer.
On the subject of charting I can definitely stand to improve my documentation skills. When I chart in the ER I have a tough time when the team starts really moving fast on assessments,my medical terminology is not at the level of the MD's and RN's. I always have a sheet of paper that I can write stuff down that I hear and then complete my chart when everyone is finished. I also keep a cheat sheet for meds and thier proper spelling. Like everything else there is always the need to continue perfecting skills like documentation whether you are paid or volunteer.
medic417
The Truth Provider
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Number 1 that myth has been shown to be just that a myth multiple times. With proper priority's any area can go paid, they just have to establish priority's.
You should bill all patients. If every patient just paid $10 a month over time that would add up to a large amount of income every month. So again mismanagement is the blame.
WolfmanHarris
Forum Asst. Chief
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My department has a budget approved by regional council. Council provides that money from the tax base. This includes capital expenditures and service enhancements. The region then presents the operating budget to the province which reimburses 50% of that.
The co-payment collected from patients does not directly fund the service but returns to the public purse.
No direct fundraising.
The co-payment collected from patients does not directly fund the service but returns to the public purse.
No direct fundraising.
They couldn't go after property or personal possessions anyways as it is an unsecured debt.
It has also been stated and proven in numerous other threads that rurals counties can offer paid services. In fact, there is an active thread on it now..........
I've said it time and time again. If the two poorest counties in Texas (which as a reminder are also in the top ten in the U.S.) can offer paid ALS services, then it can be done.
Sometimes, you just have to be creative and prioritize resources.