Responsibilty vs. Liens for EMS bills

January 14, 2004

I am all for leins to compensate for EMS bills not being paid.

We are responsible for our affairs whether male or female, black or

white, short or tall, young or old, brilliant or a dumbass, etc. If

this were not the case, maybe I could go out and buy a new car every

week because, hell... I ain't payin' for it! Just sign the line and

keep rollin'. What are they going to do? Take it away? I'll just

get another one next week. I HOPE no one is surprised that this is

NOT how life operates - at least not for the majority.

Unfortunately, a growing segment of society seems to share this

view. Getting back to the EMS subject of this post... leins for

outstanding EMS fees... Impose leins against those who have not paid

their bills AND the ambulance was not a " medical necessity " . Scared

people won't call for an ambulance? I assure you that they will - as

long as the resource is available, they'll continue to use it to a

point that it is " worn down to a nub " .

Whether EMS is public or private, increasing utilization rates and

decreasing is not a good combination. The fire department I am

employed does not want any mention of payment, money, or cost to

people when discussing transport via an ambulance. I agree with this

to an extent. If the person strictly needs " a ride " to the hospital

and the patient is deciding whether to go with us OR go on their own,

they should be informed of their financially responsibility when

insurance or medicaid does not pay because ambulance transport was

not medically necessary. This information is listed on the PCR

anyway where they sign and it is their right to know. BTW, my FD

requires us to transport ANYONE who wants to go by ambulance.

Putting two and two together, it does not take one long to have the

seedling of the idea of " go by ambulance and get seen right away "

planted firmly in his or her head. My answer is this is quite

simple... After they sign the PCR or refuse to, I WALK them into the

traige area of the ER and make sure that the staff has a crystal

clear understanding that our patient needs meds, big toe hurts, upset

because his boy/girlfreind left him, too lazy to drive, etc. The

patient is then sent to the ER admitting/waiting room to stand and

wait his/her turn in line like everyone else. Not only does s/he

continue to wait his/her turn for the ER (clinic), but they also have

a HELLUVA taxi bill. THIS IS THE TYPE OF PATIENT THAT SHOULD GET A

LEIN WHEN S/HE DOESN'T PAY HIS/HER AMBULANCE BILL.

January 15, 2004

There is an interesting concept.....

I will remind you though, that the lien can only be placed for injuries as a

result of someone else's negligence.

But, the responsibility matter, that's a different story.

We have no qualms about insisting the the nursing home pay it's bill, but in

some services that I have been associated with, the amount the nursing homes

owed as opposed to the amount that a multitude of average Joe's owed, was

miniscule, why is it then, that we are unafraid to go after the nursing

home, but tremble in fear at asking 'Joe' to pay his bill? I am a firm

believer in letting the patient know that the ambulance ride may not be

covered by insurance, and that they may be responsible for the bill, this

too must be done at the appropriate time, not when they are gasping for

breath, or clutching their chest, but when it is a cough and fever X 1 week,

and the Dr's office is full, then sure, they need to know.

When done tactfully, and firmly, some services have been able to recoup at

least a portion of the bill, which is better than nothing at all.

>>>>>snipped for space<<<

> I am all for leins to compensate for EMS bills not being paid.

>

> We are responsible for our affairs

> The fire department I am

> employed does not want any mention of payment, money, or cost to

> people when discussing transport via an ambulance. >

January 15, 2004