Re: Duct Tape

[Guest guest]

I have been out of the billing side of EMS for a while, but, I am fairly

sure that you cannot bill for itemized procedures such as immobilization any

longer. There are several professional EMS billing people on the list, maybe

they will educate us on the latest information.

Lee

Re: Duct Tape

Alfonso,

Please connect the dots between Dr. Bledsoe's encouraging services

to adopt a selective spinal immobilization protocol and your

assertion that private providers depends on backboarding patients as

a revenue source.

More specifically, are you trying to make a point or even a stab in

the dark that private providers are more likely to continue

backboarding patients then are tax funded providers?

Are you saying that the Medical Director's of private services are

not capable or willing to provide a selective spinal immobilization

protocol? Or maybe you have determined that all tax funded services

have a selective spinal immobilization protocol. Without my test

either of those theories, I would bet they are both without validity.

If you are taking that sort of a swipe at various providers, what

information do you hold that would support that sort of a

statement?

My question to you Alfonso, what did you mean by your comment?

bkw

> >

> > This whole argument would me more meaningful if all EMS services

in

> Texas

> > used one of the selective spinal immobilization policies.

Instead of

> looking

> > at backboards stacked like cord wood, you will be taking EMS

> students to the

> > ED storage and say, " Look young whippersnapper. These are

backboards. We

> > used to use them more often than oxygen--now they are used once

in a

> blue

> > moon. Get a good look--but don't touch "

> >

>

> Yes, Dr. B, but that makes too much sense. Tell that to the

private

> providers who depend on this service for their cash-flow. :-)

>

> Alfonso R. Ochoa

>

[Guest guest]

Lee,

As bundled billing is the growing standard and to become the

eventual standard of all EMS providers billing CMS, you are correct.

My question remains for Alfonso.

bkw

> > >

> > > This whole argument would me more meaningful if all EMS

services

> in

> > Texas

> > > used one of the selective spinal immobilization policies.

> Instead of

> > looking

> > > at backboards stacked like cord wood, you will be taking EMS

> > students to the

> > > ED storage and say, " Look young whippersnapper. These are

> backboards. We

> > > used to use them more often than oxygen--now they are used

once

> in a

> > blue

> > > moon. Get a good look--but don't touch "

> > >

> >

> > Yes, Dr. B, but that makes too much sense. Tell that to the

> private

> > providers who depend on this service for their cash-flow. :-)

> >

> > Alfonso R. Ochoa

> >

>

>

>

>

>

>

>

>

>

[Guest guest]

Lee,

As bundled billing is the growing standard and to become the

eventual standard of all EMS providers billing CMS, you are correct.

My question remains for Alfonso.

bkw

> > >

> > > This whole argument would me more meaningful if all EMS

services

> in

> > Texas

> > > used one of the selective spinal immobilization policies.

> Instead of

> > looking

> > > at backboards stacked like cord wood, you will be taking EMS

> > students to the

> > > ED storage and say, " Look young whippersnapper. These are

> backboards. We

> > > used to use them more often than oxygen--now they are used

once

> in a

> > blue

> > > moon. Get a good look--but don't touch "

> > >

> >

> > Yes, Dr. B, but that makes too much sense. Tell that to the

> private

> > providers who depend on this service for their cash-flow. :-)

> >

> > Alfonso R. Ochoa

> >

>

>

>

>

>

>

>

>

>

[Guest guest]

Lee,

As bundled billing is the growing standard and to become the

eventual standard of all EMS providers billing CMS, you are correct.

My question remains for Alfonso.

bkw

> > >

> > > This whole argument would me more meaningful if all EMS

services

> in

> > Texas

> > > used one of the selective spinal immobilization policies.

> Instead of

> > looking

> > > at backboards stacked like cord wood, you will be taking EMS

> > students to the

> > > ED storage and say, " Look young whippersnapper. These are

> backboards. We

> > > used to use them more often than oxygen--now they are used

once

> in a

> > blue

> > > moon. Get a good look--but don't touch "

> > >

> >

> > Yes, Dr. B, but that makes too much sense. Tell that to the

> private

> > providers who depend on this service for their cash-flow. :-)

> >

> > Alfonso R. Ochoa

> >

>

>

>

>

>

>

>

>

>

[Guest guest]

I understand you post Britton, thanks for the info

Lee

Re: Duct Tape

Lee,

As bundled billing is the growing standard and to become the

eventual standard of all EMS providers billing CMS, you are correct.

My question remains for Alfonso.

bkw

> > >

> > > This whole argument would me more meaningful if all EMS

services

> in

> > Texas

> > > used one of the selective spinal immobilization policies.

> Instead of

> > looking

> > > at backboards stacked like cord wood, you will be taking EMS

> > students to the

> > > ED storage and say, " Look young whippersnapper. These are

> backboards. We

> > > used to use them more often than oxygen--now they are used

once

> in a

> > blue

> > > moon. Get a good look--but don't touch "

> > >

> >

> > Yes, Dr. B, but that makes too much sense. Tell that to the

> private

> > providers who depend on this service for their cash-flow. :-)

> >

> > Alfonso R. Ochoa

> >

>

>

>

>

>

>

>

>

>

[Guest guest]

I understand you post Britton, thanks for the info

Lee

Re: Duct Tape

Lee,

As bundled billing is the growing standard and to become the

eventual standard of all EMS providers billing CMS, you are correct.

My question remains for Alfonso.

bkw

> > >

> > > This whole argument would me more meaningful if all EMS

services

> in

> > Texas

> > > used one of the selective spinal immobilization policies.

> Instead of

> > looking

> > > at backboards stacked like cord wood, you will be taking EMS

> > students to the

> > > ED storage and say, " Look young whippersnapper. These are

> backboards. We

> > > used to use them more often than oxygen--now they are used

once

> in a

> > blue

> > > moon. Get a good look--but don't touch "

> > >

> >

> > Yes, Dr. B, but that makes too much sense. Tell that to the

> private

> > providers who depend on this service for their cash-flow. :-)

> >

> > Alfonso R. Ochoa

> >

>

>

>

>

>

>

>

>

>

[Guest guest]

I understand you post Britton, thanks for the info

Lee

Re: Duct Tape

Lee,

As bundled billing is the growing standard and to become the

eventual standard of all EMS providers billing CMS, you are correct.

My question remains for Alfonso.

bkw

> > >

> > > This whole argument would me more meaningful if all EMS

services

> in

> > Texas

> > > used one of the selective spinal immobilization policies.

> Instead of

> > looking

> > > at backboards stacked like cord wood, you will be taking EMS

> > students to the

> > > ED storage and say, " Look young whippersnapper. These are

> backboards. We

> > > used to use them more often than oxygen--now they are used

once

> in a

> > blue

> > > moon. Get a good look--but don't touch "

> > >

> >

> > Yes, Dr. B, but that makes too much sense. Tell that to the

> private

> > providers who depend on this service for their cash-flow. :-)

> >

> > Alfonso R. Ochoa

> >

>

>

>

>

>

>

>

>

>

[Guest guest]

Why can't we just use super glue?

[Guest guest]

Why can't we just use super glue?

[Guest guest]

Hold up. I'm sure we could find a way to super glue the head to the board.

If super glue doesn't work, maybe hot glue would work.

[Guest guest]

Hold up. I'm sure we could find a way to super glue the head to the board.

If super glue doesn't work, maybe hot glue would work.

[Guest guest]

--------------- In Reply To:

----------------------------------------------------------------

Yes, Dr. B, but that makes too much sense. Tell that to the private

providers who depend on this service for their cash-flow. :-)

--------------- End of Quote

--------------------------------------------------------------

I really try to stay quiet around here, but afraid that it's not going to work

this time.

No wonder I've recently read here that EMS appears to " eat its own " . As a

whole, we scream, yell, and pound fists on the table to demand recognition from

the world as unified medical professionals: EMS. And yet in the same room, we

find ourselves separated simply by the type of service we work for.

We are all certified to at least a statewide standard of education and skills,

no matter what service employs us... city, private, fire, or volunteer. No one

with a heart and a humble ego immobilizes anyone for their own selfish pleasure

or to gain from insurance. And as I've easily found by a simple web search, CMS

does not reimburse for immobilization no matter what service you work for. For

reference, please see

http://www.trailblazerhealth.com/notices.asp?action=detail & id=1798

(www.trailblazerhealth.com/notices.asp?action=detail & id=1798). I truncated the

very extensive list to just the immobilization procedures below:

From CMS carrier Trailblazer Health:

> " The following supplies are considered part of the transport and a separate

charge is not reimbursable by Medicare and not billable to the patient.

>>> Back board.

>>> CID (cervical immobilization device, C-collar, cervical collar).

>>> Inflatable arm or leg splint.

>>> Minor extrication.

>>> Neck board (neck brace). "

Please pass the Real Tree camo-colored duct tape, and I'll try to sit here quiet

and camoflaged a while more. ;-)

K. Pelletier

[Guest guest]

--------------- In Reply To:

----------------------------------------------------------------

Yes, Dr. B, but that makes too much sense. Tell that to the private

providers who depend on this service for their cash-flow. :-)

--------------- End of Quote

--------------------------------------------------------------

I really try to stay quiet around here, but afraid that it's not going to work

this time.

No wonder I've recently read here that EMS appears to " eat its own " . As a

whole, we scream, yell, and pound fists on the table to demand recognition from

the world as unified medical professionals: EMS. And yet in the same room, we

find ourselves separated simply by the type of service we work for.

We are all certified to at least a statewide standard of education and skills,

no matter what service employs us... city, private, fire, or volunteer. No one

with a heart and a humble ego immobilizes anyone for their own selfish pleasure

or to gain from insurance. And as I've easily found by a simple web search, CMS

does not reimburse for immobilization no matter what service you work for. For

reference, please see

http://www.trailblazerhealth.com/notices.asp?action=detail & id=1798

(www.trailblazerhealth.com/notices.asp?action=detail & id=1798). I truncated the

very extensive list to just the immobilization procedures below:

From CMS carrier Trailblazer Health:

> " The following supplies are considered part of the transport and a separate

charge is not reimbursable by Medicare and not billable to the patient.

>>> Back board.

>>> CID (cervical immobilization device, C-collar, cervical collar).

>>> Inflatable arm or leg splint.

>>> Minor extrication.

>>> Neck board (neck brace). "

Please pass the Real Tree camo-colored duct tape, and I'll try to sit here quiet

and camoflaged a while more. ;-)

K. Pelletier

[Guest guest]

--------------- In Reply To:

----------------------------------------------------------------

Yes, Dr. B, but that makes too much sense. Tell that to the private

providers who depend on this service for their cash-flow. :-)

--------------- End of Quote

--------------------------------------------------------------

I really try to stay quiet around here, but afraid that it's not going to work

this time.

No wonder I've recently read here that EMS appears to " eat its own " . As a

whole, we scream, yell, and pound fists on the table to demand recognition from

the world as unified medical professionals: EMS. And yet in the same room, we

find ourselves separated simply by the type of service we work for.

We are all certified to at least a statewide standard of education and skills,

no matter what service employs us... city, private, fire, or volunteer. No one

with a heart and a humble ego immobilizes anyone for their own selfish pleasure

or to gain from insurance. And as I've easily found by a simple web search, CMS

does not reimburse for immobilization no matter what service you work for. For

reference, please see

http://www.trailblazerhealth.com/notices.asp?action=detail & id=1798

(www.trailblazerhealth.com/notices.asp?action=detail & id=1798). I truncated the

very extensive list to just the immobilization procedures below:

From CMS carrier Trailblazer Health:

> " The following supplies are considered part of the transport and a separate

charge is not reimbursable by Medicare and not billable to the patient.

>>> Back board.

>>> CID (cervical immobilization device, C-collar, cervical collar).

>>> Inflatable arm or leg splint.

>>> Minor extrication.

>>> Neck board (neck brace). "

Please pass the Real Tree camo-colored duct tape, and I'll try to sit here quiet

and camoflaged a while more. ;-)

K. Pelletier

[Guest guest]

Okay. Alfonso and I used to work for a service that

depended on doing the most for the pt, i.e.

immobilization. Now everytime you immobilize a pt you

do not always bill medicare/medicaid. Let's not

forget about insurance. 90% of immobilized pts are

from MVCs, and who do you bill, normally the

insurance. And for those who think discussing this is

a waist of time, this is a DISCUSSION list. Here

everyone can get ideas from one another and hopefully

try and get things flowing in our individual systems,

based on what everyone else is doing.

Salvador Capuchino

EMT-Paramedic

--- Kim wrote:

>

> --------------- In Reply To:

>

----------------------------------------------------------------

>

> Yes, Dr. B, but that makes too much sense. Tell

> that to the private

> providers who depend on this service for their

> cash-flow. :-)

>

> --------------- End of Quote

>

--------------------------------------------------------------

>

>

>

>

> I really try to stay quiet around here, but afraid

> that it's not going to work this time.

>

> No wonder I've recently read here that EMS appears

> to " eat its own " . As a whole, we scream, yell, and

> pound fists on the table to demand recognition from

> the world as unified medical professionals: EMS.

> And yet in the same room, we find ourselves

> separated simply by the type of service we work for.

>

>

> We are all certified to at least a statewide

> standard of education and skills, no matter what

> service employs us... city, private, fire, or

> volunteer. No one with a heart and a humble ego

> immobilizes anyone for their own selfish pleasure or

> to gain from insurance. And as I've easily found by

> a simple web search, CMS does not reimburse for

> immobilization no matter what service you work for.

> For reference, please see

>

http://www.trailblazerhealth.com/notices.asp?action=detail & id=1798

>

>

(www.trailblazerhealth.com/notices.asp?action=detail & id=1798).

> I truncated the very extensive list to just the

> immobilization procedures below:

>

> From CMS carrier Trailblazer Health:

> > " The following supplies are considered part of the

> transport and a separate charge is not reimbursable

> by Medicare and not billable to the patient.

> >>> Back board.

> >>> CID (cervical immobilization device, C-collar,

> cervical collar).

> >>> Inflatable arm or leg splint.

> >>> Minor extrication.

> >>> Neck board (neck brace). "

>

>

> Please pass the Real Tree camo-colored duct tape,

> and I'll try to sit here quiet and camoflaged a

> while more. ;-)

>

> K. Pelletier

>

>

>

>

>

> [Non-text portions of this message have been

> removed]

>

>

>

>

[Guest guest]

Okay. Alfonso and I used to work for a service that

depended on doing the most for the pt, i.e.

immobilization. Now everytime you immobilize a pt you

do not always bill medicare/medicaid. Let's not

forget about insurance. 90% of immobilized pts are

from MVCs, and who do you bill, normally the

insurance. And for those who think discussing this is

a waist of time, this is a DISCUSSION list. Here

everyone can get ideas from one another and hopefully

try and get things flowing in our individual systems,

based on what everyone else is doing.

Salvador Capuchino

EMT-Paramedic

--- Kim wrote:

>

> --------------- In Reply To:

>

----------------------------------------------------------------

>

> Yes, Dr. B, but that makes too much sense. Tell

> that to the private

> providers who depend on this service for their

> cash-flow. :-)

>

> --------------- End of Quote

>

--------------------------------------------------------------

>

>

>

>

> I really try to stay quiet around here, but afraid

> that it's not going to work this time.

>

> No wonder I've recently read here that EMS appears

> to " eat its own " . As a whole, we scream, yell, and

> pound fists on the table to demand recognition from

> the world as unified medical professionals: EMS.

> And yet in the same room, we find ourselves

> separated simply by the type of service we work for.

>

>

> We are all certified to at least a statewide

> standard of education and skills, no matter what

> service employs us... city, private, fire, or

> volunteer. No one with a heart and a humble ego

> immobilizes anyone for their own selfish pleasure or

> to gain from insurance. And as I've easily found by

> a simple web search, CMS does not reimburse for

> immobilization no matter what service you work for.

> For reference, please see

>

http://www.trailblazerhealth.com/notices.asp?action=detail & id=1798

>

>

(www.trailblazerhealth.com/notices.asp?action=detail & id=1798).

> I truncated the very extensive list to just the

> immobilization procedures below:

>

> From CMS carrier Trailblazer Health:

> > " The following supplies are considered part of the

> transport and a separate charge is not reimbursable

> by Medicare and not billable to the patient.

> >>> Back board.

> >>> CID (cervical immobilization device, C-collar,

> cervical collar).

> >>> Inflatable arm or leg splint.

> >>> Minor extrication.

> >>> Neck board (neck brace). "

>

>

> Please pass the Real Tree camo-colored duct tape,

> and I'll try to sit here quiet and camoflaged a

> while more. ;-)

>

> K. Pelletier

>

>

>

>

>

> [Non-text portions of this message have been

> removed]

>

>

>

>

[Guest guest]

Okay. Alfonso and I used to work for a service that

depended on doing the most for the pt, i.e.

immobilization. Now everytime you immobilize a pt you

do not always bill medicare/medicaid. Let's not

forget about insurance. 90% of immobilized pts are

from MVCs, and who do you bill, normally the

insurance. And for those who think discussing this is

a waist of time, this is a DISCUSSION list. Here

everyone can get ideas from one another and hopefully

try and get things flowing in our individual systems,

based on what everyone else is doing.

Salvador Capuchino

EMT-Paramedic

--- Kim wrote:

>

> --------------- In Reply To:

>

----------------------------------------------------------------

>

> Yes, Dr. B, but that makes too much sense. Tell

> that to the private

> providers who depend on this service for their

> cash-flow. :-)

>

> --------------- End of Quote

>

--------------------------------------------------------------

>

>

>

>

> I really try to stay quiet around here, but afraid

> that it's not going to work this time.

>

> No wonder I've recently read here that EMS appears

> to " eat its own " . As a whole, we scream, yell, and

> pound fists on the table to demand recognition from

> the world as unified medical professionals: EMS.

> And yet in the same room, we find ourselves

> separated simply by the type of service we work for.

>

>

> We are all certified to at least a statewide

> standard of education and skills, no matter what

> service employs us... city, private, fire, or

> volunteer. No one with a heart and a humble ego

> immobilizes anyone for their own selfish pleasure or

> to gain from insurance. And as I've easily found by

> a simple web search, CMS does not reimburse for

> immobilization no matter what service you work for.

> For reference, please see

>

http://www.trailblazerhealth.com/notices.asp?action=detail & id=1798

>

>

(www.trailblazerhealth.com/notices.asp?action=detail & id=1798).

> I truncated the very extensive list to just the

> immobilization procedures below:

>

> From CMS carrier Trailblazer Health:

> > " The following supplies are considered part of the

> transport and a separate charge is not reimbursable

> by Medicare and not billable to the patient.

> >>> Back board.

> >>> CID (cervical immobilization device, C-collar,

> cervical collar).

> >>> Inflatable arm or leg splint.

> >>> Minor extrication.

> >>> Neck board (neck brace). "

>

>

> Please pass the Real Tree camo-colored duct tape,

> and I'll try to sit here quiet and camoflaged a

> while more. ;-)

>

> K. Pelletier

>

>

>

>

>

> [Non-text portions of this message have been

> removed]

>

>

>

>

[Guest guest]

If you're going to recommend brands look at www.tigerstraps.com without a

doubt the best thing on the market, and oh by the way, I sell them :-)

Mike

Re: Duct Tape

Nylon rescue webbing is more secure, easier to apply, does not stick

to gloves and is reusable. It can also be easily sized to patients

and applied through the loops on backboards to provide a safer pattern

of securing someone. As a bonus, is also works well in the rain.

Liability-wise, is your tape manufacturer willing to put a load rating

on its tape? Nylon rescue webbing comes with an ANSI standard load

rating. Also, will that load rating apply to the " hold point " where

the tape " sticks " to the backboard? Which would you rather have your

patient secured with when your ambulance flips over and that 350 lb

patient is now directly over your head?

Mike

> Hello gang,

>

>

> I have found duct tape to be very useful and can be applied very

quickly. If

> you run into multiple victims, it does come in very handy. I hope the

tape

> you currently use isn't the silver stuff you find at Home Depot. They "

tape

> manufactures " have a mil spec that is " medical tape " it comes in white.

It can

> be a little bit of a tangle with medical gloves on, but when you get

used to

> it, it works great. The price is right, and it can't be stolen from the

> hospital. How many spider straps do you have to loose before going to

tape?

>

> Happy Thanksgiving, God Bless all of your families!

>

>

> Ron

>

>

>

>

[Guest guest]

If you're going to recommend brands look at www.tigerstraps.com without a

doubt the best thing on the market, and oh by the way, I sell them :-)

Mike

Re: Duct Tape

Nylon rescue webbing is more secure, easier to apply, does not stick

to gloves and is reusable. It can also be easily sized to patients

and applied through the loops on backboards to provide a safer pattern

of securing someone. As a bonus, is also works well in the rain.

Liability-wise, is your tape manufacturer willing to put a load rating

on its tape? Nylon rescue webbing comes with an ANSI standard load

rating. Also, will that load rating apply to the " hold point " where

the tape " sticks " to the backboard? Which would you rather have your

patient secured with when your ambulance flips over and that 350 lb

patient is now directly over your head?

Mike

> Hello gang,

>

>

> I have found duct tape to be very useful and can be applied very

quickly. If

> you run into multiple victims, it does come in very handy. I hope the

tape

> you currently use isn't the silver stuff you find at Home Depot. They "

tape

> manufactures " have a mil spec that is " medical tape " it comes in white.

It can

> be a little bit of a tangle with medical gloves on, but when you get

used to

> it, it works great. The price is right, and it can't be stolen from the

> hospital. How many spider straps do you have to loose before going to

tape?

>

> Happy Thanksgiving, God Bless all of your families!

>

>

> Ron

>

>

>

>

[Guest guest]

Salvador,

It is nice that you step up to the plate to explain what Alfonso was

saying;

.... that you and he worked for a service that considered a patient's

ability to pay or a class of individuals' ability to pay to

establish how you treated those you encountered. Exactly how long

did it take either of you to have that epiphany?

Are you announcing that your Medical Director was so intimately

involved in the billing process that his/her medical treatment

protocols were established on EMS reimbursement rules.

Or were you saying that your Medical Director had no clue and that

the Director of the Service set the Standing Delegated Orders for

the medics to follow?

Or are you saying the Director and the Medical Director had so

little confidence in the judgment skills of the Medics to

consistently do the right things they would not consider allowing a

selective spinal immobilization protocol to be implemented knowing

the staff would not evaluate the patient properly to come to the

reasonable conclusion of a low probability of spinal injury?

Were you saying that you and Alfonso worked at the same place during

a time when the " standard of care " in Texas prehospital treatment

was to c-collar and c-spine everybody that had some sort of bump or

fall?

Exactly what were are you saying?

I asked Alfonso to explain his comment, your attempt did not answer

the question.

We know some well financed EMS systems, both public and private,

that continues to raise the bar for treatment standards. I am

reasonably certain that for every good action from a publicly funded

agency one will find the same or similar from a private agency. The

same will likely hold true for private agencies doing a bad action

will be duplicated by a publicly funded service.

I am not trying to start an argument, but trying to exploit how

thoughtless and unsubstantiated comments, such as those that

Alfonso made, are not beneficial nor do they support the position.

They are more likely to be perceived as an assault on a class or

group. Our society has recognized those types of verbal

generalizations as a bad thing.

A blanket assault on Public, Private, Hospital Based, Third Service,

P.U.M, ESD, FD, Not for Profit, For Profit, Volunteer (please

forgive me if I failed to mention a group) is not necessary and will

pretty much always leave one with the taste of a foot in the mouth.

My thoughts, yours may vary.

bkw

>

> >

> > --------------- In Reply To:

> >

> ----------------------------------------------------------------

> >

> > Yes, Dr. B, but that makes too much sense. Tell

> > that to the private

> > providers who depend on this service for their

> > cash-flow. :-)

> >

> > --------------- End of Quote

> >

> --------------------------------------------------------------

> >

> >

> >

> >

> > I really try to stay quiet around here, but afraid

> > that it's not going to work this time.

> >

> > No wonder I've recently read here that EMS appears

> > to " eat its own " . As a whole, we scream, yell, and

> > pound fists on the table to demand recognition from

> > the world as unified medical professionals: EMS.

> > And yet in the same room, we find ourselves

> > separated simply by the type of service we work for.

> >

> >

> > We are all certified to at least a statewide

> > standard of education and skills, no matter what

> > service employs us... city, private, fire, or

> > volunteer. No one with a heart and a humble ego

> > immobilizes anyone for their own selfish pleasure or

> > to gain from insurance. And as I've easily found by

> > a simple web search, CMS does not reimburse for

> > immobilization no matter what service you work for.

> > For reference, please see

> >

> http://www.trailblazerhealth.com/notices.asp?action=detail & id=1798

> >

> >

> (www.trailblazerhealth.com/notices.asp?action=detail & id=1798).

> > I truncated the very extensive list to just the

> > immobilization procedures below:

> >

> > From CMS carrier Trailblazer Health:

> > > " The following supplies are considered part of the

> > transport and a separate charge is not reimbursable

> > by Medicare and not billable to the patient.

> > >>> Back board.

> > >>> CID (cervical immobilization device, C-collar,

> > cervical collar).

> > >>> Inflatable arm or leg splint.

> > >>> Minor extrication.

> > >>> Neck board (neck brace). "

> >

> >

> > Please pass the Real Tree camo-colored duct tape,

> > and I'll try to sit here quiet and camoflaged a

> > while more. ;-)

> >

> > K. Pelletier

> >

> >

> >

> >

> >

> > [Non-text portions of this message have been

> > removed]

> >

> >

> >

> >

[Guest guest]

Salvador,

It is nice that you step up to the plate to explain what Alfonso was

saying;

.... that you and he worked for a service that considered a patient's

ability to pay or a class of individuals' ability to pay to

establish how you treated those you encountered. Exactly how long

did it take either of you to have that epiphany?

Are you announcing that your Medical Director was so intimately

involved in the billing process that his/her medical treatment

protocols were established on EMS reimbursement rules.

Or were you saying that your Medical Director had no clue and that

the Director of the Service set the Standing Delegated Orders for

the medics to follow?

Or are you saying the Director and the Medical Director had so

little confidence in the judgment skills of the Medics to

consistently do the right things they would not consider allowing a

selective spinal immobilization protocol to be implemented knowing

the staff would not evaluate the patient properly to come to the

reasonable conclusion of a low probability of spinal injury?

Were you saying that you and Alfonso worked at the same place during

a time when the " standard of care " in Texas prehospital treatment

was to c-collar and c-spine everybody that had some sort of bump or

fall?

Exactly what were are you saying?

I asked Alfonso to explain his comment, your attempt did not answer

the question.

We know some well financed EMS systems, both public and private,

that continues to raise the bar for treatment standards. I am

reasonably certain that for every good action from a publicly funded

agency one will find the same or similar from a private agency. The

same will likely hold true for private agencies doing a bad action

will be duplicated by a publicly funded service.

I am not trying to start an argument, but trying to exploit how

thoughtless and unsubstantiated comments, such as those that

Alfonso made, are not beneficial nor do they support the position.

They are more likely to be perceived as an assault on a class or

group. Our society has recognized those types of verbal

generalizations as a bad thing.

A blanket assault on Public, Private, Hospital Based, Third Service,

P.U.M, ESD, FD, Not for Profit, For Profit, Volunteer (please

forgive me if I failed to mention a group) is not necessary and will

pretty much always leave one with the taste of a foot in the mouth.

My thoughts, yours may vary.

bkw

>

> >

> > --------------- In Reply To:

> >

> ----------------------------------------------------------------

> >

> > Yes, Dr. B, but that makes too much sense. Tell

> > that to the private

> > providers who depend on this service for their

> > cash-flow. :-)

> >

> > --------------- End of Quote

> >

> --------------------------------------------------------------

> >

> >

> >

> >

> > I really try to stay quiet around here, but afraid

> > that it's not going to work this time.

> >

> > No wonder I've recently read here that EMS appears

> > to " eat its own " . As a whole, we scream, yell, and

> > pound fists on the table to demand recognition from

> > the world as unified medical professionals: EMS.

> > And yet in the same room, we find ourselves

> > separated simply by the type of service we work for.

> >

> >

> > We are all certified to at least a statewide

> > standard of education and skills, no matter what

> > service employs us... city, private, fire, or

> > volunteer. No one with a heart and a humble ego

> > immobilizes anyone for their own selfish pleasure or

> > to gain from insurance. And as I've easily found by

> > a simple web search, CMS does not reimburse for

> > immobilization no matter what service you work for.

> > For reference, please see

> >

> http://www.trailblazerhealth.com/notices.asp?action=detail & id=1798

> >

> >

> (www.trailblazerhealth.com/notices.asp?action=detail & id=1798).

> > I truncated the very extensive list to just the

> > immobilization procedures below:

> >

> > From CMS carrier Trailblazer Health:

> > > " The following supplies are considered part of the

> > transport and a separate charge is not reimbursable

> > by Medicare and not billable to the patient.

> > >>> Back board.

> > >>> CID (cervical immobilization device, C-collar,

> > cervical collar).

> > >>> Inflatable arm or leg splint.

> > >>> Minor extrication.

> > >>> Neck board (neck brace). "

> >

> >

> > Please pass the Real Tree camo-colored duct tape,

> > and I'll try to sit here quiet and camoflaged a

> > while more. ;-)

> >

> > K. Pelletier

> >

> >

> >

> >

> >

> > [Non-text portions of this message have been

> > removed]

> >

> >

> >

> >

[Guest guest]

Salvador,

It is nice that you step up to the plate to explain what Alfonso was

saying;

.... that you and he worked for a service that considered a patient's

ability to pay or a class of individuals' ability to pay to

establish how you treated those you encountered. Exactly how long

did it take either of you to have that epiphany?

Are you announcing that your Medical Director was so intimately

involved in the billing process that his/her medical treatment

protocols were established on EMS reimbursement rules.

Or were you saying that your Medical Director had no clue and that

the Director of the Service set the Standing Delegated Orders for

the medics to follow?

Or are you saying the Director and the Medical Director had so

little confidence in the judgment skills of the Medics to

consistently do the right things they would not consider allowing a

selective spinal immobilization protocol to be implemented knowing

the staff would not evaluate the patient properly to come to the

reasonable conclusion of a low probability of spinal injury?

Were you saying that you and Alfonso worked at the same place during

a time when the " standard of care " in Texas prehospital treatment

was to c-collar and c-spine everybody that had some sort of bump or

fall?

Exactly what were are you saying?

I asked Alfonso to explain his comment, your attempt did not answer

the question.

We know some well financed EMS systems, both public and private,

that continues to raise the bar for treatment standards. I am

reasonably certain that for every good action from a publicly funded

agency one will find the same or similar from a private agency. The

same will likely hold true for private agencies doing a bad action

will be duplicated by a publicly funded service.

I am not trying to start an argument, but trying to exploit how

thoughtless and unsubstantiated comments, such as those that

Alfonso made, are not beneficial nor do they support the position.

They are more likely to be perceived as an assault on a class or

group. Our society has recognized those types of verbal

generalizations as a bad thing.

A blanket assault on Public, Private, Hospital Based, Third Service,

P.U.M, ESD, FD, Not for Profit, For Profit, Volunteer (please

forgive me if I failed to mention a group) is not necessary and will

pretty much always leave one with the taste of a foot in the mouth.

My thoughts, yours may vary.

bkw

>

> >

> > --------------- In Reply To:

> >

> ----------------------------------------------------------------

> >

> > Yes, Dr. B, but that makes too much sense. Tell

> > that to the private

> > providers who depend on this service for their

> > cash-flow. :-)

> >

> > --------------- End of Quote

> >

> --------------------------------------------------------------

> >

> >

> >

> >

> > I really try to stay quiet around here, but afraid

> > that it's not going to work this time.

> >

> > No wonder I've recently read here that EMS appears

> > to " eat its own " . As a whole, we scream, yell, and

> > pound fists on the table to demand recognition from

> > the world as unified medical professionals: EMS.

> > And yet in the same room, we find ourselves

> > separated simply by the type of service we work for.

> >

> >

> > We are all certified to at least a statewide

> > standard of education and skills, no matter what

> > service employs us... city, private, fire, or

> > volunteer. No one with a heart and a humble ego

> > immobilizes anyone for their own selfish pleasure or

> > to gain from insurance. And as I've easily found by

> > a simple web search, CMS does not reimburse for

> > immobilization no matter what service you work for.

> > For reference, please see

> >

> http://www.trailblazerhealth.com/notices.asp?action=detail & id=1798

> >

> >

> (www.trailblazerhealth.com/notices.asp?action=detail & id=1798).

> > I truncated the very extensive list to just the

> > immobilization procedures below:

> >

> > From CMS carrier Trailblazer Health:

> > > " The following supplies are considered part of the

> > transport and a separate charge is not reimbursable

> > by Medicare and not billable to the patient.

> > >>> Back board.

> > >>> CID (cervical immobilization device, C-collar,

> > cervical collar).

> > >>> Inflatable arm or leg splint.

> > >>> Minor extrication.

> > >>> Neck board (neck brace). "

> >

> >

> > Please pass the Real Tree camo-colored duct tape,

> > and I'll try to sit here quiet and camoflaged a

> > while more. ;-)

> >

> > K. Pelletier

> >

> >

> >

> >

> >

> > [Non-text portions of this message have been

> > removed]

> >

> >

> >

> >

[Guest guest]

Mr. Molino, I was apparently very wrong. The duct tape issue

does seem to start some sticky arguments. I stand properly chastised

and will now take 10 minutes to reevaluate my life, flog myself with

duct tape and hide my young before they are eaten.

Crosby

EMT-B

PS: I will still use duct tape for quick and easy auto, home repair and

minor veterinary needs....

PPS: I hope you had a very enjoyable Thanksgiving after your shift was

up (or maybe during?).

Re: Duct Tape

Salvador,

It is nice that you step up to the plate to explain what Alfonso was

saying;

.... that you and he worked for a service that considered a patient's

ability to pay or a class of individuals' ability to pay to

establish how you treated those you encountered. Exactly how long

did it take either of you to have that epiphany?

[Crosby, E] Snipped for brevity

________________________________________________________________________________\

_____

This email and its attachments, if any, are intended for the personal use of the

named recipient(s) and may contain confidential, privileged, or proprietary

information. If you are not a named recipient, or an agent responsible for

delivering it to a named recipient, you have received this email in error. In

that event, please (a) immediately notify me by reply email, ( do not review,

copy, save, forward, or print this email or any of its attachments, and ©

immediately delete and/or destroy this email and its attachments and all

electronic and physical copies thereof. Thank you.

________________________________________________________________________________\

_____

[Guest guest]

Mr. Molino, I was apparently very wrong. The duct tape issue

does seem to start some sticky arguments. I stand properly chastised

and will now take 10 minutes to reevaluate my life, flog myself with

duct tape and hide my young before they are eaten.

Crosby

EMT-B

PS: I will still use duct tape for quick and easy auto, home repair and

minor veterinary needs....

PPS: I hope you had a very enjoyable Thanksgiving after your shift was

up (or maybe during?).

Re: Duct Tape

Salvador,

It is nice that you step up to the plate to explain what Alfonso was

saying;

.... that you and he worked for a service that considered a patient's

ability to pay or a class of individuals' ability to pay to

establish how you treated those you encountered. Exactly how long

did it take either of you to have that epiphany?

[Crosby, E] Snipped for brevity

________________________________________________________________________________\

_____

This email and its attachments, if any, are intended for the personal use of the

named recipient(s) and may contain confidential, privileged, or proprietary

information. If you are not a named recipient, or an agent responsible for

delivering it to a named recipient, you have received this email in error. In

that event, please (a) immediately notify me by reply email, ( do not review,

copy, save, forward, or print this email or any of its attachments, and ©

immediately delete and/or destroy this email and its attachments and all

electronic and physical copies thereof. Thank you.

________________________________________________________________________________\

_____

[Guest guest]

Mr. Molino, I was apparently very wrong. The duct tape issue

does seem to start some sticky arguments. I stand properly chastised

and will now take 10 minutes to reevaluate my life, flog myself with

duct tape and hide my young before they are eaten.

Crosby

EMT-B

PS: I will still use duct tape for quick and easy auto, home repair and

minor veterinary needs....

PPS: I hope you had a very enjoyable Thanksgiving after your shift was

up (or maybe during?).

Re: Duct Tape

Salvador,

It is nice that you step up to the plate to explain what Alfonso was

saying;

.... that you and he worked for a service that considered a patient's

ability to pay or a class of individuals' ability to pay to

establish how you treated those you encountered. Exactly how long

did it take either of you to have that epiphany?

[Crosby, E] Snipped for brevity

________________________________________________________________________________\

_____

This email and its attachments, if any, are intended for the personal use of the

named recipient(s) and may contain confidential, privileged, or proprietary

information. If you are not a named recipient, or an agent responsible for

delivering it to a named recipient, you have received this email in error. In

that event, please (a) immediately notify me by reply email, ( do not review,

copy, save, forward, or print this email or any of its attachments, and ©

immediately delete and/or destroy this email and its attachments and all

electronic and physical copies thereof. Thank you.

________________________________________________________________________________\

_____