Ethical, illegal or greedy?

[Guest guest]

Back the bus up!!!

therefore, when

the school bus knocks down a Volkswagen, all 52 kids on the bus have to be

written up as patients just because their parents are not there to refuse for

them.

NOT!

I totally disagree, I think everyone of those children need to be written up.

Maybe not intensely but at least to the point where you have their name and age

along with injuries or lack of documented. I firmly believe each parent should

be contacted. It really doesn't take that much time to do so. Two things it does

1. When you do go to court you will know at least that your medic did check the

child out. 2. It gives you a real picture of when you do your yearly statistics

when it comes to patient or if you will person contacts. By the way they are all

your patients until you assess them and determine that they are not a patient.

Hen ry

Re: Ethical, illegal or greedy?

> > > >

> > > > A number of years ago (been a while) a smaller service in the eastern

> > > Texas

> > > > area (fortunately long ago shut down), was well known for charging as

> > > much as

> > > > $500.00 for no-rides and in one case (as the story was told) they sent

> > > on of

> > > > their " no-ride " bills to an elderly lady who had just lost her husband

> > > who

> > > > was coded on their living room floor. This occurred after the local

> > > police

> > > > department had to respond to an area river to alert them to the call -

> > > it seems

> > > > they were fishing and were away from their radio.

> > > >

> > > > I think unethical and greedy fit that case.

> > > >

> > > > Don

> > > >

> > > > >>> " Wayne D " <rxmd911@... <rxmd911%40yahoo.rxm>> 07/24/07 8:53

> AM

> > > >>>

> > > > Thanks for the replys. This was just something that was brought up

> > > yesterday

> > > > during an EMS discussion and talk about EMS fraud.

> > > >

> > > > Wayne

> > > >

> > > > Wayne D <rxmd911@... <rxmd911%40yahoo.rxm>> wrote:

> > > > Company X goes on a public assist call because granny has fallen and

> > > can't

> > > > get up. The crew for company X arrives and gets granny up out of the

> > > floor.

> > > > She does not want to be transported to the ER. Crew gets her

> information

> > > and

> > > > signed AMA. Company X then charges granny $75 as a no transport

> charge.

> > > Is this

> > > > legal? Is the company just greedy for money? Does the pt for her

> > > insurance

> > > > company pay?

> > > >

> > > > How about one that you AMA from a fight because they did not call for

> > > EMS

> > > > and don't want to be billed for services they did not request?

> However,

> > > they

> > > > get billed the same amount as granny did for AMA. Pt refuses to

> provide

> > > info,

> > > > so crew calls the local hospital for billing info. Does this violate

> > > HIPPA

> > > > since the pt was never seen in the ER this trip?

> > > >

> > > > There are providers out there that do this. What is everyones view on

> > > this.

> > > >

> > > > Wayne

> > > >

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

> > > > Need a vacation? Get great deals to amazing places on Yahoo! Travel.

> > > >

> > > >

[Guest guest]

Excellent point, who determines if they are a patient or not? If I

do not assess them how do I know, and if I have assessed then I need

to document the assessment at least.

> > > > > Company X goes on a public assist call because granny

has fallen and

> > > > can't

> > > > > get up. The crew for company X arrives and gets granny

up out of the

> > > > floor.

> > > > > She does not want to be transported to the ER. Crew gets

her

> > information

> > > > and

> > > > > signed AMA. Company X then charges granny $75 as a no

transport

> > charge.

> > > > Is this

> > > > > legal? Is the company just greedy for money? Does the pt

for her

> > > > insurance

> > > > > company pay?

> > > > >

> > > > > How about one that you AMA from a fight because they did

not call for

> > > > EMS

> > > > > and don't want to be billed for services they did not

request?

> > However,

> > > > they

> > > > > get billed the same amount as granny did for AMA. Pt

refuses to

> > provide

> > > > info,

> > > > > so crew calls the local hospital for billing info. Does

this violate

> > > > HIPPA

> > > > > since the pt was never seen in the ER this trip?

> > > > >

> > > > > There are providers out there that do this. What is

everyones view on

> > > > this.

> > > > >

> > > > > Wayne

> > > > >

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

> > > > > Need a vacation? Get great deals to amazing places on

Yahoo! Travel.

> > > > >

> > > > >

[Guest guest]

In a message dated 7/25/2007 9:37:05 P.M. Central Daylight Time,

wegandy1938@... writes:

So get out the yellow pads and the crayons and write up a policy.

Absent directions often comes assumptions and we all know what assumptions

are!

As for the yellow pads and crayons remark, I resemble that remark

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

(Home Phone)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

************************************** Get a sneak peek of the all-new AOL at

http://discover.aol.com/memed/aolcom30tour

[Guest guest]

The GETAC Medical Directors’ Committee has established a document entitled

“What is a Patient?”

BEB

From: texasems-l [mailto:texasems-l ] On

Behalf Of vmmedic

Sent: Thursday, July 26, 2007 10:41 AM

To: texasems-l

Subject: Re: Ethical, illegal or greedy?

Excellent point, who determines if they are a patient or not? If I

do not assess them how do I know, and if I have assessed then I need

to document the assessment at least.

> > > > > Company X goes on a public assist call because granny

has fallen and

> > > > can't

> > > > > get up. The crew for company X arrives and gets granny

up out of the

> > > > floor.

> > > > > She does not want to be transported to the ER. Crew gets

her

> > information

> > > > and

> > > > > signed AMA. Company X then charges granny $75 as a no

transport

> > charge.

> > > > Is this

> > > > > legal? Is the company just greedy for money? Does the pt

for her

> > > > insurance

> > > > > company pay?

> > > > >

> > > > > How about one that you AMA from a fight because they did

not call for

> > > > EMS

> > > > > and don't want to be billed for services they did not

request?

> > However,

> > > > they

> > > > > get billed the same amount as granny did for AMA. Pt

refuses to

> > provide

> > > > info,

> > > > > so crew calls the local hospital for billing info. Does

this violate

> > > > HIPPA

> > > > > since the pt was never seen in the ER this trip?

> > > > >

> > > > > There are providers out there that do this. What is

everyones view on

> > > > this.

> > > > >

> > > > > Wayne

> > > > >

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

> > > > > Need a vacation? Get great deals to amazing places on

Yahoo! Travel.

> > > > >

> > > > >

[Guest guest]

Where could we see this document or get a copy?

Maxine Pate

hire-Pattison EMS

---- Original message ----

>Date: Thu, 26 Jul 2007 15:19:55 -0500

>

>Subject: RE: Re: Ethical, illegal or greedy?

>To: <texasems-l >

>

> The GETAC Medical Directors’ Committee has

> established a document entitled

> “What is a Patient?â€

>

> BEB

>

[Guest guest]

Well, you can do that if you have the time and the manpower, but a person

is not necessarily a patient until there's some complaint. Mechanism of

injury is not a complaint, although many seem not to realize that.

Just tonight, I was listening to Tucson Fire, and they were transporting a

person with minor injuries to the Level I because, " any MVC with an impact at

greater than 40 mph warrants a Level I. " What hogwash.

We all want to do the right thing, especially when kids are involved, but if

they're not hurt or sick, they are not a patient and they don't need

assessment.

What if I call you and say that all the people in Mall X are getting sick.

Do you go over there and forcibly assess every one of them? Or forcibly

assess all the kids?

Gene

>

> Excellent point, who determines if they are a patient or not? If I

> do not assess them how do I know, and if I have assessed then I need

> to document the assessment at least.

>

>

> > > > > > Company X goes on a public assist call because granny

> has fallen and

> > > > > can't

> > > > > > get up. The crew for company X arrives and gets granny

> up out of the

> > > > > floor.

> > > > > > She does not want to be transported to the ER. Crew gets

> her

> > > information

> > > > > and

> > > > > > signed AMA. Company X then charges granny $75 as a no

> transport

> > > charge.

> > > > > Is this

> > > > > > legal? Is the company just greedy for money? Does the pt

> for her

> > > > > insurance

> > > > > > company pay?

> > > > > >

> > > > > > How about one that you AMA from a fight because they did

> not call for

> > > > > EMS

> > > > > > and don't want to be billed for services they did not

> request?

> > > However,

> > > > > they

> > > > > > get billed the same amount as granny did for AMA. Pt

> refuses to

> > > provide

> > > > > info,

> > > > > > so crew calls the local hospital for billing info. Does

> this violate

> > > > > HIPPA

> > > > > > since the pt was never seen in the ER this trip?

> > > > > >

> > > > > > There are providers out there that do this. What is

> everyones view on

> > > > > this.

> > > > > >

> > > > > > Wayne

> > > > > >

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

> > > > > > Need a vacation? Get great deals to amazing places on

> Yahoo! Travel.

> > > > > >

> > > > > >

[Guest guest]

In a message dated 7/27/2007 1:15:18 A.M. Central Daylight Time,

wegandy1938@... writes:

Or forcibly assess all the kids?

The problem is that we teach the medico-legal stuff on the first night and

almost always paint the " you will be sued " etc. picture and it sticks in the

mind of the Provider for life! Reality has nothing to do with that of course

and so fourth.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

(Home Phone)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

************************************** Get a sneak peek of the all-new AOL at

http://discover.aol.com/memed/aolcom30tour

[Guest guest]

Not billable to any one person, but ; would you or could you not bill the

city/county for the response?

wegandy1938@... wrote: Dudley,

I don't have a problem with billing for services that are requested. I

thought I made that clear. But what about this:

There's a little fender bender, and a passerby calls 911 from his cell while

passing by. He's not involved and not on scene when you get there. On

arrival, all passengers are out of the cars, uninjured, all refuse service, and

all say they did not request that EMS respond. Would you bill those people?

Gene

>

>

> This discussion greatly bothers me. Why should EMS, like all other facets

> of healthcare, not be able to charge to cover their expenses? I like Henry's

> statement about the freezer repair man...what a great analogy. Despite the

> fact that no one pays for it out of pocket (in most cases) it costs dollars

> each and every time the " rig " is pulled out of the barn. Diesel is almost $3

a

> gallon, wear and tear adds up, the cost of people (except volunteers.. This

> discussion greatly bothers me. Why should EMS, like all other facets of

> healthcare, not be able to charge to cover their expenses? I like Henry's

> statement about the freezer repair man...what a great analogy. Despite the

fact

>

> One of the primary issues we will have in survival of EMS is the fact that

> we have TRADITIONALLY had our services tied to transporting people. As we go

> forward, scope of practice expands, and we are taking less and less to the

> hospital in favor of other options...(read the EMS Agenda for the Future)...if

> our only " non-greedy " form of payment is tied to turning wheels we will

> die...

>

> We charge an " aid call " fee for those patients who we respond to and treat.

> It is $125. We also charge an Air Med Assist fee for those patients who get

> flown out (about 18 of 6,200 requests annually) of $250 because it makes no

> sense for us to extricate, strap to a board, start 2 IV's, intubate,

> pharmacologically assist, etc, etc and send them off in a helicopter.. We

charge an

> " aid call " fee for those patients who we respond to and treat. It is $125.

> We also charge an Air Med Assist fee for those patients who get flown out

> (about 18 of 6,200 requests annually) of $250 because it makes no sense for us

to

> extricate, strap to a board, start 2 IV's, intubate, pharmacologically

> assist, etc, etc and send them off in a helicopter..<wbr>.and not charge...the

air

> med

>

> Really folks, we have to get past the fact that us getting paid for the

> services we provide is somehow wrong or immoral. The volunteer, all here for

the

> community, concept was great as we started....but we have to move past it.

> Times have changed and if we continue to stand in this tar pit of " we can't

> charge, that's wrong " we will soon become extinct like other dinosaurs of the

> past.

>

> Think about this...on the hospital administrator list serve or the physician

> list serve...how many discussions do you suppose they have regarding how

> immoral or unethical it is to charge an extra $1.25 a cup of coffee in the

> starbucks in the lobby so that the hospital gets its take? Or is it okay to

> charge for the aspirin given to the chest pain patient that left AMA? Well I

> never...

>

> Dudley

>

> Re: Ethical, illegal or greedy?

>

> A number of years ago (been a while) a smaller service in the eastern Texas

> area (fortunately long ago shut down), was well known for charging as much as

> $500.00 for no-rides and in one case (as the story was told) they sent on of

> their " no-ride " bills to an elderly lady who had just lost her husband who

> was coded on their living room floor. This occurred after the local police

> department had to respond to an area river to alert them to the call - it

seems

> they were fishing and were away from their radio.

>

> I think unethical and greedy fit that case.

>

> Don

>

> >>> " Wayne D " 07/24/07 8:53 AM >>>

> Thanks for the replys. This was just something that was brought up yesterday

> during an EMS discussion and talk about EMS fraud.

>

> Wayne

>

> Wayne D wrote:

> Company X goes on a public assist call because granny has fallen and can't

> get up. The crew for company X arrives and gets granny up out of the floor.

> She does not want to be transported to the ER. Crew gets her information and

> signed AMA. Company X then charges granny $75 as a no transport charge. Is

this

> legal? Is the company just greedy for money? Does the pt for her insurance

> company pay?

>

> How about one that you AMA from a fight because they did not call for EMS

> and don't want to be billed for services they did not request? However, they

> get billed the same amount as granny did for AMA. Pt refuses to provide info,

> so crew calls the local hospital for billing info. Does this violate HIPPA

> since the pt was never seen in the ER this trip?

>

> There are providers out there that do this. What is everyones view on this.

>

> Wayne

>

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

> Need a vacation? Get great deals to amazing places on Yahoo! Travel.

>

>

[Guest guest]

See here is the rub...the city is me and I am the city...so I bill the city and

it comes out of my budget to pay it....

Dudley

Re: Ethical, illegal or greedy?

>

> A number of years ago (been a while) a smaller service in the eastern Texas

> area (fortunately long ago shut down), was well known for charging as much as

> $500.00 for no-rides and in one case (as the story was told) they sent on of

> their " no-ride " bills to an elderly lady who had just lost her husband who

> was coded on their living room floor. This occurred after the local police

> department had to respond to an area river to alert them to the call - it

seems

> they were fishing and were away from their radio.

>

> I think unethical and greedy fit that case.

>

> Don

>

> >>> " Wayne D " 07/24/07 8:53 AM >>>

> Thanks for the replys. This was just something that was brought up yesterday

> during an EMS discussion and talk about EMS fraud.

>

> Wayne

>

> Wayne D wrote:

> Company X goes on a public assist call because granny has fallen and can't

> get up. The crew for company X arrives and gets granny up out of the floor.

> She does not want to be transported to the ER. Crew gets her information and

> signed AMA. Company X then charges granny $75 as a no transport charge. Is

this

> legal? Is the company just greedy for money? Does the pt for her insurance

> company pay?

>

> How about one that you AMA from a fight because they did not call for EMS

> and don't want to be billed for services they did not request? However, they

> get billed the same amount as granny did for AMA. Pt refuses to provide info,

> so crew calls the local hospital for billing info. Does this violate HIPPA

> since the pt was never seen in the ER this trip?

>

> There are providers out there that do this. What is everyones view on this.

>

> Wayne

>

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

> Need a vacation? Get great deals to amazing places on Yahoo! Travel.

>

>

[Guest guest]

If you are a city or county run EMS this would not work. If you are a private or

third entity EMS this would need to be in the contract.

My best guess would be to examine how many times the occurance of this happens

during a year and use that information as a budget item for the next year. This

may change each year so in order to keep all happily co-existing the budget may

need to reflect this.

Sounds good in theory doesn't it?

THEDUDMAN@... wrote:

See here is the rub...the city is me and I am the city...so I bill the city and

it comes out of my budget to pay it....

Dudley

Re: Ethical, illegal or greedy?

>

> A number of years ago (been a while) a smaller service in the eastern Texas

> area (fortunately long ago shut down), was well known for charging as much as

> $500.00 for no-rides and in one case (as the story was told) they sent on of

> their " no-ride " bills to an elderly lady who had just lost her husband who

> was coded on their living room floor. This occurred after the local police

> department had to respond to an area river to alert them to the call - it

seems

> they were fishing and were away from their radio.

>

> I think unethical and greedy fit that case.

>

> Don

>

> >>> " Wayne D " 07/24/07 8:53 AM >>>

> Thanks for the replys. This was just something that was brought up yesterday

> during an EMS discussion and talk about EMS fraud.

>

> Wayne

>

> Wayne D wrote:

> Company X goes on a public assist call because granny has fallen and can't

> get up. The crew for company X arrives and gets granny up out of the floor.

> She does not want to be transported to the ER. Crew gets her information and

> signed AMA. Company X then charges granny $75 as a no transport charge. Is

this

> legal? Is the company just greedy for money? Does the pt for her insurance

> company pay?

>

> How about one that you AMA from a fight because they did not call for EMS

> and don't want to be billed for services they did not request? However, they

> get billed the same amount as granny did for AMA. Pt refuses to provide info,

> so crew calls the local hospital for billing info. Does this violate HIPPA

> since the pt was never seen in the ER this trip?

>

> There are providers out there that do this. What is everyones view on this.

>

> Wayne

>

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

> Need a vacation? Get great deals to amazing places on Yahoo! Travel.

>

>