Leaderboard

For 911's you respond no matter what. For non emergent transfers pay up front or walk.

Only a third? Wish we had 2 thirds pay.

...and to add insult to injury, you can't balance bill medicare like you can other insurance payments. At least with balance billing you stand a chance to recuperate at least part of what insurance doesn't reimburse for.

All those genius fire chiefs who browbeat their city councils into approving FD takeovers of EMS as a financial measure FAIL to tell the truth. Selfish, lying bastards. http://www.abc-7.com/Global/story.asp?S=12228984 A third of patients don't pay ambulance bills Posted: Mar 30, 2010 3:23 PM Updated: Mar 30, 2010 5:03 PM LEE COUNTY [Florida]: One third of patients who depend on emergency transportation services in Lee County don't pay their bills. The county is left writing off the debt. Every year, ambulances in Lee County make more than 52,000 trips transporting patients in the air and on the ground. Last year $8.2 million in emergency transportation bills went unpaid. More than half the debt comes from companies like Medicare and Medicaid, which are contracted to only pay a certain amount. Private insurers and patients owe the rest. "We realize there will be individuals who can't pay and we just have to accept that," said David Kainrad, Lee County Division of Public Safety. In what has turned into an annual vote, Lee County Commissioners pardoned the patients who used county EMS but never paid their bill. County commissioners raised EMS rates last week. It's the first fee increase in five years, but higher rates will mean higher bad debt. It's a process one county commissioner says is inherently flawed. "It's not fair to make that one honest American who's been saving bills all his life and has the $3000 in the bank and make him pay and all those other guys take a walk. It's not fair," said Commissioner Frank Mann. "You take the bad with the good. You look at hospitals, doctors, we're all faced with that situation with medical care, and we realize that," said Kainrad.

Every EMS system does. And every EMS system needs to charge. Period. By not charging you give ammo to lower reimbursment rates from both public and private insurance. By not collectuing you encourage the taxi-cab mentality.

It's just like how ER's and hospitals don't get paid everything. Too many people use the ER as a free clinic and ignore the bill. At least in the city I was in they considered us a free taxi sometimes. We'd have people call us for a minor "emergency" and would request a certain hospital in different areas of town. We'd take them, get them in the ER and as soon the nurse see's them they request to leave AMA even before being seen or examined. At one hosp. it was a 200 yrd walk to one of the malls. Do you think they are going to pay anything??? Yea, hold on to that dream.

Why in the hell did I marked down for that? It is a fact our service writes off a large portion of part-charge debt and the fact that they charge at all is unusual given our genrally free-to-the-end-user-directly universal healthcare system. A lot of people do not know Ambulance response incurs a part-charge (the amount varies based on where you live) and a portion of that debt (I have heard in excess of a million dollarsa year but I do not know a more exact figure) gets written off due to non payment. I am not a bean counter so am unsure exactly why it is not pursued but I believe it has a number of reasons around cost of collection vs the part charge itself (which is nominal) and some fear of perception of the orginisation being seen negitavely if collection were pursued. Furthermore it is an instrument of the Service's contract with the Ministry of Health that the part-charges currently in place are not raised if the contractually agreed amount of funding is to be provided from Government.

Where did I say that? Don't put words in that aren't there.

Some agencies use a charity account to pay bills, or write off bills of people who just can't pay. Those that can, and won't, collections. Large EMS systems need to have their own Collections Agency. Time to get what's owed.

Well, I've missed the last two episodes, so I am a little behind here. I I just now watched them while waiting for the forum to come back up. But here's the exciting critique of tonight's episode: Ever notice that not a single emergency vehicle in the show is California law compliant with their lights? Cellphone picture taker at shooting scene, lol. That’s realistic! All these people standing around with the suspect outstanding, even cops. Field abx prophylaxis in California, lol. Not in our lifetime. They’ve just about broken Rabbit’s spirit. That too is realistic. Every big department does it sooner or later. Tyler bought himself a $300 Littman, lol. Whacker! Too lazy to put your vest under your shirt, where it belongs? You deserve to die. But at least it covers up those stupid badges. Shooting something out of Tyler’s hand is just way too formula. Doctor walking around in bloody surgical gown. Puhleeze… this is the 21st century. Regardless, I’m beginning to think I’d do her. I still wouldn’t touch the blonde bimbo with AK’s dick though. This is becoming like Star Trek. As soon as you see knew faces, you know they’re fixin’ to become casualties. Sniper wasn’t near as good as his equipment. Poor aim. Trigger jerk. Way to go, blonde bimbo. Just about got the cop killed. Hopefully she’ll lose her ticket next episode. Ambulance on scene with lights running, but engines off? Yeah, everybody does that. Putting a bulky dressing on a GSW over body armour, lol. Marisa’s wings are Air Force Flight Surgeon wings. Puhleeze. Not all bad. It may be improving a bit with the character development, finally. This would have been a great episode to kill off the blonde bimbo though.

There are a lot of factors that you should take into account when deciding on which programme to take. Personally i'd write a list of pros and cons with all the schools you're interested in, that should help you make the decision. As for opinions on the programmes, you're going to hear a lot of different ones. Some will be good, some will be bad and all will be biased, so take each one with a grain of salt. I only know a little bit about each school. When I was applying for programmes several years ago i got accepted to Humber, but didn't apply to either Centennial or Niagara. Several things turned me off of Humber, the first being how the programme was structured. I honestly can't remember the details, I just remember it not appealing to me. Another thing, and the one that was the biggest turn off, was during the Open House, I asked what the first write A-EMCA pass rate was for Humber's last class. She replied "100%". I knew this wasn't true as I known people who had gone to Humber in that year. I felt that if she wasn't willing to give me an honest answer then I didn't want to be there. As for the calibre of Humber students, I can't really comment on that. I've known people who have graduated from there and they are good medics. What I know about Centennial is that they have HUGE class sizes. That turns me off right from the get go. But I do know some of the faculty there and I know it's a good program. Niagara, I really can't say much about it as I've only know a few people who've gone there. What I can say is that i've had students from both Niagara and Centennial rideout with me, and hands down the Centennial students have been better. But again, that may not be a reflection on the school, but rather of the students. For finding work, it has, for the most part, very little with where you went to school, at least for the larger services in the GTA. Some smaller services tend to prefer to hire on the students who do their consolidation with them, but most of the larger ones will go for anyone as long as they have the requirements and know what they're doing. As for CMA accreditation, within the next few years just about all the public paramedic programs will be accredited so I wouldn't worry about that.

And then what? If someone does not pay their bill, does that mean we won't respond if they owe money on previous services? I've seen stacks of bills at people's homes, for the previous trips for alcohol abuse, a taxi ride to the hospital to deliver their latest baby, or a person's 10th seizure of the month because they are noncompliant with their meds and are drinking. You can't get blood from a turnip, and for the ones who (ab)use the system, they aren't exactly worried about their credit scores taking a hit because they do not pay their bills. Put some accountability in the system and watch the abuse drop dramatically. Allow a certain number of "free" rides, but after that, just like anyone else, it will cost. Same for (ab)using ER's. As it stands now, there is no incentive to properly access EMS, nor is there a penalty for abusing it. In other words, what is the down side for abusing the system? A few dollars out of their monthly government check and just maybe they are more compliant with their medications and do what they are supposed to do.

Our part charges are a bit of a touchy issue; I've seen around that the Service writes off a portion of debt that is "large", "significant", "substantial" or something like that. Fee-for-service is unusual in our universal healthcare system but Ambulance is one of the few Health services that directly charges for use.