Do you discuss costs?

[zzyzx]

I'm wondering if any of you guys are instructed to or even allowed to tell your patients of the possible costs of the ambulance transport if the patient never asks you.

For the services that I've worked for, we would only tell the patient if they specifically asked us.

A lot of people assume that ambulance transport is a free, just like calling for a fire engine or a police car. It seems that we are doing them a great disservice by not telling them of the costs if they have no insurance. On the other hand, if we did tell them, it would seem like we were trying to talk them out of it.

I have a related question for those of you who work in the ER. What happens to someone with no insurance and no way of paying for a large hospital bill? Will the hospital always send the bill to collection?

[tamaith]

i myself just do transporting now so the pts know that it cost them money. however, i believe in school we were taught not to discuss money / insurance while in the truck with the pt.. i don't work in the er but. i think it depends on the hospital. some may pay for it others will just bill. i know when i was taking to e.r. i made sure everyone ( medics, doctors, nurses ) knew that i didn't have insurance. i had to pay for the ambulance but the hospital hooked me up ( i went for syncope, and had an ecg put on ).

[Timmy]

Depending on the urgency I normally ask if they have ambulance membership.

Most paramedics I deal with will ask the same.

[Timmy]

Depending on the urgency I normally ask if they have ambulance membership.

Most paramedics I deal with will ask the same. If they don’t the ambos just make sure the patient is aware of the costs associated.

[Ridryder 911]

Actually if the patient is on Medicare, they require one to inform the patient (especially those that do not require stretcher services or may not be covered). One is to as well have the patient sign a release stating that they realize they maybe be billed for such services. If one does not discuss prices how is the patient to know the costs? Why would the costs be hidden? Patients are supposed to be informed of all their options and risks.

In regards to non-paying patients in the ER, alike in EMS, we turn them over to a collection agency in 90 days if no payment has been received. In fact, in one of the ER I managed they were not able to receive their prescription unless some form of payment was made. Yes, assessment and initial treatment was given, so life threatening injuries and illnesses was corrected or determined. It did not matter the amount.. $3.00 to what ever also a discount was made for those with cash payment.

R/r 911

[sirduke]

Here in Georgia we are required to have them sign a form , Medicaid and Medicare pts, which details the cost and the fact that they may be liable for the bill if it is deemed a non emergency transport. The hospitals have a Medical Screen Out option, in which the doctor determines if a emergency condition exist, and if they don't have a emergency, they are required to pay up front a fee, before they will recieve further care.

We often have ones who sign the form and are transported, even though we know and they know they have no intention of paying. Our county does refer them to a collections agency, but the percentage is only about 21 percent as far as getting any money.

If they ask, I always tell them our rates, in fact, they are posted in the back of the ambulance per county protocol.

The ones who are most concerned about the cost are the ones who do pay, and our county is very good at working with these people to set up payment options.

But yes, it does seem that most people think that we are a free service. One of the most heard comments is that we are a county government owned service, and "their" taxes pay for us, so why do they have to pay again.

I understand their frustration, especially with the high cost of everything, but there it is...

[itku2er]

Here if the patient asks we tell them how much the cost is. At the NH we have a few patients that will not go to the closest hospital so there family is told upfront how much they will have to pay to send them to the facality they want to go to. As long as the waiver is signed and they agree to the cost the are on their way. I have never had a ambulance company not tell me when I call what the price of a ambulance ride will be. I have done this both for my nursing job and for my family.

[HellsBells]

i believe in school we were taught not to discuss money / insurance while in the truck with the pt..

Why wouldn't you discuss it with them? If a patient asks I have no problem telling them what the cost will be. The municipality I work for is very flexable when it comes to paying for service. If the patient contacts our billing office, they even offer monthly payment options to make it easier.

I don't think that informing people of the cost is akin to trying to talk them out of an ambulance trip. If they balk at the cost, I simply inform them that there are a lot of payment options, and the prime concern is their health.

[Just Plain Ruff]

whoever told you to not discuss the costs with a patient was a idiot. In fact, your service should be providing you with that information for the patient if they ask.

If anyone uses the cost of the ambulance bill to be a aid to get a patient to refuse is out of line. I know it's never happened right?

I always tell the patient and I've even gone down the road to list out our prices and show them what their approximate bill would be.

You see what the price of gas is, you see what the price of the gallon of milk is and we know what the price of a car is so why not know what the price of the ambulance call is.

[spenac]

If anyone uses the cost of the ambulance bill to be a aid to get a patient to refuse is out of line. I know it's never happened right?

Actually Ruff if the person has no need of the ambulance why would that be wrong? You are basically discouraging use of the ambulance when you have them sign the medicare/medicaid form that tells them that the transport may not be covered and they by signing are agreeing to pay. You are just educating patient to the fact that their choices come with a price.

Of course this would not even be worth discussing if all had the right to just say no if caller actually had no injury or illness that would be made worse going by private car.