A third of patients don't pay ambulance bills

[Dustdevil]

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.

Edited April 2, 2010 by Dustdevil

[JPINFV]

...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.

[spenac]

Only a third? Wish we had 2 thirds pay.

[Kiwiology]

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.

[firedoc5]

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.

[Chief1C]

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.

Edited April 2, 2010 by 4c6

[brentoli]

Large EMS systems need to have their own Collections Agency. Time to get what's owed.

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.

[HERBIE1]

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.

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.

[Chief1C]

And then what? If someone does not pay their bill, does that mean we won't respond if they owe money on previous services?

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

[spenac]

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