This hose monkey has some questions for you. Please answer honestly, anonymously if you like, but some things have been bothering Happy as of late.
Question #1
Does your employer discourage you from being honest with your patients when it comes to transport decisions?
Question #2
Has your employer asked you to omit information on your reports that would prevent billing a patient a certain way?
Question #3
If a patient asked your opinion, you told the truth and they refused care, would you be in fear for your job?
Question #4
Does your service encourage starting an IV or EKG monitoring for BLS patients to upgrade the billing?
Question #5
Are you aware that the above situations could constitute fraud?
If you are trying to decide whether to do what is right by your patient or keep your job, email me. Your employer, municipal or private, paid or volunteer, is wrong and we need help changing their practices.
If you are comfortable and supported by your service when being honest with your patients about their conditions and transport options, please list your service in the comments section, they deserve praise.
HM
Question #1
Does your employer discourage you from being honest with your patients when it comes to transport decisions?
Question #2
Has your employer asked you to omit information on your reports that would prevent billing a patient a certain way?
Question #3
If a patient asked your opinion, you told the truth and they refused care, would you be in fear for your job?
Question #4
Does your service encourage starting an IV or EKG monitoring for BLS patients to upgrade the billing?
Question #5
Are you aware that the above situations could constitute fraud?
If you are trying to decide whether to do what is right by your patient or keep your job, email me. Your employer, municipal or private, paid or volunteer, is wrong and we need help changing their practices.
If you are comfortable and supported by your service when being honest with your patients about their conditions and transport options, please list your service in the comments section, they deserve praise.
HM
Comments
1. No
2. No
3. No
4. No
5. YES
Former Private EMS service:
1. Yes, they do.
2. No.
3. Possibly now, not then (if I still worked there).
4. No.
5. Still yes.
I do know medics that have been told to do #2, & 4.
1. No
2. No
3. No
4. No
5. YES
Former Private EMS service:
1. Yes, they do.
2. No.
3. Possibly now, not then (if I still worked there).
4. No.
5. Still yes.
I do know medics that have been told to do #2, & 4.
1 Absolutely not. Do we sometimes do "defensive EMS" (read anti-law suit) yes but that's it
2 No only no but hell no. We don't f with that, the fear or lawsuit is severe around here
3 No (but the owner of the private may get a little cranky, but no)
4 No (both the volley fire based and the private special event only service)
5 Yes
2. No
3. No
4. No
5. YES
Former Private EMS service:
1. Yes, they do.
2. No.
3. Possibly now, not then (if I still worked there).
4. No.
5. Still yes.
I do know medics that have been told to do #2, & 4.
As to EMS 2.0, I'm not sure I get the connection. In general with EMS 2.0, I don't sense a unified idea of what the direction should be. I'll have to think about that and then write a post.
1 Absolutely not. Do we sometimes do "defensive EMS" (read anti-law suit) yes but that's it
2 No only no but hell no. We don't f with that, the fear or lawsuit is severe around here
3 No (but the owner of the private may get a little cranky, but no)
4 No (both the volley fire based and the private special event only service)
5 Yes
1. N/A, really.
2. Yep.
3. Somewhat.
4. Never to me. In fact, for Medicaid patients, it's prefered we BLS it no matter what it is, since the payout will be the same, and theoretically we'll be back in service faster.
5. Only if they actually submit the bill, which isn't my decision or fault, really, if you think about it.
POC 911 departmemt:
1. It's never really come up. I'm as honest as I can be without straying too far beyond my scope and knowledge.
2. No.
3. Department wouldn't do anything, but I would likely spend an inordinate amount of time worrying about what might happen legally.
4. No.
5. Yes, but only because I've worked a private before. My collegues that haven't, probably don't.
As to EMS 2.0, I'm not sure I get the connection. In general with EMS 2.0, I don't sense a unified idea of what the direction should be. I'll have to think about that and then write a post.
2. No
3. No
4. No, but we get a lot of scheduled transports that were dispatched as ALS that turn out to be BLS, because call taker did not get correct information. I chart it as BLS, but am not sure if they bill it ALS since that is what was ordered.
5. Yes, and I would have no problem calling my company out on the carpet if they tried to pull this crap.
#1 Sort of. They want us to be honest about patient volume and diversion status, but we're supposed to transport anyone who wants it to anywhere they want to be transported to.
#2 No
#3 Maybe. The company doesn't push "always transport," but there is a heavy feel of "transporting is better than not."
#4 No because Medicaid isn't going to pay for it. So, treatment is very much patient-specific.
#5 Yes. If anyone had a problem with any of it happening.
It means more education, it means tougher standards, but if that is what it takes to make this thing we think is patient care work, I'm for it.
So, the connection for me is that in my EMS 2.0 I don't get audited when I leave Bubba Fishbiscuit to go about his business when he didn't need us in the first place. Not refusing care, yet, just weeding out the confused. I look forward to your thoughts.
1. N/A, really.
2. Yep.
3. Somewhat.
4. Never to me. In fact, for Medicaid patients, it's prefered we BLS it no matter what it is, since the payout will be the same, and theoretically we'll be back in service faster.
5. Only if they actually submit the bill, which isn't my decision or fault, really, if you think about it.
POC 911 departmemt:
1. It's never really come up. I'm as honest as I can be without straying too far beyond my scope and knowledge.
2. No.
3. Department wouldn't do anything, but I would likely spend an inordinate amount of time worrying about what might happen legally.
4. No.
5. Yes, but only because I've worked a private before. My collegues that haven't, probably don't.
2. No
3. No
4. No, but we get a lot of scheduled transports that were dispatched as ALS that turn out to be BLS, because call taker did not get correct information. I chart it as BLS, but am not sure if they bill it ALS since that is what was ordered.
5. Yes, and I would have no problem calling my company out on the carpet if they tried to pull this crap.
#1 Sort of. They want us to be honest about patient volume and diversion status, but we're supposed to transport anyone who wants it to anywhere they want to be transported to.
#2 No
#3 Maybe. The company doesn't push "always transport," but there is a heavy feel of "transporting is better than not."
#4 No because Medicaid isn't going to pay for it. So, treatment is very much patient-specific.
#5 Yes. If anyone had a problem with any of it happening.
It means more education, it means tougher standards, but if that is what it takes to make this thing we think is patient care work, I'm for it.
So, the connection for me is that in my EMS 2.0 I don't get audited when I leave Bubba Fishbiscuit to go about his business when he didn't need us in the first place. Not refusing care, yet, just weeding out the confused. I look forward to your thoughts.
2. No
3. No
4. No (absolutely not)
5. You bet!
Does your employer discourage you from being honest with your patients when it comes to transport decisions?
A: Somewhat, the EMS director prefers we dont mention the pt having a choice of hospital. Though if the pt speaks up we will take them to their preference. We can discuss alternate options of getting to the hospital w/o getting in trouble.
Question #2
Has your employer asked you to omit information on your reports that would prevent billing a patient a certain way?
A: Nope
Question #3
If a patient asked your opinion, you told the truth and they refused care, would you be in fear for your job?
Always recommend transport to avoid lawsuits. :-(
Question #4
Does your service encourage starting an IV or EKG monitoring for BLS patients to upgrade the billing?
A: No because our ALS1 and BLS rates are the same this avoids the above problem.
Question #5
Are you aware that the above situations could constitute fraud?
Yes.
2.no
3.no
4.no
5.yes
Gold Cross Ambulance eastern division.
Does your employer discourage you from being honest with your patients when it comes to transport decisions?
Ans:No
Question #2
Has your employer asked you to omit information on your reports that would prevent billing a patient a certain way?
Ans:No.
Question #3
If a patient asked your opinion, you told the truth and they refused care, would you be in fear for your job?
Ans:No
Question #4
Does your service encourage starting an IV or EKG monitoring for BLS patients to upgrade the billing?
Ans:Absolutely not.
Question #5
Are you aware that the above situations could constitute fraud?
Ans:Yes.
Question #5
Yes, which sucks.
2. No
3. No
4. No (absolutely not)
5. You bet!
Does your employer discourage you from being honest with your patients when it comes to transport decisions?
A: Somewhat, the EMS director prefers we dont mention the pt having a choice of hospital. Though if the pt speaks up we will take them to their preference. We can discuss alternate options of getting to the hospital w/o getting in trouble.
Question #2
Has your employer asked you to omit information on your reports that would prevent billing a patient a certain way?
A: Nope
Question #3
If a patient asked your opinion, you told the truth and they refused care, would you be in fear for your job?
Always recommend transport to avoid lawsuits. :-(
Question #4
Does your service encourage starting an IV or EKG monitoring for BLS patients to upgrade the billing?
A: No because our ALS1 and BLS rates are the same this avoids the above problem.
Question #5
Are you aware that the above situations could constitute fraud?
Yes.
2.no
3.no
4.no
5.yes
Gold Cross Ambulance eastern division.
Question #5
Yes, which sucks.
1) You said that you are made to transport the patient to wherever they want to go. Doesn't the "closest appropriate facility" come into play at all for your agency? Medicare/Medicaid will reimburse $9.00/mile but only to a certain extent without physician certification...just curious how this benefits the company if they're giving "free" rides.
2) MISTREATED PATIENTS?!?!?! There is ALWAYS a way to fix that problem. Facility pacification be damned. As an EMS provider we have a duty to advocate for the patients right to life, liberty and freedom from harm...what's going on here? Social Services might be a good place to start if an assult or battery charge can't solve the problem.
A couple of people above have mentioned that it may be a southern thing, uummm....could be. I dunno. There is one thing I'm most confident in and that is karma (or insert your form of retribution), in that it will effect everyone if they are involved in fraudulent activities. First to the employer if they are caught and also to the provider if they are fudging to make reports billable....it only takes one time before that one incident comes back baring teeth to bite you.
Question 2 this was primarily nursing home abuse/neglect witnessed with private transport. I tried to help but got severely popped for interfering up to and including fired. Horrific adventure this week---- morbidly obese paramedic unable to access patient in full arrest, salvageable patient and he died. I complained (almost) and my job is seriously on the line. Haven't turned in official written complaint yet and they immediately informed her. She's my asst. supervisor and I expect some ugly fallout. So stay tuned for more adventures from the deep south....lol. Y'all hiring?
1) You said that you are made to transport the patient to wherever they want to go. Doesn't the "closest appropriate facility" come into play at all for your agency? Medicare/Medicaid will reimburse $9.00/mile but only to a certain extent without physician certification...just curious how this benefits the company if they're giving "free" rides.
2) MISTREATED PATIENTS?!?!?! There is ALWAYS a way to fix that problem. Facility pacification be damned. As an EMS provider we have a duty to advocate for the patients right to life, liberty and freedom from harm...what's going on here? Social Services might be a good place to start if an assult or battery charge can't solve the problem.
YES to all. (Private service... only option here in La, unfortunately.)
but... bad day for the boss- because I refuse to hurt our system further. I am honest with all patients, down to whether or not their call is truly an emergency. If my judgement states that the person needs an IV or EKG, I run one... but on a toe pain call? No.
The list goes on.
A couple of people above have mentioned that it may be a southern thing, uummm....could be. I dunno. There is one thing I'm most confident in and that is karma (or insert your form of retribution), in that it will effect everyone if they are involved in fraudulent activities. First to the employer if they are caught and also to the provider if they are fudging to make reports billable....it only takes one time before that one incident comes back baring teeth to bite you.
Question 2 this was primarily nursing home abuse/neglect witnessed with private transport. I tried to help but got severely popped for interfering up to and including fired. Horrific adventure this week---- morbidly obese paramedic unable to access patient in full arrest, salvageable patient and he died. I complained (almost) and my job is seriously on the line. Haven't turned in official written complaint yet and they immediately informed her. She's my asst. supervisor and I expect some ugly fallout. So stay tuned for more adventures from the deep south....lol. Y'all hiring?
YES to all. (Private service... only option here in La, unfortunately.)
but... bad day for the boss- because I refuse to hurt our system further. I am honest with all patients, down to whether or not their call is truly an emergency. If my judgement states that the person needs an IV or EKG, I run one... but on a toe pain call? No.
The list goes on.
2. Yes. We have required training each year that discourages us from using phrases such as "Pt ambulated to the gurney without assistance." We are told to start our narrative with phrases like "Pt requires ALS transport because..."
3. Yes. A paramedic in my county was recently fired, then rehired (after the union intervened) after he AMA'd a patient involved in an MVA who adamantly refused transport and later turned out to have a C3-C4 Fx. He thoroughly documented the pt's refusal and she signed an AMA form though my company still tried to fire him when she sued. And he did nothing but tell her she needed to go to the hospital.
4. No.
5. No comment.
2. Yes. We have required training each year that discourages us from using phrases such as "Pt ambulated to the gurney without assistance." We are told to start our narrative with phrases like "Pt requires ALS transport because..."
3. Yes. A paramedic in my county was recently fired, then rehired (after the union intervened) after he AMA'd a patient involved in an MVA who adamantly refused transport and later turned out to have a C3-C4 Fx. He thoroughly documented the pt's refusal and she signed an AMA form though my company still tried to fire him when she sued. And he did nothing but tell her she needed to go to the hospital.
4. No.
5. No comment.
Question #2 No
Question #3: No
Question #4: No
Question #5: Yes
Question #2 No
Question #3: No
Question #4: No
Question #5: Yes
Question #2 No
Question #3: No
Question #4: No
Question #5: Yes