1. #1

    Join Date
    Sep 2009
    Posts
    4

    Unhappy Billing Question

    If your fire department transports patients this question is for you.... Do you bill for patient refusals if say you splint an arm, give some D50, oral glucose, bandage a wound? My fire department has just mandated that we start to bill on all patient refusals if we use any supplies. thanks for the response

  2. #2
    Early Adopter
    cozmosis's Avatar
    Join Date
    Jan 1999
    Location
    Arkansas
    Posts
    1,925

    Default

    Quote Originally Posted by tucker72 View Post
    If your fire department transports patients this question is for you.... Do you bill for patient refusals if say you splint an arm, give some D50, oral glucose, bandage a wound? My fire department has just mandated that we start to bill on all patient refusals if we use any supplies. thanks for the response
    My FD doesn't transport and, thus, doesn't bill... But I do know ambulance services who do exactly what you are talking about. The easily trackable stuff -- administering D50, for instance -- usually gets written up as "treatment but no transport" and billed accordingly. The stuff that is harder to track (bandaging supplies, etc.) is sometimes provided as charity on the part of the ambulance crew with no report written.

  3. #3
    MembersZone Subscriber

    Join Date
    Sep 2006
    Location
    Northeast Coast
    Posts
    3,911

    Default

    My understanding is that if you bill Medicare at all you must follow their billing guidelines for all calls, which includes no longer being allowed to bill for any call that doesn't result in transport. Our FD bills all insurance and patients and follows Medicare rules and basically there are two billable rates: ALS transports and BLS transport, with addition money paid per loaded mile of transport. All rates are set by the Fed's but are subject to regional adjustments.

  4. #4
    Forum Member

    Join Date
    Nov 2006
    Location
    N. Ridgeville, Ohio
    Posts
    811

    Default

    No ride, no bill!
    Jason Brooks
    IAFF Local 2388
    IACOJ

  5. #5
    MembersZone Subscriber

    Join Date
    Aug 2007
    Posts
    29

    Default

    We do bill for Treat/Release...kind of medic discretion. We use Tablet PCR for our medic reports. If a call is marked as Treat for the outcome it ends up being routed to the billing que...refusals do not get routed. So, if I get called to the scene by a third party and the pt. doesnt want us they sign a refusal..no bill. If the pt. calls and we give some form of care and the pt. decides not to go to the hosp. it is done as a Treat/Release...costs $100. It is part of our city ordinance.

  6. #6
    Forum Member
    PaladinKnight's Avatar
    Join Date
    Aug 2006
    Posts
    2,413

    Default

    Quote Originally Posted by jbrescue View Post
    No ride, no bill!
    Ditto.....

  7. #7
    MembersZone Subscriber

    Join Date
    May 2000
    Location
    SW MO
    Posts
    4,249

    Default

    Quote Originally Posted by cozmosis View Post
    My FD doesn't transport and, thus, doesn't bill... But I do know ambulance services who do exactly what you are talking about. The easily trackable stuff -- administering D50, for instance -- usually gets written up as "treatment but no transport" and billed accordingly. The stuff that is harder to track (bandaging supplies, etc.) is sometimes provided as charity on the part of the ambulance crew with no report written.
    Most ambulances I've worked for or have been around do this, a treat/no transport. They bill for the materials used and have the patient sign that they're refusing transport and further care.

    A "trick" I learned on things like D-50, narcan, dehydration, heat exposure, siezures, etc. is to get them in the rig and start transport as I'm treating. It's justified due to the altered LOC that often accompanies, and you're already en route to the ER by the time they regain full consciousness. Even if they want to refuse, they can easily be talked into going on in since you're already on the way.

  8. #8
    Forum Member
    PaladinKnight's Avatar
    Join Date
    Aug 2006
    Posts
    2,413

    Default

    Implied Consent = Consent that is inferred from signs, actions, or facts, or by inaction or silence.

    Expressed Consent = Consent which is communicated by the spoken or written word.

    Assumed Consent = Consent is based on the principle that proposed interventions are described in advance and consent is assumed; see DANGEROUS

    ----------------------------

    No haula = No mula

    ----------------------------

  9. #9
    MembersZone Subscriber
    LVFD301's Avatar
    Join Date
    Jun 2006
    Posts
    4,025

    Default

    SOME PLACES (cough, cough) the ground ambulance makes sure that whenever a chopper is called, they haul the patient somewhere first, even if the chopper has a great landing area in the front yard, they will tell them to land
    a tenth of a mile away. That way, they hauled, they bill.

Thread Information

Users Browsing this Thread

There are currently 1 users browsing this thread. (0 members and 1 guests)

Similar Threads

  1. Extrication Billing
    By UFDRESCUE in forum Firefighters Forum
    Replies: 1
    Last Post: 11-05-2004, 10:45 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Log in

Click here to log in or register