1. #1
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    Default Fractional mileage odometers

    For those of you who have ambulances and bill, how do you plan to address the new "Fractional Mileage" policy from Medicare?

    We have one Ford ambulance that does not read the tenths on the odometer and are discussing the ways to record this. Some option include using the trip meter which does record to the tenth, utilizing GPS (to time consuming?), or installing a Dispatch driven GPS unit (no idea of the costs).

    It seems likely that going forward Ford will make the odometers read tenths as they do in many, but I wonder why given the huge number of Ford units in service, they can't write some computer code to modify the current units? It has been noted there are over 30,000 Ford ambulances that cannot read the tenths, so it would seem to be a fairly significant issue that will begin 1/1/11. Thoughts or comments?

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    Default Trip Odometers

    One service I work for is using the trip odometer. All calls start at 0.0 and end at the actual transport mileage.

    The service(s) that use a MDT/ Nomad. The GPS function rounds up to the nearest milage.
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    All three of our ambulances show to the tenth of the mile, so I guess I never gave it a thought..

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    Quote Originally Posted by Casco18 View Post
    One service I work for is using the trip odometer. All calls start at 0.0 and end at the actual transport mileage.

    The service(s) that use a MDT/ Nomad. The GPS function rounds up to the nearest milage.
    Obviously the trip odometer is the simplest solution, though I can see this being forgotten early on, thus falling back to using Google maps to find the mileage as needed.

    The rounding up issue is the problem Medicare is "solving" by requiring the tenth of a mile decimals. I guess if the GPS rounds up every number start to finish, it wouldn't be a big issue. I know one local service in our area who rounds up (I must assume only to their favor) using the odometers and anticipates this policy will cost them roughly $15k a year. Thankfully we never rounded ours at all, merely noted the last whole number, therefore statistically the money should be a wash for us.

    At least one place offers a GPS option that gives the mileage to the tenth and integrates dispatch info into compatible mobile GPS devices (Nuvi, Tom Tom, etc), but pricing is not offered on their website.

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    talk to a ford dealer, perhaps they could install a second odometer. Probably wouldn't be too difficult plugging a second odometer into the computer.

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    Quote Originally Posted by nameless View Post
    talk to a ford dealer, perhaps they could install a second odometer. Probably wouldn't be too difficult plugging a second odometer into the computer.
    We already have the separate tip odometer that will red out next to the total mileage odometer, but we'd rather have the main odometer read the tenths. Why the trip does and the main does not is beyond me, but again this should be simple computer code writing, right? If there is such a thing.

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    We just leave the trip odometer on and use that reading. Given how easy it is to just do that, I just can't see a true need to spend money on something like a second odometer.

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    Quote Originally Posted by RFDACM02 View Post
    For those of you who have ambulances and bill, how do you plan to address the new "Fractional Mileage" policy from Medicare?

    We have one Ford ambulance that does not read the tenths on the odometer and are discussing the ways to record this. Some option include using the trip meter which does record to the tenth, utilizing GPS (to time consuming?), or installing a Dispatch driven GPS unit (no idea of the costs).

    It seems likely that going forward Ford will make the odometers read tenths as they do in many, but I wonder why given the huge number of Ford units in service, they can't write some computer code to modify the current units? It has been noted there are over 30,000 Ford ambulances that cannot read the tenths, so it would seem to be a fairly significant issue that will begin 1/1/11. Thoughts or comments?
    Yea baby, ONE LESS thing we have to worry about. NO Ems,NO transport,No medicare. LIFE IS GOOD! Check with Ford,they MAY have a replacement head with tenths for your units that don't have 'em.I'm not sure. T.C.

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    Quote Originally Posted by FireMedic049 View Post
    We just leave the trip odometer on and use that reading. Given how easy it is to just do that, I just can't see a true need to spend money on something like a second odometer.
    OK, I'm starting to get the picture. I was under the impression that our Billing Agents wanted us to convert the trip odometer into the total odometer for documentation, but more than likely they just wanted the actual loaded miles to the tenth documented?

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    We use a product from Fleeteyes. www.fleeteyes.com They integrate the cad/dispatch into a web product that can be used to track incidents, resources, locations, weather etc. They started a big gear up for fractional mileage, and have the ability to track vehicle mileage to the decimal using the hardware most ambulances have already for internet and AVL. They also add the benefit of mobile applications (Blackberry, Iphone, and rumor of Android shortly) so you can see everything from the field, not just a dispatch room or office computer. Pricing has been very competitive, especially when you see what some of the "big gun" companies charge.

    www.fleeteyes.com

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    Quote Originally Posted by dstar2002 View Post
    Pricing has been very competitive, especially when you see what some of the "big gun" companies charge.
    Any guesstimates on how much per unit? Likely we'll go the trip odometer route, but who knows.

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    last i knew it was 30 per month, per unit, and that got you the whole kit and kaboodle with the company's services. we wanted avl and resource management anyway, so it was a no brainer.

    the pcr company we use has a type of mdt/tracking product that starts at over 3,000 a truck to start, plus maintenance fees of 700 a year, so the $360 a year per truck was a no brainer with all the stuff it got us, on top of having a secure audit trail of recorded vehicle movements for fractional mileage disputes

    we know that they are going to start to hammer places if they have reason to believe your mileage isnt exact. this allows us to prove it and download our data and save for any future problems (not just fractional mileage, but vehicle accidents, response complaints, etc)

    they gave us a no commitment demo, i imagine they would do the same for anyone else, i know a lot of other places that tried them the same way we did, and havent looked back

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    Quote Originally Posted by dstar2002 View Post

    we know that they are going to start to hammer places if they have reason to believe your mileage isnt exact. this allows us to prove it and download our data and save for any future problems (not just fractional mileage, but vehicle accidents, response complaints, etc)
    This was our assumption as well. It seems like as long as you can show your mileage is accurate, they can audit your runs but will come up with little actual issues. Though my understanding of EMS service audits is that they feeze all payments until you've successfully disputed their claims, resulting in a loss of revenue for that period of time, which could seriously affect smaller services who are already struggling to pay for adequate units on the road.

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    I don't mean this to sound mean or offensive, but why is this even an issue? Charge mileage by the whole mile. If you worried about overcharging for fractions of a mile, round down instead of up.

    Our department does not charge by the mile. We have a transport fee, period.
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    Quote Originally Posted by RFDACM02 View Post
    OK, I'm starting to get the picture. I was under the impression that our Billing Agents wanted us to convert the trip odometer into the total odometer for documentation, but more than likely they just wanted the actual loaded miles to the tenth documented?
    I don't know what your Billing Agents want, but it's my understanding that what Medicare wants is "actual loaded miles" down to the tenths and not specifically a full starting/ending mileage.

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    Maybe I'm oversimplifying. Our ambo service that we contract with resets the odometer every run, and when going in route to a hospital on the radio broadcasts the starting mileage, and when arriving does the same with the trip length. This helps make sure it gets done, and is a double safety to make sure no mistakes are made. Dispatch will prompt them for mileage if not given by the unit...
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    Quote Originally Posted by MemphisE34a View Post
    I don't mean this to sound mean or offensive, but why is this even an issue? Charge mileage by the whole mile. If you worried about overcharging for fractions of a mile, round down instead of up.

    Our department does not charge by the mile. We have a transport fee, period.
    This was never an issue as we do just as you suggest, actually we just stop reading the odometer to the immediate left of the decimal point. Until now, no issue. Beginning Jan. 1, 2011 Medicare will require all mileage to be down to the tenth,as they're paying up to 1.8 miles more than the actual by using any rounding methods. Those services that bill Medicare, have no choice but to play by their rules or not be paid. When they say jump... well you know the rest.

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    We do as Casco stated, before you leave the scene you reset the trip odometer and at the hospital you write down how far it was. If need be you can always google your route if you forget.

    Freightliner M2, FL60, Sterling, and our 3 GMC C5500's all have the capability.

    We have always done to the tenth of the mile on our PCR's anyway so this is the one Medicare update that won't change how we operate.

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