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  1. #1
    MembersZone Subscriber TruckSkipper's Avatar
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    Default Calling 911 in New Jersey Dangerous to Wallets

    Funny how New jersey has the highest ALS costs in the nation, and it's also the only stat that does not allow Fire Depts. to have ALS units.javascript:smilie('')


    Updated: 07-09-2003 09:58:14 AM

    Calling 911 in New Jersey Dangerous to Wallets

    ............
    JIM HOFFER
    Courtesy of ABC7

    In parts of New Jersey, the cost of paramedic service is so high -- some residents are afraid to dial 911. An Eyewitness News investigation has found those rates among the highest in the nation. Jim Hoffer has been looking into this. Here's his report.

    We decided to investigate after receiving a complaint from a woman whose paramedic bill was twice the cost of her emergency room treatment.

    What we found in New Jersey is one of the costliest emergency medical systems anywhere. And in the case of one company, failure to pay those steep costs could land you in court.

    Ellen Wall: "When you see them in the road, I'm telling you that's $1,600 going down the road."

    Teddy Zakrzewski: "They're overcharging people."

    Meet some of the patients of Monmouth County's only paramedic service.

    They all have one thing in common, a bill they received after calling 911, a bill they say is enough to give them a heart attack.

    Jim Hoffer: "Any medication?"
    Joyce Zakrzewski: "No. None."
    Jim Hoffer: "They checked your vitals."
    Joyce Zakrzewski: "That's all they did."

    Anthony Viscuso: "How the hell are we supposed to be paying this because it is a totally outrageous figure."

    Anthony Viscuso also got a bill from Monmouth Ocean Health Services. The company's critical care mobile unit transported him from the hospital, across the parking lot to another building for an MRI scan. The paramedics then drove him back to the hospital. About 500 feet each way. The bill: nearly $3,300. When he refused to pay, MONOC threatened to put a lien on his house.

    Anthony Viscuso: "I told my wife if I ever get sick, whether it be a stroke like I had, to throw me in the trunk of the car but don't ever call MONOC ambulance."

    Anthony Viscuso wasn't the only one threatened with a lawsuit by MONOC. Our investigation has found that in the past two-and-a-half years, the non-for-proft paramedic company has filed suit against more than 700 patients.

    Vince Robbins, CEO MONOC: "We need to get that money."

    MONOC'S chief executive officer says those being sued are a small fraction of its patients, a fraction who have repeatedly failed to pay their bills.

    Vince Robbins: "It's our money, we need to have it to finance our operation."

    MONOC says its average charge is around $1,300. The company claims that other services that charge less are heavily subsidized by town taxes. MONOC argues that mandatory caps on what it can charge medicare patients also forces it to shift costs to other customers or else go out of business.

    Vince Robbins: "We're a non-profit corporation, but that doesn't mean that we're for bankruptcy or that we can operate with expenses higher than our revenue. If that occurred, we wouldn't be here for about a year or two, we'd go bankrupt."

    But Maureen Glover, who had to defend herself in court for refusing to pay a bill that was twice the total cost of her emergency room treatment, accuses MONOC of price gouging.

    Maureen Glover, MONOC Patient: "Those were trained doctors and nurses doing many more tests that was only $855. I thought it was absurd to get a bill double that."

    Glover and others believe the high costs are the result of MONOC'S monopoly as the only paramedic company in Monmouth County.

    Jim Hoffer: "There's no competitor here." Vince Robbins: "No, there shouldn't be, that would only drive cost up and quality down."

    But in neighboring New York where competition thrives, costs are dramatically less. Compare Empress, a similar, non-subsidized paramedic company in Westchester County. For the same services, Empress charges $400 to $600.

    Jim Blumenstock, New Jersey Deputy Commissioner of Health: "The issue of, again, of pricing and cost is not a primary mission of this department."

    Jim Hoffer: "But your department commissioner set up monopolies, where there is no competition among these paramedic services. Yet there is no price control?"

    Jim Blumenstock: "There is not price control. And again, the system was created 30 years ago." Jim Hoffer: "But isn't that unfair to the patients?" Jim Blumenstock: "Well, as I said, we are taking a look at the situation as we speak."

    The New Jersey Department of Health is partly to blame for the high prices, according to a national health care research center.

    Penny Mohr, Center For Health Affairs: "If the state is granting them monopoly rights that they should also be responsible for setting caps on prices."

    Absent those caps or competition, many in New Jersey say they'll have to think twice before calling 911.

    Joyce Zokrzewski: "If it ever happens again or I need 911 I will be afraid to call because we can't afford to have them come."

    A few other New Jersey paramedic services charge about the same as MONOC, but have nowhere near the same number of lawsuits against patients.

    If you have any information about this story or any other that you'd like investigated, please call our Tip-Line at 877-TIP-NEWS.
    DKK
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  2. #2
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    I had a little cardiac episode in Dec. 2002. I was transported ALS approx. 11 miles to the ED. The ins. co. paid most of the approx. $2500.00 bill. What they wouldn't pay was the $13.00 per mile they are trying to charge me. $13.00 per mile! When I called to complain, they explained that this $ was for the Vol. FD bus that took me to the ED. I flew off (I know, you're shocked) and explained to them that the Vol. FD doesn't get a blasted nickel from the hospital and threatened to report their fraud. I got a letter explaining that the person who told me this was new and it was actually for wear and tear for the MICU.

    They can kiss my butt for this money because I have still not paid it.

  3. #3
    Temporarily/No Longer Active dfdex1's Avatar
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    "It's our money, we need to have it to finance our operation."
    Dont know that sounds like someone is lineing there pockets if they charge that and still are in the red.

    "Well, as I said, we are taking a look at the situation as we speak."
    Yes cause there are cameras in his face,cameras gone his "inquiery" stops.

    I have an aunt in Cherry Hill and visting her I notice that
    NJ is packed to the gills the with stupid, the sick and the lazy so you would be a fool not to open a ambie company there. There should be some competition to drive down these costs cause that is crazy!<<<<< Bones Im mortified,a misspelling in my post?
    Last edited by dfdex1; 07-09-2003 at 05:57 PM.

  4. #4
    Forum Member Bones42's Avatar
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    NJ is packed to the gills the with stupid,the sick and the lazy so you would be a fool not to open a ambie company there. There should be some compition to drive down these costs cause thats is crazy!
    Check the spelling...I guess you would fit right in.

    But seriously, MONOC is very good at billing people, such as they did George, and making it look as though it is to cover the expenses of the volunteer squad doing the transport. We have had many complaints of people getting a bill for our services and are constantly explaining to people that it's a bill from MONOC, not from the volunteer squad and the squad gets nothing for it.

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    I have always thought it was weird that fire departments can not provide paramedic services here. Who made that rule? I mean come on, how dumb.
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    Forum Member firenresq77's Avatar
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    That is absolutely rediculous!! I feel sorry for those poor folks in NJ.........

    You too George.........

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    That's ridiculous. I've been in EMS long time, got my start in New Jersey.

    My parents still live there, and it scares me that on their retirement income that they would be faced with a bill like that. Even though EMS collection rates really stink, (50% is good!!)there is no reason for 13.00 per mile, or a bill of $3,300.00 for a couple of trips across the parking lot.

    I wonder what their Medicare profile is like?

    Ed
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  8. #8
    Forum Member MIKEYLIKESIT's Avatar
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    Default You learn somethin new everyday

    I am a member of a department that has been ALS since 1973. I never knew the practice existed in N.J. that didnt allow Fire Department paramedics. What is the reasoning?

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    Originally posted by KyleWickman
    I have always thought it was weird that fire departments can not provide paramedic services here. Who made that rule? I mean come on, how dumb.
    I didn't get treated by MONOC, it was St. Clare's Health System.

    The New Jersey Department of Health made that rule over 20 years ago. The hospitals are a major lobby. The non-competition medic units generate revenue. Get the picture?

    Here is a trivia question for you old time NJ folks: When it was proposed to start paramedic serice in NJ, who was the most vocal group against it?

  10. #10
    Forum Member MIKEYLIKESIT's Avatar
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    Default GUESSING GAME

    Let me guess.. The Unions

  11. #11
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    Default Re: GUESSING GAME

    Originally posted by MIKEYLIKESIT
    Let me guess.. The Unions
    Nope. Guess again.

  12. #12
    Forum Member MIKEYLIKESIT's Avatar
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    Default

    Thank god... Anyway, either the Volunteer asssociation or the Chiefs? The hospitals or private ambulance lobby would seem to easy.

  13. #13
    MembersZone Subscriber TruckSkipper's Avatar
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    Here is a trivia question for you old time NJ folks: When it was proposed to start paramedic serice in NJ, who was the most vocal group against it?
    I think it was the New Jersey State Vol. First Aid Association, or something like that.

    Let me guess.. The Unions
    I know my local union (IAFF 384), the NJ Professional Firefighters Union (PFANJ) and the IAFF all strongly support fire Dept. based ALS.
    DKK
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  14. #14
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    Originally posted by MIKEYLIKESIT
    Thank god... Anyway, either the Volunteer asssociation or the Chiefs? The hospitals or private ambulance lobby would seem to easy.
    Close enough. The volly squads had a cow. Remember the ambulace caravans around the statehouse in protest. After all, it wasn't about patient care, it was about them. This whole effort was led by the stone age NJ First Aid Council (who BTW, remains anti-ALS today).

  15. #15
    Forum Member MIKEYLIKESIT's Avatar
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    Like I said before we have been ALS for THIRTY years.. I wouldnt want it any other way.

  16. #16
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    I had no idea ther was or is a "law" about that ....... what a mess that services cant be consolidated or managed better. Sorry George, that's outrageous. !
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  17. #17
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    Down here it's Atlantic Health Systems. (I sure you knew that George.) I just think it's weird that in our town if someone has a heart attack, the paramedics come from the emergency room 2 towns over. Granted their is a BLS service in our town but still I work and live in a very populated area. Sometimes MICU units are very busy or too tied up to even respond. To top it all off, my fire department used to do 1st responder. They gave it up in the 70's. Now that we are trying to get it back, our 1st aid squad does not want us. It's a very long story.
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  18. #18
    Forum Member DaSharkie's Avatar
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    The service I work for is about $385 for us to show up, about $11 per mile, $50 for oxygen, Monitor costs $110, IV is about $75, I can't recall what the drugs cost.

    Think about this though;

    Average ambulance call is about an hour of time - Two medic's salary for that hour is about $35 - $40.

    Life Pak 12 - $25,000. Ambulance - $85,000.

    Add up the cost of salary for dispatcher, billing, sepervisors, oxygen delivery, maintenance, fuel, wear and tear on a truck, and, lest we forget - the HUGE cost of vehicle insurance AND liability insurance for the company.

    Now, most of these companies / services have to charge this to cover their costs, plan for capital expenditures and improvements to their vehicles and structures, pay benefits for crews, and make a profit.

    Add to this the fact that medicare and medicaid only reimburses about 50% - 65% of the actual cost of treating a patient and the high cost of the variety of medications we use - Amiodorone $65 per vial, need to use 2 - 3. Narcan multi-dose vial - $36. Adenosine - $35 - $60 depending upon the dose. Glucagon - $50. The reimbursements for these meds is no where near the cost of them.

    When you break it all down I'll bet the service is still not making as much as you might think. I'm not saying that this isn't gouging, but think about all of the incidentals involved that you don't even realize.
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    Ontario it's $48.00 a trip whether it's a taxi ride or the pump every drug in the bus and use every piece of equipment. Also doesn't matter what City or Town you are in it's the same everywhere. Problem is sometimes it's too cheap

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    C'mon LadyCapn, don't rub it in to our American Neighbours.

    It is a flat rate here in BC as well, although it is closer to $400 per trip. $1300 is ludicrous. Let me bleed out, it will be less painfull than getting that bill.

    I'm going to print off that NJ story and post it here in our little clinic for the next time some complains about the cost of non-resident care.
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