Ambulance transport charges to local hospitals?

[Dr. Zuki 1]

A friend called 911 and was transported by Empress in Yonkers from the area of Midland Avenue @ Bronxville Road to nearby Lawrence Hospital for a charge of $400.00.

Does Empress and the others have fees based on the mileage from your home to the hospital requested, similair to taxi cab zone charges????

Do volunteer ambulances charge either residents or non residents for emergency trips to local hospitals ?

And what about the Town of Greenburgh PD ambulances?

Statflight charges $4K for a trip to the County Medical Center???

Thanks.

Dr. Zuki

Lawrence Hospital

[OoO 24]

I believe ~$400 is the maximum amount Medicare will reimburse for a ambulance transport, so that is what most agencies charge as a flat rate.

[ny10570 745]

Most agencies follow the medicaid reimbursement schedule for their billing. I don't know the exact numbers, but its a flat figure depending on the level of care (ALS or BLS), and increases based upon the number of medications administered and the miles transported.

[Guest]

Most agencies follow the medicaid reimbursement schedule for their billing. I don't know the exact numbers, but its a flat figure depending on the level of care (ALS or BLS), and increases based upon the number of medications administered and the miles transported.

Slight correction on this, it's the Medicare reimbursement rate. There is a flat fee for BLS and ALS Level 1 and ALS Level 2. If I remember correctly, Level 2 is more than 3 medications.

Most VAC's do bill for their services and many of those "Soft Bill".

[ny10570 745]

I thought there were three ALS levels. I also thought the first 2 drugs were free, but I then again I don't do billing. I just do the damage.

Edited March 27, 2008 by ny10570

[Guest MVFD334]

"Do volunteer ambulances charge either residents or non residents for emergency trips to local hospitals ?"

Depends on the department. Mahopac dosent and I know Mahopac Falls does not either. When the medic (ALS) is on board they collect billing info but that is for their care only.

[mikelouf2 0]

"Do volunteer ambulances charge either residents or non residents for emergency trips to local hospitals ?"

Depends on the department. Mahopac dosent and I know Mahopac Falls does not either. When the medic (ALS) is on board they collect billing info but that is for their care only.

I know that carmel volunteer ambulances charge residents to take them to the hospitals but i don't know how much they charge

[JetPhoto 626]

Beacon Vol Amb charges any one we transport. This is our primary financial support. We do not receive any tax based moneys. As said we follow the Medicaid reimbursement schedule for their billing, we also tag mileage on the bill. Something we had to do several years ago and it appears to work for us.

[Guest paramedico987]

$400 actually sounds kinda cheap to me... If memory serves ALS rate starts at $500 and change.

I know those numbers seem high, but running an ambulance in today's overly litigious society is extremely expensive. Someone once told me [although I'd have no way to confirm] that Empress pays 30K+ a month for vehicle insurance on EACH ambulance.

[trauma74 111]

$30K per vehicle per month? Most likely, it is $30K a month that covers all their vehicles.

[TXCHIEF 9]

The FD that provides EMS response in the community I live in down here has the following rate structure for billing

ALS - Resident = $705

ALS - Non-Resident = $855

BLS - Resident = $637

BLS - Non-Resident = $787

Treatment/No-Transport = $175

Mileage for either ALS or BLS = $15 per mile

[ny10570 745]

$400 actually sounds kinda cheap to me... If memory serves ALS rate starts at $500 and change.

I know those numbers seem high, but running an ambulance in today's overly litigious society is extremely expensive. Someone once told me [although I'd have no way to confirm] that Empress pays 30K+ a month for vehicle insurance on EACH ambulance.

At 500 a trip you guys would have to pop off 14 transports a week every week. Plus your pay, equipment, gas, maintenance, vehicle replacement, and they've got to fund the 911 side of the business. I'd go with a number closer to trauma's figures.

[GAW6 66]

Most VAC's do bill for their services and many of those "Soft Bill".

There is no such thing as "soft billing". A relative of mine was charged by a VAC, after Medicare paid, he was harrassed for $35.00! Got phone calls from the billing company looking for the money. Had another resident where a VAC transported on a mutual aid call, received a bill stating that they were being put into collection for the $35.00. This was an elderly woman who was very upset - she had never received a notice in her life threatening collection.

[LTNRFD 266]

At 500 a trip you guys would have to pop off 14 transports a week every week. Plus your pay, equipment, gas, maintenance, vehicle replacement, and they've got to fund the 911 side of the business. I'd go with a number closer to trauma's figures.

Back in the early days of Abbey Richmond the BLS rate was $ 38.50 and $ 1.50/mile +$ 20 for oxygen administration.

[helicopper 1,050]

"Do volunteer ambulances charge either residents or non residents for emergency trips to local hospitals ?"

Depends on the department. Mahopac dosent and I know Mahopac Falls does not either. When the medic (ALS) is on board they collect billing info but that is for their care only.

Legally EMS agencies must charge everyone - regardless of residency, etc. How aggressively they do that is another thing.

I don't think Mahopac or the Falls CAN bill for services as they are FD ambulances whereas Carmel is an independent VAC.

[mfkap 0]

There is no such thing as "soft billing". A relative of mine was charged by a VAC, after Medicare paid, he was harrassed for $35.00! Got phone calls from the billing company looking for the money. Had another resident where a VAC transported on a mutual aid call, received a bill stating that they were being put into collection for the $35.00. This was an elderly woman who was very upset - she had never received a notice in her life threatening collection.

There certainly is "soft billing", but your relative was not being soft billed. I know of certain agencies that set up a policy with their billing company to send a bill, and then send a reminder (for a total of 2 bills). There are no phone calls or collection agencies.

However, there is an exception. Some insurance policies only pay the patient directly and then the patient is expected to pay the hospital and/or EMS themselves with that money. If the insurance company notifies the billing company that the patient was paid for the ambulance costs, our billing company goes after the insurance money from the patient. There are some frequent fliers that pay their rent by calling the ambulance once or twice a month, get paid by their insurance, and stiff the ambulance and keep the money. If you do that twice a month for a year, that adds up to a pretty penny.

[pv102 0]

To answer most of the questions and I' m sure that someone else can back me up on this. My understanding was if the agency has a tax bracket, meaning it is paid for and controlled by the town,city, or village it cannot bill. But most VAC's and all private agencies are corporations contracted to the town, city, or village to provide a service. So they recive a fee thats paid for by the taxes but the service provided is dictated by the mutually signed contract not by the town, therefore the agency only has to answer to town on items agreed upon in the contract. From what I understand New York has a law that says an agency with a tax bracket cannot bill, but one that has a contract can there are I believe rules dictating billing maximums but I could be wrong. Other than that it is up to the agency to decide on billing policies and procedures although most contracts provide stipulations as to billing. Now as to soft billing it does exist and my VAC uses it. Most places however refer to it as relaxed 3rd party billing which means 1 another company bills for the agency and 2 the agency accepts what insurance pays and will send out notices for the rest but wont actively purse them if not paid. But you should foward them to your insurance company just to CYA. thanks all

( all information provided herein in is known to be true to my knowledge and should be verified by the billing representitive of the agency requesting payment before following any advice, direction, or other statments made in this post) Sorry guys like I said CYA ,Pete

[ny10570 745]

A municipal based agency most certainly can bill in NYS. Only fire districts are unable to bill.

[GAW6 66]

A municipal based agency most certainly can bill in NYS.

This is true, ONLY if they have obtained a signed resolution by their governing board, which in many cases would be the Town Board. I didn't make this up - I did my homework on this subject.

By the way, the instances I wrote about earlier were NOT frequent fliers and they were both lifelong residents of the Town/Village.

[Bnechis 3,961]

Legally EMS agencies must charge everyone - regardless of residency, etc. How aggressively they do that is another thing.

I don't think Mahopac or the Falls CAN bill for services as they are FD ambulances whereas Carmel is an independent VAC.

in NYS municipal FD's may charge. Fire Districts may not charge. The NYS Assoc of Fire Districts has been trying to change this for 15 years. The state legislature never goes for it. It means the local property owners (read - taxpayers) pay for all service instead of the people who use it.

Edited March 28, 2008 by Bnechis

[pfdfirefighter01 1]

i know when i was transported a year ago from pawling to putnam hospital, alamo charged me upwards of $800.00 for als. Thankfully insurance covered it all.

Edited March 28, 2008 by pfdfirefighter01

[Guest]

In CT the rate is se by the state as far as a max charge. Some companies also charge mileage(also set by state) but they are not allowed to increase these rates due to fuel costs.

Legally EMS agencies must charge everyone - regardless of residency, etc. How aggressively they do that is another thing.

I don't think Mahopac or the Falls CAN bill for services as they are FD ambulances whereas Carmel is an independent VAC.

In Stratford city residents are not charged for ambulance servies. If they have insurance their insurance carrier is charged but if they are uninsured they are not charged. It is part of their taxes and from my understanding Stratford EMS went through a long ordeal to get regulations changed to allow them to follow this procedure.

Edited March 31, 2008 by bhansensfd

[NWFDMedic 58]

There certainly is "soft billing", but your relative was not being soft billed. I know of certain agencies that set up a policy with their billing company to send a bill, and then send a reminder (for a total of 2 bills). There are no phone calls or collection agencies.

Actually, soft billing is illegal and if you are getting money from Medicare or Medicaid, you can get in trouble for it. Most of the third party billing companies are very careful about the way they do and practice methods similar to "soft billing". Basically they are skating around the law.

As I understand it, the current Medicare standards have a few different levels. First is BLS, then BLS with EKG, then ALS 1 and ALS 2 (dependent on the number of procedures or medications given). Those rates are flat rates and most agencies use those rates as a guideline for establishing their billing procedures. There are also 2 allowances that I am aware of: one for oxygen use (a flat fee) and one for mileage (if not specifically documented, I believe Medicare uses the ZIP of origin to the ZIP of destination).

[GM911 0]

Interesting timing... there is a lot of commotion down here regarding Mayor Fenty's secretive fare increases for ambulance transports. A quick summary, he increased fares from BLS: $268 to $530, ALS: $471 to $832, ALS2: $953. He also added an extra fee of $6.06 per mile.

http://www.examiner.com/a-1311133~Fenty_qu...lance_fees.html

[NWFDMedic 58]

Interesting timing... there is a lot of commotion down here regarding Mayor Fenty's secretive fare increases for ambulance transports. A quick summary, he increased fares from BLS: $268 to $530, ALS: $471 to $832, ALS2: $953. He also added an extra fee of $6.06 per mile.

http://www.examiner.com/a-1311133~Fenty_qu...lance_fees.html

That article simply shows that people don't know what they are talking about. He's increasing the fees probably to go along with current Medicare reimbursements. If DC charged less, they'd be basically giving money to the government for no reason. Those who are crying hardship to residents should probably realize that they aren't recovering from the people who can't pay to begin with, why not get the money that is out there to get.

[sr71 1]

Down in Darien Ct. Post 53 (the only totally teen run volunteer ambulance corps in the Nation) they do not charge for any of their services. The VAC only does BLS and ILS so if ALS is needed, they mostly call Stamford paramedics (or Norwalk if they are on the boarder). if those outside agencies come in they will charge the patient. post 53 will handle the bill since they are the transporting agency 95 percent of the time

[Guest]

i do enjoy reading things about bills and EMS. DO privates bill and not volly's?? Soft billing etc?? I especially like the fact that the original topic of Empress' bills etc was started by a Hospital person. A hospital that bills for every peice of anything that they use on you. I got a bill from an ER visit about 3 weeks ago and they charged me $19.00 for the IV Cath alone. ONE CATH. I'm sick and tired of people complaining about bills and EMS when health care costs are going up - becuase - MD's get paid more, RN's get paid more, Hospital's charge more. A $400-600 EMS bill in the grand total of health care is nothing. It cost $5000.00 for my son to be born - that's 1000.00 per day in the hospital.

Edit by Moderator: I deleted the repeat post of this message. -SageVigiles

[antiquefirelt 994]

If any agency regardless of type (VAC, municipal, private) bills Medicare, then they must follow their (MC) rules! They are very strict and if they think you're not living up to their standard can immediately withhold payments and force you to prove your legit.

Some Medicare Rules:

*You must bill everyone equally. No resident vs. non-resident rates

*No balance billing (I'm 98% sure on this one, not quite 100)

*You must be a "good corporate partner" meaning you cannot buy anything from members or their family members for the service.

*You must ensure none of your employees are on the Federal loan default list. In other words anyone who defaulted on a student loan cannot work for you.

* In order to write off old bills rather than use a collection agency you must have a written policy on how, when etc.

*You can not bill for goods anymore, just the flat rates and mileage.

*You must use their rate maximums for your area, and ares are very different across the country

There are tons more MC rules but it's been a while since I took a class or had any reason to dig them out. Once we st up and became compliant we rely on our billing serviced to tell us the upcoming changes for enactment.

[NYMedic37 22]

Back in the early days of Abbey Richmond the BLS rate was $ 38.50 and $ 1.50/mile +$ 20 for oxygen administration.

Wow! Abbey Richmond! I haven't heard that name for years (my first EMS job back in 1979).

Anyway, Tarrytown Ambulance ... which is all volunteer except for 4 paid daytime employees, has a revenue recovery program. We bill the insurance companies and list the mileage on the form. We also collect money from the NYS Thruway Authority when we do jobs on the NYS Thruway or the Tappn Zee Bridge.

Paul