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View Diary: Reducing the Cost of Health Insurance - pat on my own back (8 comments)

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  •  You did a good thing. (4+ / 0-)

    My dad was in a nursing home the last four years of his life and made multiple trips to & from the hospital, and you've got me thinking. If the categories you describe apply here (St. Louis suburbs) he was routinely transported BLS but for that 5 minute drive, a majority of his trips could have been ATS. The nursing home never ordered it. Hmm.

    •  Officially it is medicare fraud ... (3+ / 0-)
      Recommended by:
      FG, elfling, chimene

      to send someone by Ambulance (BLS/ALS) when they could go by Wheelchair and Medicare is paying. (I think it is the same for Medicaid)

      Why most nursing homes order the Ambulance is they don't know anything about what the choices are.  Or they don't want to hear the patient complain that they are not going by cot.  (many people feel they should go by Ambulance when they don't meet the standard.  "I just had my knee replaced!" but they can sit upright on their own and can stand and pivot to the chair.)

      Medicare says it won't cover unnecessary care, but they don't crack down on this aspect.  Mostly because anyone can write up something that makes it look like the patient needed to go by higher level of care.

      Private companies don't like wheelchairs because at best you break even on them.  Most of the time you bill $50 for the trip and when Medicare gets around to paying it is like $35. But if you don't have ATS/Wheelchair service you are a lot less likely to get contracts for the ambulance service.  

      I know my employer would love to do ALS trips that don't need more than BLS care.  But the management will tell you to -do the "write" thing- (internal joke) and downgrade when appropriate.  But love it when it gets billed higher (and paid)

      Stupid question hour starts now and ends in five minutes.

      by DrillSgtK on Wed Mar 20, 2013 at 03:00:46 PM PDT

      [ Parent ]

      •  It's yet another consequence of a system (0+ / 0-)

        with no public pricelists. How is anyone to make intelligent decisions between the options when they're not aware of the cost? We see this throughout the medical system.

        Thanks for doing your part to educate the people on your route.

        Fry, don't be a hero! It's not covered by our health plan!

        by elfling on Wed Mar 20, 2013 at 10:27:18 PM PDT

        [ Parent ]

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