Just when you think things around here can't get any worse, we havereached a new level of bungling in our EMS system. For the past couple years, every 911 patient transport has been billed at the higher ALS rate. Yep, even a simple BLS transport for constipation has been billed at the higher ALS rate.
Even if all the ALS work is done by the Spokane Fire Department, the patient is still billed for ALS by the ambulance company. Furthermore, 60% of the patient transports were suppose to be billed at the lower BLS rate. Since they are now billed at the higher ALS rate it means an extra $700,000.00 dollars per year for AMR! And consequently, the people that we are supposed to protect - are forced to pay for something that they are not receiving.
It's like ordering basic cable service (BLS) and receiving basic cable service - but people are being forced to pay for deluxe cable service (ALS). The really reprehensible aspect of this, we provide most of the ALS care at no expense to the patient.
EMS is 80% of what we do and nobody I've talked to in Spokane knows anything about this billing practice . You would think with the EMS levy just barely passing, we would take EMS issues around here more seriously. AMR billing in Seattle was contacted and they confirmed this billing practice - it's called ALS Emergency Mandated.
There may be a ray of hope out of this mess. People have been charged for ALS when the SFD Paramedic accompanies the patient to the care facility. This is a prohibited charge under the contract. Just guess how many times a year our Medics ride-in where the fine can be as high as $5,000.00 dollars for each violation. The penalties could be in the millions, but our Chief has to make the effort to fine the ambulance company.
The down side of this is how public perception about SFD EMS might change. In the future people may think EMS stands for Emergency Medical Scandal. Fundamental reform and investigation about this matter is warranted.
Happy New Year!
Bill Jackman
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