Overheard In The ED

14 comments

Ambulance Driver: "Um, the guy going back to Decubitus Acres?"

Nurse:. "Y'all are here to pick him up? Great! We've been waiting for hours!"

AD: "Y'all said he met stretcher criteria."

Nurse: "He does. Postural instability and quadriparesis. He can't sit in a wheelchair."

AD: "Riiiiight. Well, right now he's walking around the room naked, and he just pissed in the sink."

Nurse (crestfallen): "Oh. Does that mean y'all are not going to take him?"

AD: "Nice try."

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Posted by Ambulance Driver on July 23, 2012 • Filed under: Uncategorized

AC

You get all the glamour jobs.
MedicDan

The company I work for would shit a brick if we didn’t transport that guy. Insurance fraud be damned!
Ambulance_Driver

My company would shit a brick if we didn’t first get it approved through our transport authorization center. If it doesn’t meet stretcher criteria, the residential facility or the patient pays, period. They frown very much on medics fudging the stretcher criteria.
The Borg don’t play the Medicare fraud game.
Scott Kenny

And here I thought the nurse/care center was just trying to get a PITA patient out of their facility… wasn’t thinking insurance fraud!
Ambulance_Driver

Oh, they weren’t trying to commit insurance fraud. They just didn’t much care what they had to say to get the patient out of their room.
Old_NFO

You are getting a real string of winners aren’t you…
BH

We (former employer) wouldn’t have fudged the transport criteria, other than documenting that we did in fact transport him on a stretcher. It isn’t fraud until it’s billed. Not my problem.

Refusing a run= instant termination.
Ambulance_Driver

Oh, this isn’t refusing a run in their eyes. They WANT me to run it through the authorization center if the patient doesn’t meet stretcher criteria. I’d get in worse trouble if I just transported a non-billable call.
And if I fudged my documentation and put them at risk for a Medicare fraud claim, I’d probably get fired.
Say what you will about The Borg, they are VERY scrupulous in this regard.
BH

We were told to just make the transport and let billing figure it out later. My sense was they’d rather eat this transport than lose the next 10 because we pissed off the ER by not freeing up their bed, but someone else did.

I never understood what Medicare expects the hospital to do with someone who’s ready for discharge at 3am but doesn’t qualify for a stretcher. Do the Borg have overnight wheelchair vans? Because NOBODY does around here.
emtdan

Many services in my area would just transport by ambulance, bill charcar, and eat the difference. That’s the cost of doing business, and not staffing chaircars overnight.
Too Old To Work

The Borg has a very good self survival mechanism. Even before Obamacare, Medicaid fraud by ambulance companies was starting to get a lot of attention from CMS. Now, it’s going to get more. Companies that continue to play that game are in for some interesting experiences.
Mmorsepfd

If he had pissed in the sink while seated in the wheelchair naked I would have taken him; standing? Damn, even I can do that.
Johnnie Testerman

It has been a while since I was very deep in the billing arena, but a few years back I was taught that if you take one non-emergent (scheduled / non 911/ convo) trip knowing you will not get paid then CMS says you should do them all for free. If the patient did not meet stretcher criteria then somebody had to express an intent to pay the bill. I was working for a hospital based service at the time. We made lots of new friends when these changes took effect, including one ER nurse who pushed a patient a1/4 of mile in a wheelchair to return them to the nursing facility at 2 am.
jessho

Well. If I ran a nursing home, and a demented naked patient was pissing in the sink, I think I’d even call the fire department and tell them they burst into flames.