Private Transportation

[Jdean]

Hey guys, my part time job is with a private service, i was informed today that tomm before we take a dialasys pt to treatment, we are supposed to take them to a cell phone store to get her phone fixed! is this legal? I work in Houston,Texas

 

[Symbolic]

It's usually only legal if you go for Ice Cream and the patient pays..

 

[medicdan]

It may be. It's not about legality, but payment. If the patient has private payment or medicaid arranged, you can take them wherever they'd like! Just document, document, document.

 

[HotelCo]

Don't include the miles to and from the store as part of your mileage. Billing Medicare for these miles can be considered fraud.


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[Trip]

Hey guys, my part time job is with a private service, i was informed today that tomm before we take a dialasys pt to treatment, we are supposed to take them to a cell phone store to get her phone fixed! is this legal? I work in Houston,Texas

I work for a private service in NY and, like was stated, it's all about payment. There are defining factors as some of our livery transports are handled by medical insurance, but if they have cash and want to go to the casino, we go.

 

[IAems]

Medical Necessity

While I'm sure there are many upstanding departments operating in the Houston area, the city is notorious for Medicare Fraud. The standard set by Medicare is pretty much the standard for all insurance carriers (whether that be Medicaid, HMO, PPO, etc.) The Medicare standard is: an ambulance claim can only be billed if the condition of the patient at the time of transport suggests any lower level of transport is contraindicated (Medicare defines this as Medical Necessity). My guess, and I openly admit I'm not looking at the patient or the PCR, is that a patient that schedules a cellular phone repair appointment, could (insert sarcasm here) probably use another means of transport other than ambulance to get where they're going (like a wheelchair van or taxi cab). As long as you honestly document on your PCR the actual condition of your patient, you aren't doing anything wrong, even though your boss could end up in jail. And, by the way, if you start altering run tickets because your job is threatened or you're told to leave something off a run ticket, that would be illegal on their end to ask and on your end to comply; and you don't want to be on the bad side of the federal government. Ignorance of the law is no defense.

 

[Jdean]

Thanks for all the advice guys, ive heard through the ems grapvine that is illegal either here in Houston, or Texas wide. And the private sector here in Houston has suffered big time thanks to some bad apples. A few years ago there were around 300 services, now more than half our gone.

 

[EMTJay]

So are you receiving extra payment in the form of check or cash? I would of asked how this situation is being handled.

 

[Handsome Rob]

the only way that would be kosher (and even then, BS) is if the patient were paying privately. Having worked in H-town I can say that the fraud and corruption is insane. We're talking INSANE. and as was stated before, document document document. It may cost you your job (at a crappy service quite possibly) but will save your license.

Off topic, did they ever fix the Ben Taub bump in the medical center or is it still there? Gawd I hated that...lol

 

[Jdean]

Actually they have redone all the streets in the med center. McGregor is now a 6 lane road now!
Emt Jay, im not sure how its being handled, i know pt has medicaid