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A story that will make your head spin

EMS1.com News

March 29, 2012


EMS News in Focus
by Arthur Hsieh

A story that will make your head spin

Clearly something is afoot with this agency and its community, and there will be more news coming in the weeks to come

By Arthur Hsieh

Editor's note: With EMSA's operations and billing practices coming under more scrutiny this week, Art Hsieh offers his thoughts below.

I've commented on this story before regarding the expenses of politics and influence, something that EMS struggles to do well.

Clearly something is afoot with this agency and its community, and there will be more news coming in the weeks to come.

I encourage you to read all the way through the article — if your head doesn't begin to spin on how this agency tries to recover its operating costs, you must either be an accountant or a health care reimbursement expert.

There is no simple way to recover costs in health care. The system is complex, overly so, and as a result the mechanisms to bill for services are convoluted as well.

What appear to be good, reasonable billing concepts turn out not to fit all situations, resulting in unintentional, or simply wrong bills being sent.

It makes it a challenge to "follow the money," and results in charges of malfeasance and lack of transparency.

I recently had to visit an emergency department for an acute, but minor medical condition. I was traveling and was treated at a facility far from home.

In the past few days, I have received at least five statements from three departments about my care.

Some were from my insurance carrier; others were from the hospital. Reading through them, it's a bit of a challenge to make sense of the different charges and reimbursements that were done.

As a consumer, I wish I had something much simpler to look at and easier to decode. It's an exercise in frustration -- while the care was good, I'll be sorting out these issues for some time.

It's easier to be simply critical of what appears to be bad practices, without fully looking at the broader issues that result in potentially questionable practices.

No doubt the crews of this agency is fielding some of the community's frustration over the allegations. It'll be interesting what plays out over the next few weeks.

About the author

EMS1 Editor in Chief Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at Art.Hsieh@ems1.com.
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