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Walter Suiter
05-02-2017, 01:54 AM
Not quite back to the horse drawn car, but more than half a Century ago.

Would you like Oxygen?
An Ambulance ride to any Hospital in the City cost $37.75 for the ride, if you were picked up inside of the City. That's about $150 in 2017 Dollars. Patients going top Park Ridge a few miles outside the City got hit with an extra $22.50 charge for mileage, as did patients picked up outside of the City. Dispatchers were on making sure the EXTRA was charged when you called in route to Hospital. Really lucky patients who got picked up out of the City limits and hauled to Park Ridge paid more in EXTRAS than they did for the ride.

Junior found a loophole in his Contract with the City, an additional $10.00 could be charged for patients when Oxygen was administered. Big Meeting time. All crews were strongly advised to encourage patients to use Oxygen. No opportunity was to be missed to slap the plastic funnel on any patient headed for the Hospital. Every gurney was equipped with a minibottle and mask too. You loaded a woman with a sprained ankle because her heal got caught in a sewer grate, get her on Oxygen. Patient says it hurts, respond with "would you like Oxygen?". Junior makes 10 Bucks extra and the crew gets a Buck bonus for the run. By the time the patient gets the bill there is nothing they can do about it other than pay. Guys waiting for a run work the phone harassing people to pay the bill and only get paid if they collect. I doubt if anybody in the company didn't know a 330 bottle cost $4.50 to get filled by the welding supply place in Buffalo.

If you pay before we unload you-
Oddly, many patients don't want to pay for the ride. Insurance isn't going to pay either unless it's a wreck. Junior figured it was easiest for the Attendent soothing the passenger to collect on the go.
Memo: to all employees, try to pry money out of the patient before rolling them into ED. Junior even popped for a couple pizzas for crew training on how to get the money. Remember, the company Lawyer says you can tell the patient anything in the back of the car. Look at their clothes. If they look prosperous, and give you a good home address, tell them the ride is $47, and the Oxygen is 12.50. Then tell them if they pay on the go, in cash, you can discount it to a flat $45. Company gets $40 and you make an extra 5 bucks.
Junior forgot smarter guys would offer to discount the ride to a flat $50, and only give the company $40. The receipt books weren't serial numbered, and the bookkeeper passed them out freely.

I'm sorry, company policy requires me to charge you extra to ride along in the jump seat with your kid on the gurney unless you pay $10 for the ride. No opportunity to make an extra Buck was to be missed. If you missed the charge it came out of your pay. Collecting the EXTRAS made you a Buck for each EXTRA $10 you brought in. I was working for a lowlife, but it was an easy job.

Bruce Oliphant
05-02-2017, 09:59 AM
Similarly we had to wait in the ER for either the patient or a family member to write us a check for $69 trip fee plus $5 if we used oxygen. We spent a lot of time in the ER. :)

Ken Elliott
05-02-2017, 10:40 AM
I remember one occasion where we transported a man to the hospital about 10 o'clock at night and his daughter rode up front. When the patient was transferred to an ER bed, I asked the daughter if she could take care of the $35 charge and she said all she had was a hundred dollar bill. I quickly said I'll get change. But no one in the ER could break the $100, so I drove to a gas station which was just closing and persuaded the attendant to open his register to break the bill for me and returned to the ER. The ambulance company owner gave you 50 cents for every collection made at the time of service. What memories.

John ED Renstrom
05-02-2017, 10:59 AM
hasn't changed a lot. a 1 mile ride with ALS crew need or not here is a grand.
medicare will pay it. the 60 mile tip to the big Hospital is 2500.

release of information discovered with the continued attempt to close the locale VA, that in 2013 they paid the locale Ambulance service a million dollars to ferry pt back and forth to be housed in the for prophet hospital. we cold not get any facts on the other two services they were using to spread out the cost.

when we were 100% volunteer serve we started a tax district to bring in money as most of our runs were none paying rides. (again VA pt) we assured the taxpayers that we would except 3 party payment and the tax district would cover the rest. the day after it passed I watch the powers to be bill a person in the district because he had money and could afford the bill.

so not a lot has changed in the billing department of EMS

Terry Lange
05-02-2017, 11:51 AM
Great stories! I remember those days well, where the receipt book in your back pocket was just as important as the keys to the rig in your hand. Lots of down time spent knocking on doors trying to collect after the fact. Much easier, with a little bonus as well, to get paid at the time of the trip.

Wayne Krakowski
05-02-2017, 12:48 PM
I started just as the system was changing up here in 1968,all rides were a flat $20.00 no matter how far or how much stuff you used,if you thought someone was abusing the system a special code could be put on the ambulance record but it required a Doctors signature and very few of them would ever sign, but I worked with folks who had to collect on the spot or chase people for the money.luckily most services would not with hold services to people needing it.

Bruce Osborne
05-02-2017, 01:58 PM
Were cheaper than a taxi and the they knew that they wouldn't get billed.
Get the pt. to the hospital, they would get off the stretcher and walk out out of the hospital

Walter Suiter
05-02-2017, 03:22 PM
Does Canada still have Hospital Tax on all restaurant meals? I haven't been there in a long time, and probably won't be coming back since this country won't let me back in unless I pay for a Passport or enhanced Driver License.

Walkoffs here are an every day fact of life for the Commercial companies. The indigenous swampcreatures dial 911, specify the hospital they want to be delivered to so they can walk to their friend's abode. They even become combative about having to be delivered to the ED rather than dropped at the friend's place. Welfare(taxpayers) get billed North of $300 for the ride. Maybe Uber will help that, if Welfare contracts with Uber.

Ambulance Districts with Taxing authority are difficult to start in NY. I've stopped a couple myself by informing them they would no longer be running anything more than State Bid vans and stirring voters up. They already bill for service. The local Vol service is already annoyed, the day they went Bill for service both Commercial Companies prestaged cars right in the middle of the Vol turf. 911 dispatches in rotation to closest car, and can see every car squacking GPS. The Vol company is sitting on a 6+ Million endowment, employing paid crews and crying because the Commercials are eating their lunch. I don't look for sanity to prevail any time soon.

Wayne Krakowski
05-02-2017, 04:26 PM
Walter to the best of my knowledge we do not have hospital tax on meals,you should get a passport and come on up to see the ambulance museum len has down chatham ont way especially since next years meet is in the motor city.when my health is better I plan to attend more meets and the famous micro meet as well as my total love of Frankenmuth,Mich:thumbsup:

David Henry
05-02-2017, 05:19 PM
It sounds to me that Junior would make Harry Fishbine very proud.

Walter Suiter
05-02-2017, 07:21 PM
It sounds to me that Junior would make Harry Fishbine very proud.

Harry Fishbine couldn't hold a candle to Junior when it came to being a fecalhead.

I did love the quad headlights on Mother's rig though.

Bruce Osborne
05-03-2017, 03:44 PM
In Ontario The Ambulance services All ALS are Government funded thru Ontario Health Care and the region ( County) . Our Niagara Region Runs over 26 units.I used the service 2 months ago. My cost for services was $ 45.00. This style of service is basically the standard now across Canada .Province's have set standards and funding.

Bruce

Victor Baca
05-05-2017, 02:15 AM
We weren't paid a thin dime by the companies I worked for to make collections. If you couldn't do it there were others that would, and you could turn in your keys to the ambulance if you didn't like it.

One sunny afternoon in Los Angeles, we got a run from the dispatcher at 566. He sent us on a full arrest and because I was deficient in collections, he said I would lose my job if I didn't collect on this call. It was a slimy, rotten thing to do, besides I was only getting $1.47 per hour to spend my shifts running back-to-back calls in South Central L.A.

We arrived on scene and initiated CPR on a male, about 55 years old, his wife was in attendance and distraught in the extreme. While my attendant set up the gurney, I started CPR. She had to witness him puke in my mouth, me rolling him into a modified Sims position to clear his airway along with all the other indignities of CPR that were happening to him.

I kept telling her he'd be ok and we'd get him to the hospital quickly. We loaded up and I fired up the Caddy for a Code-3 run to the emergency room. That was one of the most disturbing radio exchanges I can recall. "Car-74, we're rolling code to Morningside ER, full arrest, male, mid-50s, CPR in progress."

566 answered, "Roger Seven-Four, did you get a check?"

I answered in code that we had a relative riding up front then added, "74, negative. We'll handle the details at the hospital."

Well, I knew our patient was gone and was probably not going to make it, my partner was working his tail to save the poor guy, mostly for his wife who obviously loved this man very dearly.

We handed the patient off to the ER crew and I took her aside and told her he'd be ok and was in very good hands. I knew full well that nobody's going to give you a red cent if you don't make a save. And I collected the check from her. About that time, the doc came out and I split. I can still see her face, so happy, knowing that her husband would be ok.

I will never forget as long as I am here to confess my sins, the sound of her wail echoing down the hall as she was given the news. Her hope crushed, her loss, unbearable...I never collected a bill on an emergency call again.

Steve Lichtman
05-08-2017, 09:13 PM
I worked for two different private ambulance transport services in the 80s. No emergencies.

One company, we had a little credit card embosser in the ambulance. It was a flat metal plate, you put the card on and the receipt on, then rubbed it with a little device that was basically a plastic spoon.

The other, we had calls we had to collect on - those were called "POS" calls. The dispatcher would say, "This is a POS, $88.50" or whatever the price was. Now POS didn't stand for "point of sale" like a store (or "piece of $#!+" like you were mad), in our company, it meant "Pay or Stay"!