Re: Helicopter risk/benefit

["Robert L. Carnevale" <cw5aso@erols.com>]

Ken,

Our program does most of our transports (ground and air) at risk.  The referring hospital calls our service, and we arrange the transport.  If our hospital doesn't have a bed, we will try to find one at another hospital.  Transports are done with our assets (air or ground) or those of our competition (air).  None of the referring hospitals are charged for this service or for the
transport.  We have a contract with a local hospital to perform their neonatal flights, so those flights are not at risk.

There are times when flying the patient might not be medically necessary, but in the best interest of the patient or our program.  In these situations, we will fly the patient, and our billing department will submit for the appropriate ground transport reimbursement.

Bob Carnevale


Ken Lawson-Williams wrote:

> Here too.
>
> However what about another wrinkle, the patient that does not warrant flight but the sending GP wants to 'turf' elsewhere, anywhere! And unfortunately (for him) the hospital has no budget to send by ground aambulance... Government Medicare will pay for flight, but not ground (silly - but that is how it is set up: sending hospital only pays for ground interfacility transfers).
>
> Or the patient for whom flight is inappropriate for the patient(but sending GP doesn't care (see above), or see/know why. Would your program allow the flight crew to cancel on-scene? (not discussing the situation where the required scope of care is outside that of the providers)?
>
> Fly Safe.
> Ken L-W CCEMT-P/WMT
>
> Duct tape is like the force, it has a light side and a dark side, and it holds the universe together.
>
> --- "Bruce Bowling" <caduceus@bellsouth.net> wrote:
> >An additional thought on this issue.
> >
> >Have you arrived at the bedside, and found a patient that had no idea that a
> >helicopter had been called for their transport?  I have had this happen many
> >times in the past.
> >
> >A transfer form is thrust into their hands, and they are told that this is
> >for their permission to be transported to another facility.  Most patients
> >do not see the box that is checked "air medical transport".  They assume
> >they are going by ambulance until they see the flight crew at their bedside.
> >
> >One other issue.  Have you ever seen a patient sedated into submission for
> >air transport?  This seems to be a favorite physician tactic in our area.  I
> >have seen several occasions where I was told that the patient did not want
> >to fly, so they gave them "xxx of ativan, etc."  While the patient can no
> >longer be their own advocate in this area, their wishes were made clear
> >prior to their sedation.
> >
> >Just some food for thought.  I'm sure this never happens in your part of the
> >country.  NOT!
> >
> >Bruce Bowling
> >Mt. Sterling, KY
> >
> >
> >> Have you ever been in the situation (I'm sure you all have) where the
> >patient
> >> makes it clear that he/she does not want to fly but the sending MD calls
> >you
> >> anyway thinking the flight crew "will change the patient's mind or talk
> >them
> >> into it " or it becomes "their" issue?  The fact that the patient told the
> >> sending facility he or she did not want to fly prior to you being called,
> >is
> >> only made clear to you once you have already arrived and made Pt contact.
> >>
> >>
> >
> >
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