Highway Robbery: Billing for Services for Not Rendered?

Could there be a bigger underlying issue?

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Matt Cataldo is a practicing paramedic in Westchester County, NY and a full-time paramedic instructor.

You’re driving along, minding your own business, when you’re involved in a minor motor vehicle accident. Thankfully, no one is hurt. However, a Good Samaritan decided to call 911 and EMS shows up. Take my info? Sure. A quick blood pressure? Why not? Trip to the hospital? No thanks, that won’t be necessary; you have no injuries or illnesses that require medical attention. A few days later, you receive a bill for a few hundred dollars. That’s odd….you thought you refused treatment.

With rising costs, agencies must find more and more ways to fill budget gaps, why not bill for patient refusals? One could argue that an assessment was performed, therefore billing can be justified. Perhaps it can be justified due the costs of activating the 911 system: fuel, personnel, etc.

When no injuries are present, a basic “assessment” comprises of little more than a short conversation and some vital signs. A few hundred dollars to tell someone that you’re ok is as ludicrous as it sounds. Now, imagine it wasn’t even you that requested EMS. You are essentially being forced into paying a bill for services you didn’t even request. Should a restaurant generate a bill for you perusing their menu? The offer of services exists; perhaps you ask a question regarding a particular entrée. Now you have a professional opinion and the restaurant generates a bill, regardless of you actually receiving any goods or services.

In these scary times, when the future of insurance coverage is questionable, one must ask how ethical it is to bill for such “services.” If this is a commercial agency who does “hard” billing, will collections become involved for failure to pay? Will your credit be ruined for not paying for refused services that you didn’t even request in the first place?

Such questionable billing practices need to be reevaluated not only from moral/ethical point of view, but also from a fiscal one. Do budgetary constraints require such frivolous billing? Perhaps, instead of passing along financial woes onto the general public, officials should address why an essential service is having such shortfalls. Is this a commercial service rendering life-and-death services for profit? Ethics seem to fall to the wayside when profit becomes involved, but that’s a conversation for another day. With costs of equipment and training constantly rising along with call volume, perhaps bake sales would be a more ethical approach to generating income. I do bake a mean chocolate chip cookie.

Matt Cataldo, BA, EMT-P