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Ambulance call costs $267 even without ride

If you call for an ambulance after a fender-bender, you may get a bill even if you don't go to the hospital — and you might get charged even if somebody else makes the call without your knowledge.

Jackson County's three ambulance service providers have the right to charge for treatment even if they don't transport anyone to the hospital. That has led to some surprises for motorists.

"It's a means to help meet our costs," said Ken Parsons, manager of Mercy Flights, Jackson County's largest ambulance service provider.

"About 30 percent of our responses end up in no transport," Parsons said. "Our costs are incurred whether we transport or not."

Jim Matteucci of Medford learned about the charge after a minor car accident in which police called for an ambulance.

His 20-year-old son, Tony, received a $267 bill for treatment after Matteucci said paramedics only took his son's blood pressure.

"The bottom line is we feel like a victim," Matteucci said.

Parsons said treatments that appear to be minor to a layman, like doing a physical assessment, measuring blood pressure and blood sugar or bandaging an open wound count as treatment for billing purposes.

Parsons said the Jackson County Board of Commissioners approved Mercy Flights' request to levy the "treatment-without-transport" charge in December 2005.

Mercy Flights requested the authority to levy the $250 charge to compensate in part for reduced compensation from Medicare, which pays for ambulance transport for people over 65. Those reimbursements, however, don't cover the cost of providing the service.

Allowable annual increases have raised the fee to $267.

Matteucci said he feels wronged by the charge because he did not call for an ambulance. He called Medford police to document the accident, and apparently the police department dispatched the ambulance.

The city's emergency dispatch system requires an ambulance to be dispatched when a 9-1-1 call is made.

"Anytime a person dials 9-1-1 it starts a chain of events," Medford Fire Chief Dave Bierwiler explained. "Any time we're officially notified of an emergency, we have to go."

Ambulance companies are dispatched through the 9-1-1 center. They often must do an assessment to protect themselves against potential liability down the road.

"I understand the people's dilemma (about incurring the charge)," Parsons said. "I wish they would understand ours.

"The moment we're requested, we incur a liability to make sure there's no injury," he said.

"We try to err on the side of caution," he said. "That's why we respond, or do an assessment."

Parsons said the charge is another aspect of the cost-sharing that's common across the American health-care system. Payments made by the federal government for Medicare and Medicaid patients, who account for about 65 percent of the ambulance transports, do not cover the costs of those services, so the ambulance company has to find other revenue sources to make up the difference, Parsons said.

He said people can avoid the charge by telling EMTs at an accident scene that they're not injured, but sometimes even that won't suffice. If there are obvious injuries, then saying "No" to treatment isn't sufficient, and somebody with a head injury may not be competent to refuse treatment.

"It's not like we're trying to run a racket," Parsons said.

"If we had no non-emergency calls, we wouldn't have to charge it," he said.

The county's two other ambulance service providers also charge the fee. Ben Ramsey, chief of the Rogue River Rural Fire District, said there's some leeway in his district to determine what constitutes treatment.

"Evaluations aren't treatment," Ramsey said, but he noted there's a fine line to draw in many cases. To explain his point, Ramsey described a hypothetical case involving a diabetic patient who is unconscious when paramedics arrive. They start an intravenous drip and bring the patient back to consciousness, but then the patient declines to be transported to the hospital.

"It would be our treatment that got him to where he could make an informed dissent (declining transport)," Ramsey said.

Ashland Fire Rescue also charges for treatment that does not involve transport. The City Council directed the department to charge for such cases in July 2008.

Greg Case, a division chief in the Ashland Fire Department, said the practice is fairly common nationwide, and it's been adopted because people too often use their local ambulance service companies for health care that should be provided by physicians.

"It's kind of like taking your car to the mechanic," Case said. "He checks it out and tells you what's wrong. Generally he's not going to do that for free."

Reach reporter Bill Kettler at 776-4492 or e-mail:bkettler@mailtribune.com

Motorists involved in accidents may discover they’ll be billed by an ambulance company even if they don’t want or need the service. - file photo