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I got a few questions.
1. How do the private ems companies get paid? will it be by taxes or billing insurance compaines?
2. How do you guarantee level of service?
3.Who will dispatch them pd-911 or firecom or will the call be transfered to the ems compies dispatch center? How much of a delay with this cause?
1)The privates that get the contracts normally pay there crews, its not done by tax dollars. Then the company bills for the insurance.
2) The level of service is most likely more reliable in terms of "what you are getting" right now in Nassau you can get a CC or a Medic and that is just pot luck. With the privates you have more of a chance of at least knowing what is going to be coming, especially if it is set in a contract.
3) The third question I am kind of guessing to answer but I would assume that when firecom received the call they would give it to the private dispatcher, causing the same delay as giving it to a fire department (in my mind, still way to long of a delay)
I got a few questions.
1. How do the private ems companies get paid? will it be by taxes or billing insurance compaines?
2. How do you guarantee level of service?
3.Who will dispatch them pd-911 or firecom or will the call be transfered to the ems compies dispatch center? How much of a delay with this cause?
I would imagine billing between the insurance companies and medicare/medicade should be a gold mine for these companies. Plus I am sure some of the local hospitals would have no problems "contributing/contracting" in some way to to defray their operating costs. wink, wink.
The patch on their sleeve and private QA/QI just like we do it.
I guess it would be transfered to the privates call center essentially just likeit is now with individual department's dispatch from 911/firecomm. The delay won't be any more than it already is, and even so it will be well under the 2nd and 3rd re-alerts...
I'd like EAB to be able to meet the needs of the community and as a civil servant I don't want to see anyone's job put at risk, but as a taxpayer I do not want to pay for more posts. As has been discussed ad nauseum the system is totally mismanaged and right now anything the helps the community receive timely service and has the added benefit of spending more time with my family is worth seriously exploring.
Billing
Billing can be done in any of these ways, and a combination of all:
Soft-Billing
Bill Insurance Company of Patient, Accept what Insurance Company Offers. Can become hard to keep the company operating in the black like this.
Hard-Billing
Bill Insurance Company of Patient, What ever the Insurance company does not cover, Bill Patient for Rest. Has a better result overall, but also places extra burden on your billing staff, and can go up to suing the patent's family for the money.
Grant
Money is taken from a township, or County general fund. This could be a one time payment to setup the company, or a year by year grant of money to keep the company afloat.
Taxes
Money is taken from taxes from everyone in the primary area of response. Provides the most comprehensive way to keep the company intact, and can be ajusted based on the use of Soft or Hard billing and how well that is doing.
Level of Care
If your going to provide care in the 911 system, nothing less then Advanced Life Support is really appropriate. The ambulance can go out with a BLS Crew, but ALS must be able to make Patient contact at some point. ALS In Fly Car, BLS In Bus. But if your getting paid, I see no reason to not require ALS on each ambulance.
Dispatching
Three options here, but with more the one outcome.
I think North Shore LIJ EMS has their act together and would love to start getting contracts in nassau county. They have their own dispatch center manned 24/7 with the latest technology out there. They have some good quality technicians working for them also. I'm really surprised they haven't been going around trying to get nassau contracts.
As far as the means of getting ambulance calls it would be entirely up to the contract between the municipality and the ems agency. However just keep in mind when the ambulance call eventually does come through the ambulance/responder will be staffed so they can respond as soon as they get the call. As oppose to being toned out, driving to the firehouse, and then driving to the scene with the bus.
I think this is a good alternative to help supplement the pre-existing 911 response system in nassau county and it should be looked into.
I have been following the issue of billing for ambulance service and it seems to be a universally held fact that Villages can bill Insurance Companies, Medicare and Medicaid and Fire Districts cannot. Does anyone know if that is really true or is it just an "urban legend."
a private ambulance system will ideally have in place a system checking wuality of patient care. Also, the high volume patient load and mandatory training could be good of patient care.
NS LIJ has the ability at any moment to start in Nasau... I dont know if the money intake would be enough to get them to do it.
North Shore LIJ EMS is great...they provide ALS fly car service in the town of islip 6a-6pm mon-fri....the medics who do it love it but North Shore hasn't been making any money and they keep cutting costs left and right...it would be great if they could start doing it in Nassau but they'd definitely have to start billing for services....i personally am all for it because it helps the volunteer service so much...especially when you can get a bus on the road but ALS isn't available bc its noon time and they are at their own job
in Nassau where we don't have EMD the fly car would have to show up to every call and clear BLS in order to work...if we had priorities the fly car could stay in service for only calls deemed ALS by the dispatcher
It would be a step in the right direction, A full time paid EMS system in Nassau County.The best thing would be to see the creation of Nassau County EMS. FUll time paid system and the merg 9-1-1 and Fire Com together in 1 room in 1 buildng. but that will never happen.
I already thought firecom and 911/police dispatch were in the same bldging just seperate rooms// I also think it would be a good idea to put them in the same room// but you would still have some of the same problem you have now with ems response//
I like the idea of a Nassau County EMS but this creates another problem, do your merge the police 14a's into this system along with all the volunteer Fire Departments and the volunteer ambulance corps units and put them under one unified dispatch system for ems only meaning police dispatchers don't use or track the 14 a's and the same with firecom you take all ems units out of there control?
Why cant it be done like the city does, the ambulances are contracted to the city in the case it would be the county and then you get a radio, CAD system leased from the county or however they work it and everything goes through the county dispatch so it is all one system similar to how FDNY and the Hospital units work.
Nassau-911 Private EMS Agencies
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