I recently talked with EMSA personal about the added amount of money that was put on the water bill for EMSA. After hearing all about it on the media i was under the inpression that the $4 that you pay IF you dont opt out, meant that your ambulance ride was free. However I was told that thats not the case.

I heard from EMSA personal that it is ONLY all paid for IF you are in critical condition OR the Paramedic for EMSA runs you to the hospital with lights and sirens. I was told that if those two criteria werent met than they will in fact bill your insurance and then turn around and bill you for the remaining amount. Also if the hosptial once EMSA gets there, sends you to triage then you wil be required to pay the whole bill.

Here is my problem. First off the main percent of people whom pay this $4 thinking that they will get help on the ambulance bill mostly DONT have insurance, many use the ER as the Main healthcare and dont have a Primary care physician. I understand that thats using the system but some people dont have the money nor insurance to go to a regular dr and be seen. The water bill i feel is misleading. WHy tell the citizens many had no idea that their water bill was even being charged by EMSA and that amount will cover their trip to the hospital.

Sure it is not that big of a deal weather or not you are run into the ER hot if you have insurance but think about the people that dont. Now mind you if you have CHEST PAIN but the EMSA paramedic doesnt feel that you are having a Heart attack and even though they talk you into going you will late be billed from EMSA for the trip. THIS IS WRONG.

If they want to bill the water bill every month then it shouldnt matter how you are taken to the hospital or where the hospital staff puts you to know how much you will have to pay out of pocket. I feel that myself as a citizen and healthcare provide, WHOM WE are supposed to be patient advacates, we are being lied to. I myself opted out of the water bill and now glad i did. but i have the chance to have insurance.

Anyways has anyone on here been a victim of this scam that EMSA has pulled over everyones eyes? DOES anyone CARE? or am i the only one whom thinks this is wrong and something needs to be done about it.

Oh cant forget the elderly patients whom have a strict income and are thinking that the water bill money will pay for their EMSA ride. COME on his is pathetic.

I think there's a little misunderstanding of the types of transport here...and what determines the type of run.

First off, they won't ever provide the service free to all based on the $4 charge. That is because they would hemorrage costs more than they already do. EMSA also provides non-emergency transport. So don't think just because you see an ambulance moving without lights and sirens, that it doesn't have a patient. Any ambulance service will provide transport services between facilities, for example.

The other facet is the determination of the transport type. More often than not, a paramedic will ASK you if you want to be transported by ambulance if it's not life threatening. You DO have the right to refuse transport and go in your own vehicle. Say, you call 911, they check you out, and it's not really life threatening right then. You can go to the ER on your own, wait in line, and see what happens. If you ride in, even without being a life threatening condition, you get prefferential treatment...ie you get a room faster than a person in the lobby. That's because they need to dump you off the transport bed and onto a hospital bed so the ambulance can leave. A car accident is a good example. You may be injured pretty well, but if you have other means to get to the hospital, you can save a LOT of cash by driving yourself (meaning someone else drive you).

I don't mean to sound discounting, but i work with medical billing. These types of service companies usually operate in the loss and often go bankrupt. That's why pretty much EVERYWHERE else, they are provided by the Fire Department and then you pay a tax to support it.

If EMSA hadn't gotten this $4 charge, we would be without EMSA coverage right now. That means anyone except EOC and Moore would not have service....Midwest Regional covers those areas. I don't even know if Norman provides services anymore. They've been held above water with a straw for 20 years. This was something to make sure they didn't suffocate.

Personally, I'd rather see it folded into the Fire Department. Hire/Train the paramedics to cover that role and buy out EMSA. It would consolidate a lot of problems and streamline the opperation much better.

Personally, I'd rather see it folded into the Fire Department. Hire/Train the paramedics to cover that role and buy out EMSA. It would consolidate a lot of problems and streamline the opperation much better.

Firefighters cost a hell of a lot more than paramedics. That's what's probably keeping this from happening... well, that and EMSA probably does a lot to grease the wheels of city hall.

So, if I am having a heart attack, call 911, EMSA responds, stabilizes my condition, determines I am not in any immediate danger of dying, takes me to the hospital, I am going to have to pay for the ride?

Also, for any of you living in an apartment...is this monthly fee showing up on your monthly bill as a separate item or is it "added" in with the rest of your utility bill (Case and Associates)?

Firefighters cost a hell of a lot more than paramedics. That's what's probably keeping this from happening... well, that and EMSA probably does a lot to grease the wheels of city hall.It's true, a Firefighter makes more than a paramedic, and I will agree that a Firefighter will cost more. They should, they do more,(no disrespect to the paramedics) they(firefighters) have a dual role, and are cross trained. However, keep in mind that a paramedic cost the system more than the paramedic makes. Paramedics Plus makes a profit on every paramedic they supply EMSA. I would bet if the truth be known the spread is not as big as one might think after P.P. profits are tacked on to the wages.

It's true, a Firefighter makes more than a paramedic, and I will agree that a Firefighter will cost more. They should, they do more,(no disrespect to the paramedics) they(firefighters) have a dual role, and are cross trained. However, keep in mind that a paramedic cost the system more than the paramedic makes. Paramedics Plus makes a profit on every paramedic they supply EMSA. I would bet if the truth be known the spread is not as big as one might think after P.P. profits are tacked on to the wages.

Are paramedics union members? Do they receive anywhere close to the same sorts of benefits as firefighters? I still think that the smart play would be for the fire department to absorb EMSA's operations, but still use a contractor to put paramedics in fire department owned ambulances. Put those contract employees under the same command and management as other Fire Department personnel, and there ya go. Best of both worlds. Less duplication of effort, elimination of the costs in the EMSA contract associated with EMSA overhead and management, contract employees rather than full-time investments (which is what a public employee usually is).

Andy, I'm sure you're forgetting the pension and benefit aspects of those EMSA workers. While they cost a bit more today, the cost savings over time is likely pretty significant.

Unfortunately, most people do not understand that you only call an ambulance in an actual Emergency. (Stroke symptoms, Severe Injuries, Severe Chest Pain or Someone is unconscious and not breathing or not waking up)

I work in a local hospital and people take ambulance transports for some of the dumbest reasons. Feb 08 are ER was packed with patients with the flu. Average wait time was anywhere from 8-12 hours which is unheard of in most OKC ER's. We had one lady that was upset that she was not being seen for back pain that she went home and called 911 and had EMSA bring her back to the hospital.

Most people think Ambulances have priority regardless of patient condition which is wrong. If your symptoms are not life threatening or life altering you go to the waiting area just like everyone else that came by their own means. Another common misconception is that all walk in patients are first come first serve. It does not matter when you came in the people with the worst conditions are seen first. Not to mention, if you get an attitude with staff and you are not life or death patient the triage nurse will likely put you to the back of the line.

My suggestion is to aviod ambulance transports and ER's unless you have a life or death situation on your hands. Use your primary doctor or find an good urgent care in your area. In fact many urgent cares and a few family clinics are one stop shops that will give you medications and medical supplies all for one price. It usually costs somewhere around $60-$100.

I have used a few of them over the years before I started working for the hospital. You can usually get in and out in a hour or so and they will usually allow you to pay it out in split payments.

What oneforone said. That's the way the emergency services/ER should be utilized.

After hearing all about it on the media i was under the inpression that the $4 that you pay IF you dont opt out, meant that your ambulance ride was free. However I was told that thats not the case.

Thank you for doing some research and letting us all know the facts. I, too, opted-in for the service based on the documentation I was sent with the bill and what was on the okc.gov web site. It was my understanding that this monthly fee was basically "ambulance insurance" which it clearly is not. I don't have health insurance and cannot afford it and I don't need this wishy washy crap.



Personally, I'd rather see it folded into the Fire Department. Hire/Train the paramedics to cover that role and buy out EMSA. It would consolidate a lot of problems and streamline the opperation much better.

And to add to your post, this would likely result in substantially less than $4 in tax charges for each citizen when spread across the city and for those with health insurance, would they not qualify for a discount since the ambulance rides would no longer be a liability to the insurance company?


Again, thank you to you both for the good, informative posts.

What oneforone said. That's the way the emergency services/ER should be utilized.

Very true. Unfortunately, all too often, people without the means to pay know that by utilizing emergency services they won't be turned down. This is all too often the case (i.e. emergency calls for the flu, chicken pox, spider bites, etc.).

My suggestion is to aviod ambulance transports and ER's unless you have a life or death situation on your hands.

What if you are unconcious and/or someone else is calling 911 for you? My dad fainted on the job once a few years back and the company called 911 and had the ambulance transport him (which I don't fault them for--they were just covering their a**). Turns out he wouldn't have needed the ambulance ride as it was not a "life or death" situation.

And here's some more food-for-thought: My folks have health insurance. The insurance company agreed to pay the ambulance ride and requested that EMSA file the charges with them. EMSA refused to file with my folks' insurance company and demanded direct payment. My mom argued and argued with them but they would not file with the insurance company. The idiots finally had to eat the charges (probably just filed it as a loss and deducted from their taxes). So my experience with EMSA has not been good.

After reading all of this:

Now I'm really confused about this whole thing--I guess I will call a cab it will probably get me there a lot quicker!

Are paramedics union members? Do they receive anywhere close to the same sorts of benefits as firefighters? I still think that the smart play would be for the fire department to absorb EMSA's operations, but still use a contractor to put paramedics in fire department owned ambulances. Put those contract employees under the same command and management as other Fire Department personnel, and there ya go. Best of both worlds. Less duplication of effort, elimination of the costs in the EMSA contract associated with EMSA overhead and management, contract employees rather than full-time investments (which is what a public employee usually is).

Andy, I'm sure you're forgetting the pension and benefit aspects of those EMSA workers. While they cost a bit more today, the cost savings over time is likely pretty significant.Yes they belong to a Union unless something has changed. I don't know anything about their benefit package, but I doubt they do. I agree the F.D. should run the E.M.S., but we don't need a contractor, it could be handled with offduty F.F. at a lower rate of pay and no benefits. We proposed this idea to the City years ago, but like you said EMSA and Paramedics Plus are in tight with City Hall. They protect their Kingdom quite well.

Yes they belong to a Union unless something has changed. I don't know anything about their benefit package, but I doubt they do. I agree the F.D. should run the E.M.S., but we don't need a contractor, it could be handled with offduty F.F. at a lower rate of pay and no benefits. We proposed this idea to the City years ago, but like you said EMSA and Paramedics Plus are in tight with City Hall. They protect their Kingdom quite well.
My former roommate in the mid-90's worked for EMSA, they had nowhere near the pay/benefits that the firefighters had/have. When he was there I think AMR was the one who ran EMSA and/or provided the paramedics. They were "contracted employees" to EMSA and he was actually employed by AMR and not EMSA, so they were not under the civil service structure like fire or police are.

For what it's worth, here is the info from EMSA's website (thru the links at okc.gov)

What is TotalCare? -- Emergency Medical Services Authority (http://www.emsaonline.com/tcbenefits.html)


What is TotalCare?

TotalCare from EMSA is an ambulance subscription program that offers valuable benefits for Oklahomans of all ages. Our program is designed to cover the out-of-pocket costs, such as co-payments, deductibles and denials, that Medicare, Medicaid and most insurance companies assign to their members. Unlike standard “gap” insurance coverage, TotalCare covers all EMSA emergency transports - even if Medicare issues a denial!

Benefits of TotalCare apply exclusively to EMSA service and include:

* No co-payments or deductibles for medically necessary emergency ambulance service. TotalCare members pay no out-of-pocket costs for emergency transports.
* No co-payments or deductibles for non-emergency ambulance transports approved by members’ insurance/Medicare providers.
* A 40% cost-reduction (equaling hundreds of dollars saved!) on uncovered non-emergency transports.
...
TotalCare 2010-2011 Western Division memberships - for individuals in the Oklahoma City metro area - are valid through September 30, 2011. Enrollment begins August 1, 2010.

Annual TotalCare membership fees are $45 per household. Call 396-2888 for more information.


City of Oklahoma City TotalCare Program -- Emergency Medical Services Authority (http://www.emsaonline.com/okccitytotalcare.html)



City of Oklahoma City TotalCare Program

With the City of Oklahoma City’s TotalCare ambulance program, you’ll pay no out-of-pocket costs for EMSA emergency service. The program’s price of $3.65 per month is conveniently included on your regular City utilities bill - and benefits apply to all permanent members of your household. Now, that’s safety and security at a price you can live with!

Residential utilities customers (within city limits) are automatically enrolled in the program, though you may opt out if desired. Program benefits include:

* No out-of-pocket costs for EMSA emergency transports. For emergency transport, EMSA will collect all available third-party (insurance, Medicare and Medicaid) dollars and not bill residents of the property for out-of-pocket costs for which they are financially responsible.
* No out-of-pocket costs for EMSA non-emergency transport, if third-party coverage pays any portion of the charges. A non-emergency transport is a medical transfer that does not have a local hospital emergency room as the final destination.
* Automatic enrollment - no action needed to receive benefits!

My reading of it seems that if you haven't opted out, everything is covered (emergency and non-emergency)

As far as the apartment question, IIRC, the management of the complex decided if the complex was in or out. My complex doesn't have individual water bills so they tacked on $4 to the monthly "utility" that we pay separate from rent (water/sewage/dumpster removal). I would check with the complex manager for clarification if you are in or out (get it in writing too).

The firefighter/paramedics working for the Oklahoma City Fire Department are generally better trained and have more experience. Firefighters stay in their careers usually between 20-30 years. Paramedics for transport agencies are seasoned veterans at about 8 years service. This may have a lot to do with pay and benefits. Maybe being well paid and expecting fair and safe working conditions is not such a bad Union plan.

I have been in the emergency response business for almost 20 years, my opinion is that a fire based EMS system is a basic city service.

Bring back AmCare!

Bring back AmCare!Bring back Mother,Jugs, and Speed

I'm not trying to knock the paramedics of EMSA, but in the areas they have taken over from other organizations, the service doesn't meet the quality it once was. Take Mercy's service for example. There was a time when the larger hospital players had their own services....MWC is pretty much the only one left in town. Even though I wouldn't take my dog to MRMC, I'd trust that EMS service over EMSA any day of the week.

EMSA is just stretched too thin. They aren't provided with enough people to do the job to the full extent. And when paramedics are expected to use a parking lot as their "base", you can't really expect them to be happy. Would you be happy if you had to sit in a parking lot for 8 hours? Groups like MWC have agreements with the fire departments of the other municipalities they cover to have a joint base...ie Choctaw. So they get the benefit of at least being indoors somewhere, even if it's not exactlly swanky conditions.

Like so many things in health care, when the not-for-profits are sold to profit organizations, quality of care goes down because dollars are no longer put back towards the care of the patient...again, MRMC is a perfect example of that sad trend. What once was a great place, blows now. There's not a damn thing we can do about it because that's the world we live in, but it still sucks.

Ahhh...the great EMSA talks have started again. Let's look at a little history a bit at a time and see how we got here; for those that don't are doomed to repeat the same mistakes over and over again.

EMSA is actually a public utility trust proposed by Jack Stout that was set up to take over the failing AMCARE ambulance. It was meant to be a temporary fix to ensure OKC had ambulance coverage until a more permanent solution could be found. Now over 20 years old, this system is bleeding money from the municipalities it serves an increasing rate each year. The EMSA trust contracts out to a "for profit" company to provide manpower, billing, dispatch and stock the trucks. The city has actually acquired all hard assets (like the ambulances themselves, buildings, cardiac monitors, etc.) through the process of giving the trust money to stay afloat. The City and Trust are two separate entities, with the EMSA trust having a Board they report to; whom in turn reports back to the City.

Employees of EMSA are actually employees of Paramedics Plus (a hospital based group out of Texas) and were formally employed by other firms such as AMR. The employees became unionized several years ago because of poor working conditions, long hours with mandatory overtime and terrible benefits. These are the folks I feel for since they are bounced around in a Box for 12hrs a day going from post (parking lot) to post while the infamous computer tries to predict where the next call will drop. Most John Q citizens don't realize that anytime during the day or night; especially when little things like a tornado occur, there might be 0 ambulances available to respond to your emergency. This happens quite a bit and is termed level 0 in the EMSA world. Thus the front loaded system of 35 first response fire station. Someone with advanced medical training will be at your scene within an average of 4 min.

The water bill is bringing us one step closer to the city being in a position to dissolve the trust and cut out the middle man. Problem is the EMSA trust carries a lot of political clout and is fighting tooth and nail to stay afloat. They would like to show how an ambulance is more cost effective than sending a fire truck, but they have a little issue of standard of care. Most EMSA medics burn out before they hit the 10 year mark and turnover within the system is horrible. Very few medics out there with 10-15 years of service. In fact, many medics go to the Fire department for better wages, better working conditions and better benefits or on to nursing school and other occupations.

With the new billing, yes EMSA will still bill out your health care insurance but you shouldn't have to pay the deductible if you are a member. If you don't have insurance they bill you the full amount. Problem- you are getting a medical bill either way and it will take long phone conversations and several hours to work out the billing between EMSA and any insurance agency involved. And yes, we have over 35% of the ambulance riders that don't ever pay. Those numbers are actually down from 10 years ago and means EMSA should have to ask for less money. The "for profit" company PP makes their money regardless of whether anyone pays or not since they bill on each ambulance run not what they re-coup.

I'll post later what some of the options have been to try and fix the system. Got another EMS ride on my big red fire truck.

Now as larry stated there are 2 emsa plans. the total care that i know once was in place did make it to where all your ambulance trips are free, but i think you had to be over a certain age.

Larry on your post about nonemergency transferrs being that of not having a final destination of the ER is like going home from the ER. from what i read i didnt see anything about a non emergency trip to the ER.

EMSA decides if you are going o the hospital lights and sirens by a couple of ways. one is if you have an immediate life threat and require intervention ASAP at a level higher than paramedic. also they can run hot if the distance and time of day with the traffic would be detrimental to the patient.

Midtowner I agree to a point with you and andy. Its hard to say which would work better and which one the FD paramedics would vote for. I think that both are good options with both god and bad. I know Salt Lake City has Southwest ambulance in their firehouses and are pretty much like the crew and work the same schedule. That would help on scene as to having trust and these new EMSA paramedics that are fresh out of Pmed school coming on scene and throwing their weight around to veterans just because they work at EMSA.

EMSA has a weak union. In fact when i still worked there Paramedic Plus Inc. PPI tried to give the employees a 12% raise. however the union thought they could play with that and ended up losing it. they also got a settlement for back pay of certain EMSA members over ot issue with working 24hours shifts but they lost the paper work and many didn't receive a dime.

I do think the Fire should take over EMSA or at least the city. I still undecided about if it should be a seperate division to where the cot jockeys could only stay in the box but the fire department medics could work on the box if needed. that way the EMSA people wouldnt have to go into fires or any of that. I know many EMSA paramedics that dont want to get on at FIRE becuase they have no want to do any firefighting. I respect that. we could use them as a seperate division. I also know MANY paramedics that would love to get hired on at fire and are currently on the list chomping at the bit to get the call to start academy.

Sitting in the truck for 12 hors makes you crazy, When i did t i put weight on and i was becoming disgruntled and hated my job.

Basically the reason for this post was for an understanding of the so called EMSA water bill that provides a ambulance that, to my understanding was supposed to be free. No you DONT have to go to the hospital with them but as a paramedic it is their job to convince you to go and get looked at. they will almost always suggest you go. So if you go and they dont run hot, you will be paying for it.

So how about his, instead of cross-training them, how about setting up the paramedic division of the city. Let the paramedics be based at OCFD and OCPD locations. Then there's no problem with having to respond to fires and all that. And they also get to have somewhere other than their box to sit for 12 hours.

Think about how many firemen are already training for medical trauma. It's not quite a paramedic, but pretty danged close.

I think OKC residents don't realize how many of the large municipalities out there have FD service because the public-private relationships fail so often, and can lead to major conflicts of interest. It's not like we're talking about MediFlight where there is a limited use/need so it doesnt make sense for a city to own the chopper....it can cover far more cities on its own and would actually be detrimental to that service to be OKC owned.

Ambulance options that have been reviewed in the past. All of them have pros and cons.

#1- Leave the system alone and keep feeding it money to keep it afloat. It has been receiving money from the city for the past 10 years and will continue to do so if the residence of OKC want to keep it alive.

#2- Get out of the ambulance business and let private companies come in and take it over. This would be a 0 cost for the city but brings with it the possibility of that company or companies of pulling up stakes and leaving us high and dry in the blink of an eye. This option is a gamble even with so called "iron clad contracts".

#3- Absorb the transport side of the EMS into the fire department. There are several options within this one and it can be set up with the ambulance personnel as fire dept. employees, a separate division within the fire dept. or even private contract employees managed by FD personnel. The latter being the least desirable from all involved. Within this option you would get the most coverage of the city or Bang for your buck. Now that there is a funding option (water bill) this wouldn't cost the city anymore than the city is already paying to EMSA depending on how they set up the system. If it's not set up properly, it could cost considerably more and be even more of a drain on the city budget. If set up properly, as in other comparable cities, it's a money maker for the city and reduces total costs to the end user...ie. the patient.

#4- Set up a new division of EMS transport within the city. Call it the OKC ambo service or anything you would like. The employees would be a separate service of the city and could be managed by their own personnel, FD, police or whomever you thought would do the best job of it. They would fall under AFSME and would be true city employees with benefits. Downside to this type of system is where do they run out of? Historically there are lots of logistical issues when two different agencies are housed out of the same building and there is not a single person or agency in charge. This option also has the potential to either drain city coffers or make money.

IMO either option 3 or 4 would be the best for the citizens of OKC but both have issues that need to be resolved before the Trust can be dissolved. The contracts for both EMSA and the providing "for profit" company come up for council vote every 5 years. Right now the city does not have very much control over the trust and it would be much better serviced under direct control of city officials.

Ambulance options that have been reviewed in the past. All of them have pros and cons.

#1- Leave the system alone and keep feeding it money to keep it afloat. It has been receiving money from the city for the past 10 years and will continue to do so if the residence of OKC want to keep it alive.

#2- Get out of the ambulance business and let private companies come in and take it over. This would be a 0 cost for the city but brings with it the possibility of that company or companies of pulling up stakes and leaving us high and dry in the blink of an eye. This option is a gamble even with so called "iron clad contracts".

#3- Absorb the transport side of the EMS into the fire department. There are several options within this one and it can be set up with the ambulance personnel as fire dept. employees, a separate division within the fire dept. or even private contract employees managed by FD personnel. The latter being the least desirable from all involved. Within this option you would get the most coverage of the city or Bang for your buck. Now that there is a funding option (water bill) this wouldn't cost the city anymore than the city is already paying to EMSA depending on how they set up the system. If it's not set up properly, it could cost considerably more and be even more of a drain on the city budget. If set up properly, as in other comparable cities, it's a money maker for the city and reduces total costs to the end user...ie. the patient.

#4- Set up a new division of EMS transport within the city. Call it the OKC ambo service or anything you would like. The employees would be a separate service of the city and could be managed by their own personnel, FD, police or whomever you thought would do the best job of it. They would fall under AFSME and would be true city employees with benefits. Downside to this type of system is where do they run out of? Historically there are lots of logistical issues when two different agencies are housed out of the same building and there is not a single person or agency in charge. This option also has the potential to either drain city coffers or make money.

IMO either option 3 or 4 would be the best for the citizens of OKC but both have issues that need to be resolved before the Trust can be dissolved. The contracts for both EMSA and the providing "for profit" company come up for council vote every 5 years. Right now the city does not have very much control over the trust and it would be much better serviced under direct control of city officials.B.A., well said.

...Larry on your post about nonemergency transferrs being that of not having a final destination of the ER is like going home from the ER. from what i read i didnt see anything about a non emergency trip to the ER. ...

My reading of it is either it is a non-emergency or an emergency (no third gray area option). And the way I am reading it BOTH are covered.

As far as non-emergency...an example may have been in my mother's case. She had fallen and shattered her arm and was taken by ambulance to the Emergency room at the hospital on SW 44th. Even though she requested to be taken to St. Anthony's. Due to some agreement, they couldn't take her directly to the hospital of her choice. After the one they took her to got x-rays etc, they ended up transporting her to St. Anthonys anyway (her primary care doctor was based there too). The emergency had passed and she was just transferred to the other hospital. Much of the same tests etc were reperformed at St. Anthonys. Looks to me a case of double billing of the two hospitals and the ambulance. Fortunately, all was covered by insurance but we all end up paying for the needless duplication of effort.

Tricky isn't it Larry. Think about doctor's and visiting privelages. If you get admitted somwhere your primary doesn't have privelages, you may not get to see him there in an "official" capacity. It's as much part of liabilty and mal-practice insurance as anything. Everyone wants to cover their butt from the "unknowns".

Remember EMSA is a company. They have contracts and agreements with hospitals. You don't neccessarily always go to the closest hospital to the scene of the accident. If they have an agreement, you can go to the hospital of your choice...and if the medic feels that it won't put you in danger to take the extra time. They also have to balance their coverage. If you're in Norman and want to go to Edmond...prolly not gonna happen until you go to a more local hospital first, get an exam and then get transported.

In your mother's case, unless her chart followed her in the ambulance, I would expect the double exam. Most hospitals do a piss poor job of sharing data with ANYONE. Sometimes even their billing companies. There is no law requiring them to release the data either. You can request it, but they don't have to give it to you. That's misunderstood by a lot of people that think they own their chart...actually the hospital does. Again, if they share the chart, they put themselves up for liability for someone else to examine the chart and see that they did something wrong....potentially. It's all about rear-end covering these days.

My reading of it is either it is a non-emergency or an emergency (no third gray area option). And the way I am reading it BOTH are covered.

As far as non-emergency...an example may have been in my mother's case. She had fallen and shattered her arm and was taken by ambulance to the Emergency room at the hospital on SW 44th. Even though she requested to be taken to St. Anthony's. Due to some agreement, they couldn't take her directly to the hospital of her choice. After the one they took her to got x-rays etc, they ended up transporting her to St. Anthonys anyway (her primary care doctor was based there too). The emergency had passed and she was just transferred to the other hospital. Much of the same tests etc were reperformed at St. Anthonys. Looks to me a case of double billing of the two hospitals and the ambulance. Fortunately, all was covered by insurance but we all end up paying for the needless duplication of effort.

Kinda an agreement, but it has more to do with the hospitals rather than just EMSA. The hospitals rotate on who gets to play Level 1, 2 or 3 trauma for the day. When they get full in the ER then the hospitals can go on divert and refuse anymore pt. until they can move pt. to the floors or transfer to other facilities. It's very dynamic and sometimes doesn't leave the pt.'s with the choice they would prefer and can end up in higher bills in the long run.

The hospitals are a big part of the EMS system and have to work with not only the metro services but the rural ones that are transporting to the city as well.