By Drew Rummel, Staff Writer
Drew Rummel has been in the EMS field for almost 17 years. During his first six years in the field, he was certified as an EMT. He advanced his training to the paramedic level, which he has maintained for the past 10 1/2 years. He also has a total of eight years of EMS management experience.
If you were ever transported in an ambulance, or have been close to someone who has, you likely saw some sort of form that the paramedic or EMT asked you or your loved one to sign, whether you were transported to the hospital or not. Just like everything else in today’s society, you probably just signed it and went about your business without giving it much thought. While such forms are common, they do play an important role for both you and the ambulance service that provided the treatment.
EMS personnel refer to the first and most commonly used form in many ways. The “insurance form” — which, in my experience, is what it is most commonly referred to as — has to do with insurance and billing. This is completed whenever the ambulance service expects to bill you for a service it provided. Obviously, when you are transported in an ambulance, someone needs to pay for it.
The main goal of this form is that it allows the ambulance service to directly bill your insurance for the trip, instead of sending you the bill. A signature on this form also allows the ambulance service to re-submit any claims if the insurance rejects the initial claim. This is something that happens on occasion due to missing information upon the initial claim submission.[1]
If this form is not signed during the transport or shortly after in the emergency room, it will need to be signed before the ambulance service is able to submit the bill to the insurance company. Most of the time, you might receive this form in the mail accompanied by a letter asking you to sign and return it.
A little public service announcement here: Sign it and send it back. If the ambulance service cannot submit the bill to the insurance company, it will likely mail you the bill directly, which is often in excess of $1,000, depending on what treatment you received in the ambulance.
The other form is most commonly referred to as the “refusal form.”[2] As the name suggests, this is used when you are refusing all care or some aspect of care from the paramedics or EMTs. These are often used at the scenes of vehicle accidents when the occupants involved do not want to be transported to the hospital.
The “fine print” within the form essentially alleviates the EMS crew of liability should something happen to you after they leave, since you are refusing to be treated or transported by them. These forms can vary in design, but in addition to the aforementioned liability release, there is a section where the EMS crew can write down specific information or instructions regarding your refusal.
This form should be given more attention if you find yourself in a position to sign one, particularly the blank spaces that the EMS crew has the option to fill in. To protect yourself, ensure all of those fields on the form are completed, or struck through, before you sign. Signing a blank form could potentially leave yourself open to it being completed after your signature, allowing someone to add information that you were not aware of or did not agree to.
In contrast, diligent paramedics or EMTs will ensure such forms are complete before asking people to sign, as they can leave themselves open for liability as well.[3] In one mock educational instance, it was shown that the paramedic performed his job adequately, but due to inadequate documentation, he could be found liable by a jury. It is in the best interests of both the paramedic and the patient to ensure they have a completed form.
Sources
[1] Page, Wolfberg, & Wirth: CMS Final Rule Regarding Ambulance Signature Requirements. https://www.pwwemslaw.com/resources/law-library/ambulance-billingmedicare/cms-final-rule-regarding-ambulance-signature.
[2] Example of a refusal form: https://www.pwwemslaw.com/resources/forms/patient-refusal-documentation.
[3] Mike Smith: Itty Bitty Boxes, http://www.emsworld.com/article/10319432/patient-documentation.
