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Rural/Metro Nontransport Fee Questioned in Tenn.

JEMS.com Editor s Note: Is it fair to charge patients a non-transport fee if they called for an ambulance then refused transport? What do you think? Let us know in the comments section below.

MEMPHIS -- A diabetic Millington woman has a problem with her blood sugar and calls 911. A Rural/Metro ambulance arrives and paramedics give her glucose in her home. The diabetic emergency ends. Feeling better, she refuses transportation to a hospital. Later, Rural/Metro sends her a $410 "nontransport" bill anyway. The charge is too much, she complains.

The incident, described by Germantown Fire Chief Dennis Wolf, happened last year. It raised new ambulance issues discussed this month by Shelby County's Emergency Medical Response Oversight Committee.

The committee, comprising fire chiefs and the county's medical director, oversees the $2.9 million contract with Rural/Metro ambulance service. The committee cited three problems: Rural/Metro charged the "nontransport fee" even though such a fee did not exist on the fee schedule; the fee seemed too high; and Rural/Metro also charged $8.10 per mile even though the diabetic woman was not taken anywhere, Wolf said.

The per-mile charge was acknowledged as a mistake by the ambulance company, he said. The committee asked the company to consider reducing the nontransport fee, Wolf said.

Since the meeting, Rural/Metro has considered the request but will maintain the charge at $410, company spokeswoman Nikki Gast said. The nontransport charge deters people from abusing the 911 system, she said. "Nontransports" also create a liability for Rural/Metro, she said. "It's a liability if they decide they don't want to be transported and later on their condition gets worse."

It's a liability for the company in another way, she said. "You're sending a unit running lights and sirens to somebody's house because they have said they are suffering from a condition that requires emergency attention."

Wolf said, "If $410 is what Rural/Metro has for a nontransport fee then $410 is what it would be."

Rural/Metro charges $459 when it takes someone to the hospital on a 911 call. In addition to the nontransport and transport fees, Rural/Metro charges mileage and for supplies it uses.

Rural/Metro does not send a "nontransport" bill when a traffic-accident victim refuses transportation. That circumstance is different because any number of people witnessing the accident could call 911, Gast said. Similarly, the fee would not be charged for nontransport at a residence if, say, a neighbor called 911 on behalf of the victim.

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