Refusing Ambulance Service?

Dear Madame L,

This morning I went to the gym to do my usual half-mile swim, then sat in the steam room for about 10 minutes. I started seeing funny spots in front of my eyes and felt weak and lightheaded, so put my head down between my knees until I felt better, but when I tried to get up to walk, I felt faint again. So I lay down on my side on one of the benches by the pool. 

Some guy who had just finished swimming laps asked if I was okay, and I said yes, just feeling a little faint, and then another guy came over, and then two employees of the fitness place. One guy said he was a fireman and could he take my pulse and I said sure. 

He said it was about 80, and I said that's high for me, and he asked what's my usual resting pulse and I said 64, and he said did I feel nausea or chest pains and did I have a history of heart problems and I said no, no, and no; and he said okay he was going to go back to swimming now so I didn't feel so crowded and I said thanks. 

But then one of the other people said they should call an ambulance and I said no, no ambulance! I'm sure I'm just dehydrated. I said if someone has a phone I'll call my husband who works nearby and he can come. So I gave that first guy the phone number and he called on his smart phone and I talked to my husband, who said he would be right there. 

Then another employee showed up with a huge bottle of some Gatorade-like drink, and I took a few swallows, thanked everyone and got up to leave. The guy with the phone said two women should walk with me through the women's dressing room to make sure I was okay. So another female employee showed up and the two of them followed me into the dressing room and stood there watching me put on my shirt and shorts over my bathing suit. 

Then one of them said an ambulance had been called and I said, no, no ambulance!  I walked as fast as I could out to the front and one of them said I had to wait for the ambulance to arrive and I said the ambulance isn't here yet? That's pretty useless isn't it! (Because, really, Madame L, if I had really been having a heart attack, that was about five minutes later, and they would have been too late to save me, wouldn't they!)

Right then I saw my husband drive up so I started to leave and they said no you have to stay and I said No I don't need to go to the hospital, I'm fine, and I can't afford to pay for the ambulance, and they said, No they won't take you to the hospital they just need to ask you some questions and I said No I can't afford to pay for them to ask me some questions, and they said Oh don't worry it won't cost you any money and I said Oh yes it will and they said Not if they just talk to you and I said Oh yes it will, I'm leaving. So I went out and got in the car and left. And of course I'm fine. 

So, I have two questions:  Was I wrong to refuse to wait for the ambulance? Would I have had to pay just for letting them ask me a few questions?

Sincerely,

Healthy AND Can't Afford an Ambulance Ride

Dear Healthy,

Madame L is relieved that you're okay. She hopes you're grateful to those concerned individuals and employees who were doing the best they could for you by calling an ambulance. She also sincerely hopes that if you did need the ambulance ride, you would accept it; and reminds you that there may be times when people do need an ambulance ride but don't realize it.

On the other hand, Madame L really sympathizes with you for refusing the help.  Madame L has read recent reports in her own area suggesting that emergency response people may sometimes give "help" that isn't needed, and then charge a lot of money for it. For example, an older woman fell and skinned her knee at a Fourth of July celebration, walked to a nearby booth manned by a private ambulance company, and was given a small plastic bandage even though she said she had one in her car which was nearby; she later received a bill for over $600 for this "service."

Madame L has tried to find out more information on this topic, but the private ambulance companies are (understandably) reluctant to advertise their billing practices. Madame L doesn't know if the ambulance company would have been satisfied with your answering "a few questions" or would have insisted on getting your name and contact information so they could later send you a bill.

Madame L has been able to find this article pointing out that many health insurance companies refuse to pay for ambulance services, leaving people like you paying hundreds or even thousands of dollars for a ride, even a necessary ride, to the hospital.

Here's an information sheet from American Medical Response (AMR), one of the more commonly used private ambulance companies, explaining why these companies send you the bill even when you've called your local 9-1-1 number instead of calling a private ambulance.

This document, from a local government emergency service office, shows just what kind of information the emergency personnel might have asked for (and also reveals that the "just a few questions" they may have asked you would indeed have been enough for them to send you a bill later). Here's what they would report to their supervisors:

1. Unit number
2. Incident date
3. Incident time
4. Call receipt time
5. Dispatch time
6. Arrival at scene time
7. Incident location
8. Patient’s Name, Age and date of birth, Gender, Weight, Address (emphasis added), Chief complaint, Vital signs, and
9. Appropriate physical assessment
10. Emergency care rendered, and the patient’s response to such treatment
11. Patient disposition
12. Scene departure time
13. Arrival at receiving hospital time

If you had stayed long enough to chat with the ambulance personnel and refused their services, here is an example of a form you may have had to fill out.

 

Dear Readers, if you have any first-hand experience with this issue, please comment or send Madame L an email message with any additional information that may help all her readers.

Best wishes for your continued health and safety,

Madame L