ambulance hardship policy

8/18/2019 Ambulance Hardship Policy

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HARDSHIP POLICY September 2009

excellence in care

Patient Hardship Policy


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The Ambulance Service of NSW (the Service) is required to charge fees for servicesprovided to patients. In many cases patients are charged at a reduced rate (as NSWresidents) or are exempt from ambulance charges (eg certain pensioners). The policysets out arrangements for fee exemptions; how to apply for a waiver of fees on thegrounds of hardship and the types of circumstances that may be considered forwaiver.

Hardship Policy

In particular the Service is committedto working with patients who areexperiencing hardship, whethernancial or non-nancial. Our staff willbe compassionate, and we aimto treat all patients with dignity andrespect without making value

judgements. Patients who areidentied as experiencing some formof hardship will be protected fromfurther recovery action (eg debtcollection and legal action) whileconsideration of their circumstancesis in progress.

DEFINITION OF HARDSHIP

A patient experiencing hardship issomeone who is experiencing eithernancial or non-nancial difculties.

Where a patient is experiencingnancial hardship, the patient willhave the intention to pay but nothave the nancial capacity to paywithin the timeframe set out by theService’s payment terms. Financial

hardship may be either permanentor temporary. Likely indicators ofnancial hardship include:> The patient being eligible for

Government funded concessionssuch as a Health Care Card,social security benet or pension;

> The patient requestinginformation regarding alternativepayment arrangements;

> The patient self assessing theirnancial status; and

> The patient experiencing a

sudden change of circumstancesthat adversely affects theirnances.

Non-nancial hardship may occurfor a variety of reasons, and rendera patient unable to attend to theiraffairs for a period of time. Suchpersons will be considered to beexperiencing hardship where they areable to communicate this status tothe Service.

While the above list is an indicator ofpossible hardship, each patient willhave their individual circumstancesconsidered by the Service. Due tothe nature of the Service’s business itinteracts on a daily basis with peoplewho are distressed, injured or insituations that give rise to personalstress. Such situations will not, in andof themselves, be considered to becircumstances giving rise to hardship.

RIGHTS OF PATIENTSEXPERIENCING HARDSHIP

Patients who in the Service’s opinionare experiencing hardship have theright to:> Be treated compassionately and

with dignity and respect by staffof the Service without value

judgements being made, and tohave their circumstances keptcondential;

> Receive information aboutalternative payment arrangementsand exemptions that may beappropriate to theircircumstances;

> Negotiate a payment arrangementthat is mutually acceptable to thepatient and the Service. This mayinclude deferral of payment ornegotiation of a payment plan;

> Choose from the various paymentmethods available to patients,and receive written conrmationof agreed payment arrangementswithin 10 working days of theagreement being reached; and

> Be protected from debt collectionand legal action during thenegotiation of payment terms,and while the patient continues tomake payments according to anyagreed schedule of payments.

Where a patient is determined notto be experiencing hardship in thecontext of this policy or fails to meetthe agreed payment arrangements orchooses not to provide information

required under the policy, the Servicewill follow normal debt recoverypractices.

“Patients who are identi edas experiencing some form

of hardship will beprotected from furtherrecovery action (eg debtcollection and legal action)while consideration oftheir circumstances is inprogress.”


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Hardship Policy

AMBULANCE SERVICECHARGES

The Service charges patients foremergency and non-emergencyambulance services. Charges aredetermined annually by the NSWIndependent Pricing and Regulatory

Tribunal. Charges are availablefrom the Service’s internet site athttp://www.ambulance.nsw.gov.au/ docs/090630fees.pdf

Ambulance charges are notcovered by Medicare.

For NSW residents and residentsof States and Territories that havereciprocal rights arrangements withNSW, the NSW Governmentsubsidises Ambulance transport sothat the patient only pays 51 per centof the cost of the services provided.

For interstate residents in States and Territories that do not have reciprocalrights arrangements with NSW, theService will charge the full cost of theservices provided.

As part of the NSW public sector, theService is required to take all practicalmeans to recover debts owing tothe Service. Money recovered frompatients is used to provide services toother patients in need of emergencymedical care.

EXEMPTIONS AND WAIVERSOF CHARGES

The information below provides asummary of complex billing rules andpolicies. When considering individualcircumstances the Service will referto the full text of the billing rules orpolicy.

Insured PersonsPatients who hold private healthinsurance either for hospital coverthat includes Ambulance servicesor Ambulance only cover shouldrefer any invoices received from theService to their insurer. Instructionsfor how to do this are included on theback of the invoice.

Concession Card Holders The Service does not chargeConcession Card Holders for theprovision of emergency ambulanceservices (refer above for interstateresidents). Concession card holdersare holders of:> Pensioner Concession Cards;> Health Care Concession Cards;> Commonwealth Seniors Health

Care Concession Cards; and> Eligible Department of Veterans

Affairs Health Care Cards. Notethat the Service charges theDepartment of Veterans Affairs(DVA) for services provided tothese patients. DVA determineseligibility of individuals for free

Ambulance services. Where DVAdoes not cover the cost of the

provision of ambulance services,patients will be charged.

For non-emergency services theService will usually provide freetransport to concession card holders(refer above for interstate residents).However where concession cardholders who are NSW residents (orwho are covered by a reciprocalrights arrangement with anotherState or Territory) are seeking to betransported to or from interstate,purely to be closer to family andfriends, the Service will charge theconcession card holder the full costof the transport.

Other Exemptions The Service does not charge forservices provided to:> Wards of the State and others for

whom the responsible Minister isproviding nancial assistance fortheir care;

> Victims of sexual assault requiringinpatient treatment at a publichospital;

> Victims of domestic violence andchild abuse where the invoicing ofthe patient could be detrimental totheir wellbeing; and

> ‘Treat not transport’ servicesprovided to emergency servicesworkers while on duty.


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Waivers The Service will consider thewaiving of charges in the followingcircumstances:> Applicants for Income Support

– persons who have made anapplication for a Health CareConcession Card or PensionerConcession Card prior to theevent, on the production ofdocumentary evidence fromCentrelink;

> Refugee Status – persons whohave been granted or are applyingfor refugee status. Evidence mustbe provided through a statementfrom the appropriate authority;

> Good Samaritans – persons whorender assistance to a personor persons placed in a lifethreatening position eg aneighbour who enters a burninghouse. These cases will usuallybe documented by paramedicson the scene and no chargelevied;

> Deceased Parents/Guardians – Asibling or siblings under the age of18 years who through the eventis the only survivor or survivors ofthe immediate family eg due tomotor vehicle accident or housere. These cases will usually bedocumented by paramedics onthe scene and no charge levied;and

> Deceased Child – the parents ofa deceased child. These casesare usually documented byparamedics on the scene and nocharge levied.

The Service will consider waivers fornancial hardship or other reasons ona case by case basis. Refer below forhow to request consideration in yourcircumstances.

Hardship Policy

HOW TO REQUEST ANEXEMPTION, WAIVER,DEFERRAL OF CHARGES OR APAYMENT PLAN

Invoices may be sent to patients whoare eligible for an exemption or awaiver as the Service may not havesufcient details at the time of levyingthe charges.

Patients who meet the criteriafor an exemption or waiver of acharge should provide the relevantinformation – as detailed on the backof the invoice or in this policy – to theService, or provide details of theircircumstances that would qualifythem for an exemption or waiver,along with details of the invoice.Requests for deferral of charges or toenter into a payment plan should alsobe directed to the Service as follows:

> The Customer Service Centre on1300 655 200; or

> In writing to: Revenue Accountant Ambulance Service of

New South Wales Locked Bag 105 ROZELLE NSW 2039

Where patients are requesting thewaiver of charges due to nancialhardship, sufcient documentaryevidence of the applicant’s nancialposition will need to be provided.

This may include copies of a currentbank statement or evidence of annualincome such as an Income Tax

Assessment. A declaration as to yournancial status should be made inwriting.

It should be noted that the Servicewill rarely agree to the waiver ofcharges for nancial hardship wherethe applicant is not the holder of aConcession Card. The Service willinstead negotiate either the deferralof the debt or a payment plan basedon the individual circumstances of theapplicant.

ambulance hardship policy

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