On Fri, 12 Jun 1998, Jeff Avner wrote:
> Does anyone know what the regulations are concerning transfers from one
> institution to another. In particular, can an ED send a patient to another ED
> for further evaluation (for pediatric expertise) and can an inpatient be
> transfered to another ED for eventual admission (the ED evaluation would be
> used to determine if the child needs an ICU or general floor)? These
> situations do not seem to be effected by COBRA ... or are they?
Working as a paramedic who works in a critical care transer unit, let me
see if I can help.
We routinely tranfer sick and injured children from less capable community
hospitals to specialty centers. If the child or infant is less than
stable, we may carry a resident physician as well. Neonatal transfers are
also a regular occurance. For most neonate calls, the baby is placed in
a transfer isolette. The ambulance personnel consists of an MD (resident
or attending), Neonatal RN, and a Resp. Thereapist in addition to the
Many times we have transfered critical children. If they were not
transfered, they may have not survived admission at the community
hospital. (Many of the community hospitals do not have pediatric ICU
facilities or staff.)
Our transfers are not typically from a floor. Most often, the transfer is
from an ED. However, the transfer is typically to the floor or the unit.
As far as billing / COBRA is concerned. What I have learned is that if
the transfer is for special services or care that is not available at the
current hospital, then any transfers are covered.
I hope this helped. Jason
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