...........................

[Cinders]

Not sure if I mentioned it on the CB or not (I think it was the BB - could have been both) - but back in April I had to be taken to the ER via ambulance.. My health insurance (like most insurances) doesn't cover ambulances - and at the time they were called, I was perfectly aware of that and willing to pay the bill myself..

However, because I chose to go to a different hospital than the one closest to my DD's house, there were unnecessary things done during my long, leisurley ride (which included the ambulance stopping to rubberneck at an accident scene) that changed my transport from "basic" to "advanced life support" - and thus a much higher bill..

When I received the bill, I wrote them a letter - explaining which parts of the bill I was disputing - and provided medical documentation to verify that the "treatments" performed during transport were medically unnecessary based on my condition at the time of pick-up, during the transport, and upon arrival at the hospital.. I indicated that all communication regarding this bill must be in writing (so I would have something to back up whatever was said), asked them to re-submit the bill to me as a "basic transport" (including the mileage charge - which I was also willing to pay), and I would make arrangements for payment.. I sent it off to them by registered mail - return receipt requested - so I know that the office manager received it and signed for it..

Well - it's been months now and I still haven't heard back from them.. I don't like having unpaid bills hanging over my head and I'm not quite sure how to proceed from here.. I will not call them (again - whatever transpires, I want it in writing) - so should I write them a second letter - or wait awhile longer?

I can't imagine why it would take them this long to respond and I would assume that if they were going to stick to the original charges, I would have received another bill by now..

It's not true that most insurances do not cover ambulances charges. I've worked in billing for years and have only 2 patients' whose insurance policy did not include ambulance transports and they excluded it because they wanted to save money on their premiums. Even Medicare and Medicaid pays for ambulance transports.....emergency and non-emergency!

Exactly what procedures did they do that in your opinion were not needed based on your documention? Did you refuse these procedures at the time? Did you sign any paperwork during your transport? Could bypassing the closest facility have endangered your life?

If you have a lawyer friend, you might ask him/her to write a letter requesting action. Just seeing the letterhead should probably be enough to get them moving. The only other thing I might do is call the office, ask for billing, get a name and then verify they have the correct address. You do not want them to send it to collections because "they couldn't find you".

No lawyer is going to stick their neck out for this.

call and simply ask to check the status of the bill. They may have written it off (doesn't hurt to check!)

I highly doubt this as they sent a bill, they've done their part now they are waiting for her to do her part by paying the bill.

I have never heard of having to pay for an ambulance-is that common in other places? Here the fire departments are all volunteers as are the EMS people and all the other ambulance people. You need an ambulance you just call and within minutes a crew is at your door but you are nev er expected to pay for it. The fire department does a fund drive once a year that is not mandatory-if you want to give you do if not you don't have to. The last time my mom needed one they came so quick and were so good that I dropped off a big basket of treats at the firehouse for them all once she was out of the hospital and I had some time.

You're paying for it someway...most likely through your property taxes. Government controlled services here receive property tax monies and they use that combined with billing to run their services. Smaller services or basic/first responder type services cost much less to operate and can run on tax dollars alone.

Could be something happened at their end not related to you - family illness of the person in charge, turnover, moved offices, whatever. You could just wait a few more months. But it would probably put your mind at ease to call and ask the status.

90 days unpaid goes straight to collections. Another 30 days it goes on your credit report. Or your service may choose to go straight to court. Judges really don't like to hear excuses when it comes to not paying for ambulance bills. Last one I heard about the Judge asked the patient if they called the ambulance (yes), did they sign the paperwork presented stating they were responsible for the bill (yes), and did they allow the ambulance to treat and transport them (yes). The judge told the guy to pay immediately or set up a payment plan through the court. If he does not follow through with the payments the ambulance service simply goes back to court and if the patient doesn't pay or show up a body attachment can be placed on the patient. Which means they can be held in jail until the payment is made in full plus court costs.

So I wonder what would happen if you sent your payment for what you are willing to pay along with a certified letter stating that their acceptance of that payment constitutes payment in full of your bill?

I know what I'd do...first I'd Then I'd mail it back with the original bill. If everyone sent in what they were willing to pay we'd have no ambulance service at all.

People really do not understand how much money it takes to run a medic service. Drugs alone cost from $1 to $140. Then think about how much the actual ambulances costs, insurance, payroll, equipment, disposable supplies..... Sure you might have a patient that only needs aspirin, nitro (SL) and morphine which is cheap but then consider if they do not have a good IV site then they have to have an IO and those needles cost $100. Say they go into cardiac arrest thats another $100 for the disposable lifeband that is on the machine that does chest compressions. Medicare and Medicaid both pay a set amount based on the procedure codes....plain english different levels of payment for different levels of care, not a percentage of the actual charges.

 

[C.Ann]

 

[clh2]

C.Ann - does your insurance provider have a website where you can look up if anything was paid to the ambulance company? I know you said it doesn't, but (here's hoping) maybe they did!

 

[C.Ann]

C.Ann - does your insurance provider have a website where you can look up if anything was paid to the ambulance company? I know you said it doesn't, but (here's hoping) maybe they did!

------------------------

Received the denial from them - "uncovered services" - quite some time ago..
ER bill was paid promptly..

 

[PrincessSuzanne]

C. Ann, I am with you, most insurance companies don't cover ambulance transport, especially if it is non-emergent. I had to be taken to the hospital by ambulance in Jan 2006 and I had to pay that bill myself, but there was a chance of more injury if I had tried to be moved otherwise and couldn't easily be transported any other way and my insurance didn't pay.

I work in the medical field and know how much things cost and am shocked at what patients and insurance companies are charged for services rendered. This is the reason most people don't go to the doctor, because if they have no insurance, they can't pay that bill, so they abuse the ER system. My mom recently had a simple x-ray of othe her feet and the hospital charged her insurance over $800 and I know there is no way it should have cost that much. I am now receiving bills from the hospital where she recently passed away and am not as shocked since she was in ICU, I was actually more shocked at how little the insurance company did pay, for the services she was provided. I hope the ambulance company that transported her from our home (not even a mile) to the hospital does try to bill me, cause they are gonna get a piece of my mind (Well, they are gonna get that anyway). They treated her like a piece of meat and don't deserve to get paid one dime. People that treat animals the way they treated my mom go to jail for abuse.

Suzanne

 

[C.Ann]

C. Ann, I am with you, most insurance companies don't cover ambulance transport, especially if it is non-emergent. I had to be taken to the hospital by ambulance in Jan 2006 and I had to pay that bill myself, but there was a chance of more injury if I had tried to be moved otherwise and couldn't easily be transported any other way and my insurance didn't pay.

I work in the medical field and know how much things cost and am shocked at what patients and insurance companies are charged for services rendered. This is the reason most people don't go to the doctor, because if they have no insurance, they can't pay that bill, so they abuse the ER system. My mom recently had a simple x-ray of othe her feet and the hospital charged her insurance over $800 and I know there is no way it should have cost that much. I am now receiving bills from the hospital where she recently passed away and am not as shocked since she was in ICU, I was actually more shocked at how little the insurance company did pay, for the services she was provided. I hope the ambulance company that transported her from our home (not even a mile) to the hospital does try to bill me, cause they are gonna get a piece of my mind (Well, they are gonna get that anyway). They treated her like a piece of meat and don't deserve to get paid one dime. People that treat animals the way they treated my mom go to jail for abuse.

Suzanne

--------------------------------

I'm sorry for the loss of your mom - and how badly she was treated..

 

[PrincessSuzanne]

--------------------------------

I'm sorry for the loss of your mom - and how badly she was treated..

I just wanted to be sick watching it happen and not being able to do anything about it at the time, but I will make it my business to write to them as soon as I can find out the company name. The firemen were fussing at me about their equipment in my house, so I couldn't get away as quickly as I wanted to.

Thank you so much for the hug, I miss those.

Suzanne

 

[Cinders]

---------------------------------

I know of absolutely no one in this area with regular insurance (not Medicaid or Medicare) whose insurance covers ambulance transport - regardless of the plan..

The details of the treatment provided are something I don't care to discuss on this message board.. I have medical documentation stating it was unnecessary and that should suffice..

After I received the bill, I called to advise them that I was disputing the amount (based on what I have previously disclosed here) and was told to send them the documentation - to the attention of the office manager(which I did) and they would then review it and make a decision based on said documentation.. This was done by registered mail - return receipt requested (which I received - signed by the office manager.)

I have not heard from them since..

And you didn't even answer my basic questions...did you refuse those treatments? Did you sign documention before or during the transport? I don't understand why you can't elaborate somewhat on the so called medical documentation. Where did this medical documentation come from? It's up to the medic to decide what is needed at the time. You are the one that refused to go to the closest facility, which could be why the extra procedures were needed. Possibly when they requested to go to a facility that was not the closest they were required by their protocols to do more procedures.

For example if a crew has a patient with "chest pressure" and they don't want to go to the hospital that is 5 minutes away. The patient prefers to go to one that is 20 minutes away. Now some patients think chest pressure can't possible be as bad as actual chest pain so they don't understand why something like being put on the monitor is necessary or why the medic wants a 12-lead done before they get to far from their regular hospital. They are protecting their patient (that rarely has emergency medical training) and they are protecting their service. The medics are not allowed to diagnose...they are there to treat and transport based on what they themselves see at the time. Those advanced procedures can tell them if the patient is in cardiac arrest.....now would you rather spend $50 for an ECG or would you rather die enroute to your preferred hospital? But as with anything you could have flat out refused these procedures.

Maybe the procedure was an IV lock with blood drawn. Again per protocols if time allows an IV is to be started and 6 tubes of blood drawn. This gets the blood to the lab faster thus helping the ER diagnose the problem faster in order to start treatment. Again you could have flat out refused these procedures.

Or maybe it was an advanced airway. If your pulse ox is below a certain level per their protocols you must be put on O2 with the best method used....nasal canula to non-rebreather to OPA or NPA or even intubation. And then of course there is the CPAP and the Vent.

There aren't that many "procedures" that are/can be done in an ambulance that aren't a necessary step in definitive care.

 

[C.Ann]

 

[Cinders]

But you have the bill and they are well within their rights to send your account to collections or court if you do not pay it. And they will be within their rights in the future to not transport you to the facility of your choice since you haven't paid this bill. They can't refuse to take a 911 call and transport....but they can insist you go to the closest facility. Just something for you to think about in case of future transports. I'm just trying to get you to understand the medics have rules they are required to follow.

As for them stopping to rubberneck.....you may not know all the details as to why they stopped.

I'm not asking for details nor your medical condition. I simply asked what the procedure was...that doesn't tell us your medical condition. I asked if you refused the procedure at the time....again you're an adult if you didn't want the procedure it was up to you to say no.

 

[C.Ann]

 

[KAMLEM]

---------------------------

Actually I don't have the bill anymore.. It was returned to them with my letter of dispute - per their instructions..

If they want to get any kind of payment at all, they will need to send me another bill..

Didn't you keep a copy? You should never send originals if you don't have a copy. I know that's no help now, but just a word of advice for the future.

 

[Fire_Eater]

-----------------

It was not an emergency in the sense of the word that I needed to be transported to the nearest hospital - thus my choice to go to a different hospital.. It was not a life or death situation.. No lights - no sirens - just a nice leisurely drive through the country side - with a stop along the way so they could rubberneck at the scene of an accident..

Other than that, I see no need to give you any further details..

I called when I received the bill - told them what I was disputing - they advised me of how I needed to go about disputing it - and I followed their instructions to the letter (literally) - and the ball is in their court now..

At this point the "details" you insist upon having are irrelevant.. I was told they would review my dispute and I would be informed of their decision.. I have not been informed.. End of story..

As stated before - I have no intentions of "not" paying this bill - but it's kind of hard to pay the bill when you don't have it..

That rubbernecking could have been them doing their job by assesing the scene. It's crazy that an EMS unit would assist at the scene of a car wreck, besides i'm curious how you know what they are doing when strapped down on a stretcher in the back of the rig it's hard enough for those of us working in there to see what's going on outside.

If you chose to go to a certian hospital you pay for the trip to that hospital. Cinders has been on point in everything I have seen her post. If you get in the back of my truck your looking at the minimum of a four lead a blood draw and maybe an IV.

I'm going to do what "I" think "I" need to do while on the back of "MY" truck because it's "MY" career. If someone denies my treatment then they, by law will sign a refusel. Besides if it was so routine then why dial 911?

 

[maddiel]

Why don't you email your insurance company and ask? That has more urgency than a letter and leaves a paper trail.

M.

 

[Jeninindy]

Yep, follow up on it.

I just got a call a little while ago from a collection agency about a bill for my son from 2 years ago!!!!!!! We had gone to the ER for a foot injury, they said nothing was wrong and to follow up with his regular doc in three weeks.

The next day the poor kid was in so much more pain and crying hysterically, which was very out of character. We took him to the ortho doc, who diagnosed a serious growth plate fracture that should have been easily caught the night before.

When I got the bill, I called them to inquire about an elimination of the doctor's fees due the medical misdiagnosis and the additional doctor's bill we incurred due to the doctor's error. I was instructed to send a letter with my request - it was sent two years ago and never heard anything else about the bill it until today.......I assumed it was written off.

Had to resend the letter again (thank goodness for good records) and now we shall see what happens this time.....

So, check on it or you maybe be dealing with it in 2 years.....

 

[Cinders]

That rubbernecking could have been them doing their job by assesing the scene. It's crazy that an EMS unit would assist at the scene of a car wreck, besides i'm curious how you know what they are doing when strapped down on a stretcher in the back of the rig it's hard enough for those of us working in there to see what's going on outside.

If you chose to go to a certian hospital you pay for the trip to that hospital. Cinders has been on point in everything I have seen her post. If you get in the back of my truck your looking at the minimum of a four lead a blood draw and maybe an IV.

I'm going to do what "I" think "I" need to do while on the back of "MY" truck because it's "MY" career. If someone denies my treatment then they, by law will sign a refusel. Besides if it was so routine then why dial 911?

I didn't really touch on the issue of the rubbernecking but people need to understand we wouldn't abandon a current patient but we are allowed to assist at an emergency scene as long as the patient on board is stable and qualified personnel are with the patient at all times. We've switched out drivers who are medics at scenes and had a non-medically educated fireman drive the ambulance in the medics place. Our firemen here are not required to be medics. The patient still has the EMT or Medic they started with but the driver can be swapped out at a scene.

Thanks Fire_Eater for understanding what I was trying to get across to her. The biggest thing is EMS personnel are not allowed to "diagnos." They can only treat and transport based on how the patient presents.