How to handle ambulance bill

[u/Deep-Examination7086]

My newborn needed a transfer from the ER to a NICU, and the hospital arranged the ambulance transfer within their system. I just received a bill for over $5,600 from the ambulance company. My insurance has an allowable amount for the service, but I’m being charged the difference between that allowable and the full billed amount.

The ambulance provider was out-of-network according to them and my insurance, and these extra charges aren’t applying toward my in-network out-of-pocket max. It’s worth noting I hit that OOP max of $6500 during the NICU stay, so I have nearly $12,000 of bills coming my way.

Since this was a medically necessary transfer arranged by the hospital, I’m confused and frustrated about this huge bill and the balance billing situation, especially since I had no choice in the provider.

My insurance is through GEHA and they had me contact ClearHealth to negotiate costs but to me it doesn’t seem like this should need to be negotiated and my insurance should cover the entire bill with in-network benefits. I have reached out to everyone I can possibly think of, ambulance company, insurance, the hospital. And everyone I talk to just points the finger at eachother. I have an appeal in process with my insurance company but do not have high hopes that they will change their decision. Shit like this just makes me want to give up.

[u/flag-orama]

Don’t pay it. You never agree to their price or to use an out of network service. You are being taken advantage of. There are disclosures laws that were not followed.

[u/OtherwisePumpkin8942 → u/flag-orama]

This is terrible advice. Ambulance agencies are private businesses. They will send you to collections and they will tank your credit score.

Many ambulance agencies do offer payment plans. Call the agency and see what plans they have available for payment. Companies are usually willing to go with whatever terms are most sufficient for the client since they would rather get paid over time than not at all.

The cost to operate a single ambulance with its equipment and the 2 personnel on board would be quickly unsustainable if companies were only allowed to accept the low insurance pay outs without the ability to balance bill.

Unfortunately, if ambulances were included in the No Surprises act, many agencies would simply cease to exist. I don’t need to explain how that would be catastrophic for the community at large.

[u/Deep-Examination7086 → u/OtherwisePumpkin8942]

More catastrophic than these outrageous surprise bills?

[u/OtherwisePumpkin8942 → u/Deep-Examination7086]

Yes. If ambulances don’t exist, you are looking at having no one arrive if you call 911. Would you rather that instead?

The cost is astronomical but the basis of this issue is that ambulances are not considered essential services. This determination of it being nonessential birthed private ambulance agencies and is the reason why many counties refuse to initiate a tax-based ambulance service for their citizens. Instead they contract these private agencies because it’s cheaper than buying and operating several ambulances.

So if I had to run the choice of dealing with a bill or just having ambulance not exist. I’d choose the bill through and through. Imagine calling 911 and then saying that help is 2 hours away or worse, they aren’t coming. This actual happens in some rural communities. Money isn’t everyone’s top priority. And while I do recognize that sudden bills can be burdensome I would still rather have a 911 service to turn to if I ever need it.

[u/Deep-Examination7086 → u/OtherwisePumpkin8942]

Maybe they should work with insurance instead of lobbying to be exempt to increase profit margins. The fact that these companies can call themselves “non-profit” is laughable

[u/McNallyJoJo34 → u/Deep-Examination7086]

I don’t know of any ambulance company that calls themselves “non-profit”. Private ambulance companies are a business. They make profits.

[u/Secret-Rabbit93 → u/Deep-Examination7086]

The profit margins on ambulance services are already razor thin. It takes a crap ton of money to buy ambulances, stretchers, cardiac monitors, insurance, pay for 2 people 24 hours a day and you need enough of them to handle surges in call volume so those spend a decent portion of their day not actually generating revenue but just sitting. The smaller services are hanging on by a thread and are quickly being taken over by big conglomerates. And they’ve tried working with insurance companies. The vast majority give us the run around and don’t want to negotiate in network status let alone agree to pay enough to make that viable.

[u/Deep-Examination7086 → u/Secret-Rabbit93]

Yeah I really don’t give a fuck about your profit margins. In no world is sending people into mountains of medical debt for emergency transport (that they didn’t arrange) ethical by any means.

[u/Secret-Rabbit93 → u/Deep-Examination7086]

So what would be ethical? In your world. Ford wants money for the chassis. Fraser wants money for the box. Stryker wants money for the stretcher and monitor. We’re about half a million at this point before adding employees who want to feed their kids. Insurance companies don’t pay enough to keep the wheels rolling. Most EMS services receive no tax funding. So where does the money come from? Things don’t magically appear. You want to pay less for medical care? So do I. You can vote people in who will properly fund EMS. You could vote people in who will force insurers to properly cover transports.
Until then this is the system and it’s not the ambulance companies fault.

[u/flag-orama → u/OtherwisePumpkin8942]

hospitals total abuse patient transport. the only reason OP was forced to use an amblance was to reduce the hospital's risk. I have no doubt the patient could have been safly transported by the parents. i would never pay this bill and nobody dings credit scores for hospital bills.

[u/OtherwisePumpkin8942 → u/flag-orama]

The baby went to a Neonatal Intensive Care Unit (NICU). A patients, child or adult, being transferred to an intensive care unit is not stable by any means. ICUs are reserved for those requiring the most intense care. The hospital could have not recommended any less transport than an ambulance. I’m sure these parents would rather have an ambulance bill and a baby rather than the other way around.

Idk where you got the information that no one dings credit for hospital bills. There’s millions of people with medical bills on their credit. There is no such law that prevents that. The Biden era attempt at a law was shot down before it could even take effect. Hospitals literally sue patients to recoup medical bills. It’s not a great practice but health care is a business in this country and is treated that way. Hospitals could care less what kind of grief they cause patients as long as they get their dime. Hospital bills and ambulance bills are separate by the way. And working for an EMS agency has taught me that they’d send anyone to collections in a heart beat.

I do feel for the parents. This is a shit situation. Americans are taxed at 33% with no government funded healthcare, 100% parental leave, full disability pay etc. Healthcare shouldn’t be a business but here we are.

[u/flag-orama → u/OtherwisePumpkin8942]

Do you really think the ambulance people did anything other than just drive the baby across town?  I would bet $20 the baby never even needed to go to a NICU. The entire US health care game is about risk reduction and extracting $.  The last thing you ever want to happen to you is to wind up in the ER with good insurance.  If you do, the hospital will give you every medical intervention known to mankind and you will wind up in a deeper health hole then you could imagine.  AVOID US hospitals at all costs.  They will either kill you or maim you while robbing you of your financial future.

This will only stop when we stop throwing our money at them.

[u/OtherwisePumpkin8942 → u/flag-orama]

I see this conversation is going no where. You’re responding based on your feelings. I’m responding based on experience and facts. Neither of which you seem interested in. Keep on keeping on. Have a good day.

[u/flag-orama → u/OtherwisePumpkin8942]

Sorry I can't give your the details but my comments are based on experience. let that soak in.

[u/Secret-Rabbit93 → u/flag-orama]

Let what soak in? You provided zero information to “soak”