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/Safe_Conference5651]

I live in a major metropolitan area with exactly 1 ambulance company. They do not take insurance because they do not need to. I have paid three times for their amazingly high prices. Once, my 4 yo had "low blood ox" at a pediatrician's office, the office "insisted" we get an ambulance. I followed, at regular speed with no flasher on the ambulance. The ER asked us "why are you here, your daughter is fine". The second time my wife went to an urgent care with a massive headache, urgent care "insisted" she had to go in an ambulance. I followed in my car, at regular speed, no flashers on the ambulance. She has a migraine. Then I had a collapsed lung, I drove myself to the hospital, they inflated it, then made me take an ambulance to a different hospital for the surgery. Again, no flashers. In every case, the bill for the ambulance was WAY MORE than every other bill put together. Yes, I got my lung reinflated at one hospital, had major surgery at a different hospital with multiple days in the ICU, week total in the hospital and STILL the ambulance was by far and away my biggest cost.