r/HospitalBills • u/Deep-Examination7086 • 19d ago

How to handle ambulance bill

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.

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u/flag-orama 18d ago

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.

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u/OtherwisePumpkin8942 18d ago edited 18d ago

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.

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u/Deep-Examination7086 18d ago

More catastrophic than these outrageous surprise bills?

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u/Secret-Rabbit93 14d ago

To me at least me or my baby being dead would be more catastrophic than any bill so yes more catastrophic than surprise bills.

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u/Deep-Examination7086 14d ago

I bet it is, because you work for the people gaming the system.

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u/Secret-Rabbit93 14d ago

You think my tiny EMS employer is gaming the system, really? It’s them and not blue cross Cigna and united? I guess that’s one thought.
You’re acting like I’m taking in all these profits. I make 18 dollars an hour. With almost 15 years experience, management experience critical care training a degree all the things. And I will stand on the hill that my kids being alive outweighs any imaginable bill.

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u/Deep-Examination7086 14d ago

Maybe it’s time to find a better career path if you’re making less than a McDonald’s employee after 15 years lol