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]

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”