AMR Billing
A medical emergency can happen in an instant, and when it does, people often don’t have time to research the best options for care. That’s why many people trust their local ambulance company to give them the help they need. But when those companies bill patients for services that they didn’t actually receive, it can cause a lot of stress. “Surprise medical bills are a huge problem in the country,” says Betsy Imholz, special projects director for Consumers Union, which has collected more than 700 patient stories about surprise medical bills. At least a quarter of those involve ambulances.
Most states have laws limiting ambulance charges, but those laws don’t apply to ground ambulance rides, and they don’t protect patients in self-funded employer-sponsored health plans. That means the vast majority of patients are left vulnerable to unexpected and out-of-network charges for ambulance rides, which can add up quickly. Kaiser Health News reviewed 350 complaints about ambulance bills and found that in most cases the patients got slammed with out-of-network charges they could not afford.
Ambulance companies say they need to charge more to cover the cost of operating expensive vehicles and keeping skilled crews on call 24/7, 365 days a year. They also face a financial obstacle: private insurance companies won’t negotiate with them to be in-network providers, and Medicare and Medicaid reimburse at rates too low to cover their costs.
When patients with private insurance take an ambulance, they typically assume that they will end up in the hospital and their insurer will pick up the tab. But that’s not always the case. In fact, a study of half a million ambulance trips found that 26% ended up with out-of-network billing.
Some states have laws regulating ambulance fees, but those don’t apply to patients in self-funded employer-sponsored health plan, which cover 61% of privately insured Americans. That leaves them vulnerable to surprise medical bills for trips they didn’t anticipate and couldn’t control, a Kaiser Health News review of 350 consumer complaints across 32 states found.
One complaint that caught Kaiser Health News’ attention came from a retired Army sergeant who received an out-of-network ambulance bill for a 911 call he made when his wife had an epileptic seizure at home. The company billed him almost $700 for the 10-minute ride. “It’s a rip-off,” he says.
Another issue is that the information a patient provides to an ambulance company at the scene of an incident can sometimes be inaccurate, leading to billing errors. That’s why a patient should always ask an ambulance company for a receipt, and a copy of their insurance card. Also, if they have an upcoming trip planned and want to know the estimated out-of-pocket cost, they should consider signing up for an ambulance service’s membership program. These programs often cost $30 to $75 a year and ensure that any ride will be covered without out-of-pocket costs, as long as the person is in their service area. American Medical Response Billing