Plan to end exorbitant ‘surprise’ ambulance bills heads to Congress
https://www.theguardian.com/us-news/article/2024/jul/21/ambulance-surprise-bills-congress
Plan to end exorbitant ‘surprise’ ambulance bills heads to Congress
https://www.theguardian.com/us-news/article/2024/jul/21/ambulance-surprise-bills-congress
23 comments
Good. My mom got one of those while being transported from a hospital to a care facility to rehab after an illness–about $1500 for a mile long ride, and we weren’t even offered the option of driving her ourselves, which was doable in this instance. We were able to get it almost totally wiped out because of the lack of transparency and choice.
And it won’t go anywhere because that would help people.
Arriving soon…ambulance company lobbyists to keep your prices ridiculous.
The health insurance industry has turned most of health care in this country into an extortionist, money making scam. The insurance companies do not and have never done anything, anything to help anyone’s health. They are nothing more than a parasitic middleman and contribute nothing of value to American life. They are the central reason health care costs so much more in the USA than anywhere else.
My uncle died in his apartment and was charged $1500 for the transport to the morgue. They never got their money.
I’ll never forget the video of the injured woman on the subway platform begging not to be taken to the hospital by ambulance because of the cost.
Lifehack: establish a good relationship with your pizza place. A pizza delivery driver will charge way less than an ambulance and they often have quicker response times. They’re also way less likely to get the cops involved.
And one side will oppose it, ’cause.
My mom broke her ankle just before going to dialysis, that woman had such a high pain tolerance she sat through the whole session with her ankle swollen and flopped to the side, then the center called an ambulance to take to ER literally across the street about 200 ft away. $500 insurance doesn’t cover any of it. Wtf.
My mother not long ago was in a nursing care facility based on her dementia. One time, when I was away from home, and unable to come take her to the ER, the nursing home called an ambulance which took her to the ER.
My mother received a bill for that ambulance trip, for $1200. It was not covered by Medicare, as Medicare declared ambulance transport as ‘Not Medically necessary’. I understand the nursing home requires action to be taken when a patient/resident needs medical care, so I don’t fault the facility. However, my mother, who is on a fixed income with all of her income and savings going to care for, now have to come up with a cab ride costing $1200. Truthfully, the ER did nothing, just let it stop bleeding. It would seem the ambulance company should be aware that transporting someone for a nosebleed isn’t ‘medically necessary’, so they should get signoff from a responsible person, since as I said my mother was not capable of making the decision, that the cost wouldn’t be covered. I know that when my personal physician orders some specific tests, when I go to the Lab they will make me sign a disclosure ‘Medicare may not pay for this test, you will be personally responsible’.
I told the nursing home medical care person the issue with my mother’s ambulance ride, and told her what Medicare said. In my view is if they, called an ambulance, they would need to sign-off it was necessary, and they would be the responsible for the charges if not medically necessary. I’m also sure the response of the nursing facility would be, we are just caring for the residents, but they are taking care of their medical needs! They need to be responsible.
SORRY for the RANT, but this just annoyed me and my family.
Having worked on an ambulance for most of my life I will tell you why this happens. Ambulance companies only recoup monies for about 20-30% of transports and insurance companies never pay the full amount, Medicare and Medicaid pay pennies on the dollar. Most states do not list EMS as an “essential service” like police and fire departments, so EMS receives little funding from tax dollars. These exorbitant bills are the result of ambulance services trying to get paid so that they can keep operating as they will continue to show up, provide treatment, and transport patients regardless of their ability to pay, and will concentrate efforts on getting those who can pay to do so. The way other countries have solved this problem is by declaring EMS an “essential service” and making sure it is funded through taxes, here in the US this is decried as “socialism” and fought by some large privately owned ambulance services (AMR, Rural Metro, and Falck being the largest) as they stand to loose significant money if we were to institute a public EMS service across the nation. If this bill passes and becomes law expect a number of ambulance services to close, large corporate EMS agencies to cut services and staff, and accessing EMS to become more difficult, especially in rural areas. Do I support “surprise billing”? No, but without public funding, increased reimbursement from Medicare and Medicaid, and a requirement for health insurers to pay for ambulance transport EMS cannot continue to operate at current levels.
Hey I’m a paramedic, I think at least partially some confusion arrives regarding our billing process.
Just for some background I used to be the Assistant Chief of a third service ambulance company (Funded by taxes and insurance payouts) in the north east. I was responsible for clinical care, and billing practices at the agency.
Our industry is founded relatively recently in the 60-70s. Federal laws governing our practice have not changed much since then. Below are some links, if you are interested in our founding.
EMTALA: https://en.m.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act
The White Paper: https://en.m.wikipedia.org/wiki/Accidental_Death_and_Disability:_The_Neglected_Disease_of_Modern_Society
There are three main levels of interactions that we have with patients when 911 is called:
Refusal/cancellation: usually* are non-billable, or included in your municipality taxes, or a smaller fee. We would get “X” dollars per calls with this disposition.
Treated transported BLS: this means that an EMT-B has responsibility for the care of the patient.
Treated transported ALS: this is paramedic levels of care and is much higher than a BLS Scope of practice.
Levels of EMS care: https://www.ems.gov/assets/National_EMS_Scope_Practice_Model.pdf
(There are also intermediate levels of certifications that I won’t go into here)
With allllll that covered, you can reasonably expect to see three different tiers of bills from us. BLS/ALS/Refusal (depending on how your town does taxes).
The rub here regarding this article is that up until very recently we could not bill insurance companies directly. Meaning that if you call 911, we would bill you, and your medical insurance company will send you a check at a later date. This is also true in my area regarding you car insurance and motor vehicle accidents. You are also billed per mile, depending on the level of care.
In some places, your taxes will cover X BLS level transports per year. However, if it’s an ALS level transport, you will get a bill with the difference.
Another point to make is that, we are UNABLE to cover the cost of supplies with the money Medicare/Medicaid repays us. Just about $200-400 per transport. Private insurance covers the whole cost, $1300-3000. And is what we like to see for obvious reasons.
To run 1 ALS ambulance 24/7 365, is around $500,000 per year. That’s everything, the rig, payroll, insurance, equipment, gas….
We are also not included in your hospital bill (unless it’s a hospital based EMS system). So, we’re usually the first bill you receive; and in some cases before you have met your deductible for the year*
TL:DR ambulance companies can’t bill you insurance directly. We bill you, insurance pays you, you pay us.
I hope this info clears some stuff up. I’ll reply if I can to any questions as I am at work.
Guess which party will stop this from becoming law?
Just got denied payment on a crown for a cracked tooth. Fuck the insurance industry.
Never understood them. Bus ride here is $600 + mileage . We pay for everything thru our taxes, so why get doubled charged ? If it’s a private service, I get that, but 90% part of the fire station .Even have the Fire Dept logo on the side .
The exorbitant cost of health *CARE* is the problem.
Health insurance shouldn’t even exist.
What is an ambulance bill?
My kids would commonly get kroup cough. First time it happened we were freaked out, called ambulance. They showed up. Spent 20 mins helping make sure he was breathing ok and they left without taking him.
I got a 1500 dollar bill in the mail for an ambulance ride that never happened. Had to fight with them until they finally sent an updated bill for something stupid like 460 dollars which I paid. Still was crazy
I’ve always heard it’s like $1500 to ride in an ambulance. It’s cheaper to just die.
Decades ago I had an auto accident and was transported by ambulance to a hospital. The distance from accident site to hospital was about 5 miles. Bill for the ambulance was about $1600. At the time it was not covered by insurance.
Isn’t it so nice to read about how there used to be a great system in place until President Ronald Reagan decided to cut it for literally everything?
Can they make it retroactive so I can get my $2000 back.
I was in a car crash in Hilo back in early 2021. Other car decided to not stop at any of the stop signs bisecting a 4 lane highway and subsequently t boned my rental car. I broke my arm pretty bad in the crash.
5 miles in an ambulance to the nearest hospital cost $9500. Thankfully I had the car rental insurance and it was completely covered. There was no way I could drive there,let alone get myself out of the car without medical assistance. It shocked me the bill was that high for the following services rendered: ride to the hospital, helping getting out of the car, and drugs dulling the incredible pain and trauma in my arm.
ALWAYS GET THE CAR RENTAL INSURANCE!! I wish we lived in a world where hardworking Americans at any income level have a true right to life.