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Across the country, out-of-network ambulance rides have led to surprise medical bills for patients. Despite consumer outrage, state and federal laws protecting consumers from surprise hospital charges have not extended to ground ambulance services.
Forty years ago, most ambulance services were run by volunteer fire departments and provided free of charge. Today, private companies and venture capital firms are buying up ambulances and billing patients for services. This is called balance billing and it’s illegal if you have insurance, especially Medicare. Your health plan must show you what it pays an in-network provider for the same service, and count that toward your deductible and out-of-pocket limits.
Unlike hospitals, most ambulance services don’t negotiate rates with insurance companies. That leaves many patients with “surprise bills,” even when the ambulance ride starts at an in-network hospital. A federal law that protects consumers from surprise hospital bills doesn’t extend to ground ambulance rides, and states’ laws regulating fees vary widely. Consumers can try to avoid surprises by joining an ambulance membership program that provides a flat annual fee for transports, and the company bills the insurer directly. A program like this isn’t right for everyone, but it may be worth considering if you have a medical condition that could trigger repeated calls for an ambulance.
Whether you have insurance or not, there are many ways to pay your medical bills. Some medical providers, like hospitals, have in-network contracts with your insurance company. However, other services like surgeons, anesthesiologists and radiologists may be out-of-network, which means they charge rates higher than what is contracted by your insurance provider. This can result in a surprise medical bill for you to pay.
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Taxes & Insurance
Many people are surprised by a bill from their local ambulance service. The bills are often much higher than expected and can include fees for emergency transport, first responder services and mileage.
In the closing days of 2020, Congress passed and President Trump signed legislation to provide new federal consumer protections against surprise medical bills. But the bill excludes ground ambulance rides, which can leave consumers on the hook for thousands of dollars.
Ambulance companies often can’t agree on rates with private insurance providers, so they don’t join the insurers’ networks. When that happens, patients can face unexpected out-of-network charges, according to research from Betsy Imholz, special projects director at Consumers Union.
In Connecticut, American Medical Response was forced to pay $601,759 to settle a federal and state investigation into allegations that it improperly billed the Medicare and Medicaid government insurance programs for ambulance services. The settlement also included an agreement not to pursue collection from patients with Medi-Cal or other public health insurance plans.
If you find a medical bill that doesn’t seem right, contact the billing or accounting office directly. They can often lower the charge or work out a payment plan. If the company refused to negotiate with you, try calling your insurance to see if they can help. If you have Medicare, it may be illegal for the company to attempt to collect on a balance after they’ve been paid by your primary insurer (this is called “balance billing”). You can also report these companies to your state insurance regulator or attorney general. doxo is an independent third party that enables secure online payments on your behalf, but we are not affiliated with American Medical Response or any of its billing services. doxo does not store your credit card or bank account information. Honda Financial Customer Service