Most people react to a medical emergency by dialing 9-1-1 for an ambulance. In life or death situations, you have no choice — ambulances provide trained paramedics who can administer oxygen, CPR, and other urgent health services.
If your scenario isn’t dire and you want to limit your financial liability, consider other means of transportation to the hospital. Whether it’s for COVID-19 related treatment or something else, ambulance bills can end up costing thousands of dollars that you may be responsible for paying out-of-pocket.
Ambulances May Not Be Covered By Insurance
Ambulance companies are not required to participate in insurance and therefore are often out-of-network. Medicare will usually pick up the expenses. However, commercial carriers often have limitations and may not cover ambulances at all. Others will only cover the costs in full or part after you’ve been admitted to the hospital as an inpatient. This means that if you’re not admitted, you might end up footing the bill.
You also may not have control over where the ambulance takes you. In addition to being charged for mileage and other ambulance fees, you may be brought to a hospital that is not within your insurance network. This can result in out-of-network charges and even emergency room overcharges. If your situation is deemed a trauma, the hospital may even impose a 9-1-1 activation fee upcharge.
Air ambulances also don’t usually participate with commercial insurance carriers. If they are out-of-network with your plan, you could still owe a significant balance. These types of ambulances are used in true medical emergencies when no other option is available, such as in cases where the physical nature of the accident does not permit a standard rescue by paramedics. Air ambulances can result in bills upwards of $50,000.
Is Ambulance Transportation Covered for COVID-19 Patients?
Although the government and most commercial insurance companies have stated that COVID-19 related treatment is covered without cost-sharing with the patient, there are many caveats. If an ambulance ride is related to hospital transportation for COVID-19 treatment, coverage will be dependent on your policy.
How to Dispute an Ambulance Ride Bill
If you’re trying to dispute an ambulance ride or negotiate a reduction, there are a few steps you can take.
- Make Sure the Ambulance Company Has Your Insurance Information
It’s important to make sure the ambulance company has your correct insurance information. Even if the hospital has it, the ambulance company probably doesn’t — especially if you were picked up while unconscious or incapacitated.
- Review Your EOB
To get the benefit of any line items covered by insurance, first, confirm whether the ambulance bills were processed correctly. For example, if your ambulance ride was COVID-19 related, you need to make sure it was processed specifically for COVID-19. If the insurance company received a bill with codes for symptoms such as “shortness of breath” or “cough,” it wouldn’t be considered as a COVID-19 claim since these diagnostic codes are not specific to COVID-19. In this case, call the ambulance company and request that they send a corrected bill with the appropriate COVID-19 specific diagnosis codes.
- Offer a One-Time Settlement
Although it can be difficult to get an ambulance bill reduced, you may consider offering a one-time payment in an amount you can afford. Often, this negotiation can depend upon whether the ambulance belonged to a municipality or was privately owned — municipalities are often more limited in being able to offer a settlement.
Since negotiating a settlement often involves working your way up the hierarchy and can often benefit from a solid understanding of the nuances of claims coding and processing, it may be worthwhile to work with a medical bill advocate who has extensive experience in this area.
- Consider Other Transportation Alternatives
While certain situations necessitate ambulance transportation, consider whether yours does before making the call. If you simply don’t have transportation, a taxi, Uber or Lyft might be a more cost-effective option. If your health condition isn’t a true emergency, you might also consider going to an urgent care facility to also help avoid emergency room overcharges.
Get Help from an Advocate for Help With Your Ambulance Bill Dispute
Disputing ambulance bills or medical bills can be a complex process. Systemedic has been in the medical billing business for over 30 years and knows what it takes to dispute even the most complicated medical bills quickly and effectively.
Offering a fee-based service for those looking to dispute their medical bills, our medical bill advocates are skilled in navigating the insurance maze and will not take “no” for an answer. To get started with resolving your medical bill dispute, contact us for a consultation.