I previously wrote about ambulance surprise bills. I discovered the issue after my wife received an invoice for $4,299.56 – the amount billed by the ambulance provider for the nine mile ride to the emergency room. Unlike many others, my wife and I were fortunate that our health insurer covered the ambulance invoice – we were left with only a $50 copay. The experience did open my eyes to the nightmare many Americans experience as a result of ambulance surprise bills. I have become wary of ambulance providers.
My wife’s ambulance ride took place in April 2023. The ambulance provider sent us a bill in May. My health insurer issued a check to the ambulance provider on June 9, 2023. However, the ambulance provider’s invoice remains “pending” six months after being paid for by my insurer. It is November, and I am still trying to pay the final $50.
After reading all the horror stories about ambulance surprise billing, I wanted to make sure I took the initiative to get my wife’s bill resolved in full. I wanted to pay the ambulance vendor the $50 copay I owed and move on. My main concern was that the bill would be forgotten or slip through the cracks and then somehow end up at a collection agency. My approach has always been to be proactive when dealing with these types of issues.
Trying to Get Resolution
On August 3, 2023, I called the ambulance provider’s billing department and asked a representative for the status of my wife’s invoice. The claims representative stated we owed $654. I informed him I was looking at my health insurer’s explanation of benefits, for the payment of the ambulance ride, and it stated I only owed a $50 copay – I informed the representative my insurer paid the remaining portion of the invoice in June. He sounded confused and put me on hold. The representative returned only to say I was right about the payment and the file was still under review. He explained I should receive an updated invoice in a few weeks. Do you think I got an invoice?
Time passed and it was now November. The ambulance bill remained unresolved. I had to call the ambulance provider again to follow up.
On November 10, 2023, I called the ambulance provider. I provided the customer service representative with all the identifying information and then explained the history of my wife’s file. She put me on hold. I was on hold for close to 10 minutes. When the representative came back, all she could tell me was that my wife’s file was under review. She stated we would have an invoice in one week. It has been three weeks. Still no final invoice.
Today, November 27, 2023, I called the provider again. I will save you the long story. The representative I spoke with stated I could not make a payment today because the file was under review. He told me he was going to expedite the review of the file and I should call back in two weeks to make the final payment. We will see what happens in two weeks.
Navigating health insurance billing issues are typically confusing. The frustration intensifies when everything falls on you to pursue progress in resolving your claims or issues. If you discover yourself entangled in this mess, try to stay calm, maintain composure and persist in your follow-ups. No doubt it will take up your time, and no doubt it will frustrate you. Nevertheless, it’s a task that demands your attention.
On a side note, I just read an article that on October 8, 2023, California Governor Gavin Newsom signed bill AB 716 that will end the loophole in state and federal surprise medical billing – for surface ambulance rides. The new law will prevent private insurers and ambulance providers from billing patients more than their in-network cost-sharing for emergency and non-emergency ambulance services. Individuals without insurance will not be charged more than the Medi-Cal or Medicare rate for ambulance services, whichever is greater. If you live in California you are in luck. Hopefully, other states will follow a similar path.