CONSUMER REPORT–Last March, Consumer Reports writer Donna Rosato found herself in a serious health emergency. She had a fever and a cough and after going to her local ER was rushed to a larger hospital by ambulance.
“I had a cough that wouldn’t go away and a mild fever spiked to 103 degrees F. I went to the emergency room, where I suddenly became unable to breathe. I was put on a ventilator for 10 days and spent a few weeks in an intensive care unit, where I slowly recovered from the flu and pneumonia.” said Rosato.
When Rosato was finally allowed to go home, she was greeted with a pile of medical bills. It might be surprising to learn that the biggest bill she owed was for the ambulance ride which was not covered by her insurance company, and she is not alone.
A recent study found more than 3 out of 4 ground ambulance rides could result in an out-of-network bill. And those bills are likely not going away anytime soon. They are now part of new legislation called the No Surprises Act aimed at eliminating surprise medical bills that can arise from out-of-network providers, often in emergencies.
“If we’re protecting patients from surprise billing once they get to the ER, why not protect them for the surprise bill on their way to the ER?” brought up Chuck Bell, Consumer Reports Advocacy Expert.
Ambulance providers and insurers often disagree on what is a fair rate for this essential lifesaving service. Ambulance companies say they provide costly, labor-intensive services, and insurance reimbursements are too low for them to be in-network.
That means patients like Rosato are often left footing a hefty bill but there are some ways to fight back. “A few states like Ohio, New York, Colorado and Maryland have passed laws against surprise medical bills that include restrictions on ground ambulance billing,” said Rosato.
Also ask your insurer to review the claim. If it’s still not covered, contact the ambulance company and ask if they can lower the charge or offer a payment plan.
“Talking to my insurer did the trick. A few weeks later, I got a notice that Aetna paid the ambulance provider an additional $1,500, covering all but $283 of the original $3,000 bill,” Rosato said.