Ambulance companies have been slapped with hundreds of Better Business Bureau complaints over the past three years—a fraction of the thousands that hospitals, physicians, dentists and other trusted healthcare providers receive. And yet, the vast majority of these complaints don’t deal with ambulances at all.
Almost four decades ago, most ambulance rides were free for patients and provided by volunteer fire departments or municipal ambulance services funded with local taxes. But now, most are private companies owned by venture capital firms that use aggressive billing practices to maximize profits. Private ambulance companies often charge by the mile and even for a single service like providing oxygen. The charges can add up quickly, and patients are left with surprise bills, according to a study that looked at more than half a million ambulance trips.
Consumers Union has collected more than 700 stories of surprise medical bills, and at least a quarter of those involve ambulances. The most common reason is that ambulances are out of network, but many patients don’t know that until they get the bill. The problem is exacerbated by the fact that federal and state rules protect patients from balance-billing by doctors and hospitals, but there are no similar protections for ambulances.
The problem begins when ambulance companies decide they can’t get fair prices from insurers and so decline to become part of the insurance network. That’s not always done out of greed, but because ambulance services are often cash-strapped and have to make a choice between taking less money from insurance companies or stopping their operations, the choice is rarely made in favor of the patient, explains Betsy Imholz, special projects director at Consumers Union, which collects stories of surprise medical bills.
When an ambulance is out of network, the insurance company pays only a small portion of the cost—in this case, about $750 for Wilson’s 10-minute ride. Patients then face the prospect of paying a large bill, and some decide not to take an ambulance when they need one because they fear the financial burden. “It’s a horrible thing for people to do to their own health,” says an Atlanta physician who has spoken out about the issue.
The good news is that there are steps to fight back against out-of-network ambulance charges. Consumers can try to negotiate with their insurer, but if that doesn’t work, they can also file an appeal with the help of this guide from the Patient Advocate Foundation. And, if the problem continues, they can ask their state insurance regulator or state attorney general to investigate. In the meantime, lawmakers are pushing for changes to federal rules protecting patients from surprise hospital bills and considering adding protections for ambulances, too. Hopefully, this will put more pressure on insurers and ambulance companies to be fair with their patients. Then, maybe fewer people will be scared to call for an ambulance when they need it. And that could save lives. American Medical Response Billing