How to successfully negotiate down a $3,000 ambulance bill

[manly]

Ambulances have the highest out-of-network billing rate of any medical specialty, meaning most rides can result in a surprise bill. The new federal law will protect patients from the bills of out-of-network doctors unexpectedly involved in their care. Those protections will not extend to the ambulance trip needed to get to the doctors.

https://twitter.com/x/status/1341511861506875396

 

[Brainonska511]

I agree that it is unreasonable in many emergencies (how do you do that if you are unconscious). But, considering this is the second transport, there is a good chance that the OP knew this second transport was going to happen. If so, a phone call before the transport was probably quite doable to avoid all these hassles and expenses. At the very least, make a call now in case a third transport happens.

A lot of people during talk of reform were screaming that people need to take some responsibility for the costs and have some skin in the game. So here we are: pre-authorizations for non-emergencies, trying to figure out which things will or will not be covered by insurance, and consumers supposedly trying to be smart with their decisions.

 

[GunsMadeAmericaFree]

I went ahead and sent them a letter stating that we lost income during the pandemic (true, my wife was furloughed), we just had some expensive car repairs, and we just paid their other ambulance bill about 3 weeks ago. That, in addition to the several thousand dollars of hospital costs, have drained away our cash.

I wrote to them that we won't be able to pay, but that if they would be willing to accept $1,000 (roughly 1/3 of the around $3k they are asking for), and put in writing that this would be accepted as covering 100% of the debt, then I could ask my parents to borrow a thousand dollars and send to them. I'll just send them the same letter each time they send me a bill. Hopefully they will eventually give up and settle for the guaranteed 1/3 payment.

 

[Brovane]

The hospital simply used their own subcontractor - we were never given a chance to decide who was used for the transport. Considering the cost, I would definitely have taken a day off of work and transported her myself if given the chance.

Was the Hospital in-network? It sounds like a balance billing issue with a out-of-network provider.

What state are you located in? Some states have laws about balance billing.

 

[jameny5]

I work for the federal government but, the premium is high. I guess you could say it's a good trade off. What can you do?

Sent from my moto g(7) using Tapatalk

 

[GunsMadeAmericaFree]

Was the Hospital in-network? It sounds like a balance billing issue with a out-of-network provider.

What state are you located in? Some states have laws about balance billing.

The hospital essentially outsourced the ambulance to a subcontractor. Ohio.

 

[Brovane]

The hospital essentially outsourced the ambulance to a subcontractor. Ohio.

Have you looked into this recent law passed in Ohio about balancing billing?

https://www.wcpo.com/news/state/sta...t=Both force the patient to,is out-of-network.

The Ohio law notably goes a step further, because it regulates when there’s a surprise bill related to an ambulance ride, while the federal law did not cover that scenario.

 

[MrSquished]

Awww did I hurt your feels with my truth?

Not at all. I just don't suffer fools gladly.

I mean even a bunch of the morons in the GQP think our health insurance system is wrong here, so even a bunch of them get that right. That's saying something you are with the special ones that have no clue.

 

[GunsMadeAmericaFree]

Wow, just found out that the new Ohio law covers ground ambulances, and went into effect one day before the one that generated our nearly $3k bill. According to the law, the ambulance company can no longer claim they are 'out of network', the insurance company just pay a tiny bit and then leave the rest to us. Under the new law, that are supposed to work it out between each other instead. Not sure how that will work....

 

[Brovane]

Wow, just found out that the new Ohio law covers ground ambulances, and went into effect one day before the one that generated our nearly $3k bill. According to the law, the ambulance company can no longer claim they are 'out of network', the insurance company just pay a tiny bit and then leave the rest to us. Under the new law, that are supposed to work it out between each other instead. Not sure how that will work....

I expect there will be a lot of finger pointing considering this law just went into effect in Ohio. I hope it works out good for you. I always thought that the balance billing crap was BS.

 

[Lost_in_the_HTTP]

Interesting ....


Woman Billed Over $3K for Ambulance Ride Under 2 Miles: 'Outrageous'

The woman said her father had VA benefits and was being transferred from a VA-approved facility to the hospital for heart failure.


...

 

[GunsMadeAmericaFree]

The ambulance company is still going after us for almost $3k, but I'm going to keep sending them the same form letter back.....

 

[H T C]

The last time i had to pay for ambulance transportation (here in Portugal), it cost me 10€ for a roughly 17Km trip, IIRC: this was more than 10 years ago and i've no idea how much it costs now.

 

[Brovane]

The ambulance company is still going after us for almost $3k, but I'm going to keep sending them the same form letter back.....

I would be careful that they don't try to send it to collections. I know it would be bogus but I have learned never underestimate how low these people will go.

 

[Lost_in_the_HTTP]

Not sure if this applies or not.

Most Medical Debt To Be Removed From Credit Reports

" Equifax, Experian and TransUnion said in a joint statement Friday that medical debt that was sent to collections but paid off will be removed from credit reports rather than being kept on them for up to seven years. The credit bureaus also said they would increase the time consumers have to...

forums.anandtech.com

 

[Meghan54]

I would be careful that they don't try to send it to collections. I know it would be bogus but I have learned never underestimate how low these people will go.

Start making small monthly payments on the bill…like $10. Supposedly, making regular small pmts prevents it going to collections…so I’ve been told.

 

[deustroop]

PARTIAL truth more like sorry.

The best healthcare on earth IS available in the USA BUT if you have to ask the price.... well I think you know the rest even if you won't openly admit it.

I was brought up to love America and believe we were on the side of "right" more often then not.... how in heck does the current healthcare situation here jibe with that?

Healthcare in America makes me ashamed to be an American.




Not sure about medical debt specifically but from what I've read collection agencies usually buy debt for 20-25 cents on the dollar. (20/25%)

I'd start negotiations around that point.

BTW Canada has the best health care "in America" right now because you don't gota pay for it out of pocket ; costs r absorbed in govt'l budgets. Our taxes are higher but health care does not depend on consumer paid expenses at the retail level. Universal coverage for poor and rich. I had hip replacement for " free". The information desk said the wait for surgery was likely 2 months but if I paid cash I could have the surgery tomorrow or go to the states with the same result.
Negotiating payments/settlements is an acquired skill and if the liability is high, its best to search for just the right agent. Reminds me of the joke about the cop outside the courthouse when a lawyer often retained by the local mob walked into court with his client. The cop expressed great admiration for the lawyer, saying the guy once negotiated down a sodomy charge to " following too close ".

 

[GunsMadeAmericaFree]

Start making small monthly payments on the bill…like $10. Supposedly, making regular small pmts prevents it going to collections…so I’ve been told.

I'm not going to make any payments at all. I'm arguing with the insurance company that the new Ohio law against balanced billing went into effect the day before the ambulance trip. With the ambulance company trying to collect, I'm making the case that our savings has been savaged by medical bills, my wife being furloughed during the pandemic, etc. I have offered to make a single $1k payment by BORROWING the money from my parents, IF and only IF they send me a letter stating that it will be accepted as payment in full.

 

[Brovane]

I'm not going to make any payments at all. I'm arguing with the insurance company that the new Ohio law against balanced billing went into effect the day before the ambulance trip. With the ambulance company trying to collect, I'm making the case that our savings has been savaged by medical bills, my wife being furloughed during the pandemic, etc. I have offered to make a single $1k payment by BORROWING the money from my parents, IF and only IF they send me a letter stating that it will be accepted as payment in full.

You shouldn't have to pay them anything more than what is standard for in-network. Regardless of your financial status.
What is the response from ambulance company when you point out the Ohio law about balance billing for the ambulance trip?

 

[GunsMadeAmericaFree]

You shouldn't have to pay them anything more than what is standard for in-network. Regardless of your financial status.
What is the response from ambulance company when you point out the Ohio law about balance billing for the ambulance trip?

No response at all from the ambulance company, other than sending another 'form letter' bill.

No response at all so far from my insurance company after a month, though I submitted my complaint in writing through the proper channels.

I'm hoping that either the insurance company will successfully negotiate the cost down to a few hundred dollars under the new law, or else the ambulette company will finally decide to take me up on the offer of $1k for full payment.

If contacted by the insurance company, I will continue to assert that they need to negotiate the cost down directly with the ambulette company under the new law. If contacted by the ambulette company, I will continue sending them the same form letter, offering to pay $1k as payment in full, if they agree in writing that this would settle the bill as payment in full. Otherwise, I have told them to send it to collections. My understanding is that they typically would get less than 33% of the sought amount if selling it to a collection agency.

 

[nakedfrog]

BTW Canada has the best health care "in America" right now because you don't gota pay for it out of pocket ; costs r absorbed in govt'l budgets. Our taxes are higher but health care does not depend on consumer paid expenses at the retail level. Universal coverage for poor and rich. I had hip replacement for " free". The information desk said the wait for surgery was likely 2 months but if I paid cash I could have the surgery tomorrow or go to the states with the same result.
Negotiating payments/settlements is an acquired skill and if the liability is high, its best to search for just the right agent. Reminds me of the joke about the cop outside the courthouse when a lawyer often retained by the local mob walked into court with his client. The cop expressed great admiration for the lawyer, saying the guy once negotiated down a sodomy charge to " following too close ".

Even with insurance here in the US, you can still have a wait for surgeries even though you're going to be paying a bunch of money out of pocket too

No response at all from the ambulance company, other than sending another 'form letter' bill.

No response at all so far from my insurance company after a month, though I submitted my complaint in writing through the proper channels.

I'm hoping that either the insurance company will successfully negotiate the cost down to a few hundred dollars under the new law, or else the ambulette company will finally decide to take me up on the offer of $1k for full payment.

If contacted by the insurance company, I will continue to assert that they need to negotiate the cost down directly with the ambulette company under the new law. If contacted by the ambulette company, I will continue sending them the same form letter, offering to pay $1k as payment in full, if they agree in writing that this would settle the bill as payment in full. Otherwise, I have told them to send it to collections. My understanding is that they typically would get less than 33% of the sought amount if selling it to a collection agency.

I would recommend calling your insurance company versus writing.

 

[Brovane]

No response at all from the ambulance company, other than sending another 'form letter' bill.

No response at all so far from my insurance company after a month, though I submitted my complaint in writing through the proper channels.

I'm hoping that either the insurance company will successfully negotiate the cost down to a few hundred dollars under the new law, or else the ambulette company will finally decide to take me up on the offer of $1k for full payment.

If contacted by the insurance company, I will continue to assert that they need to negotiate the cost down directly with the ambulette company under the new law. If contacted by the ambulette company, I will continue sending them the same form letter, offering to pay $1k as payment in full, if they agree in writing that this would settle the bill as payment in full. Otherwise, I have told them to send it to collections. My understanding is that they typically would get less than 33% of the sought amount if selling it to a collection agency.

Have you been able to talk to a live person at either company?

For the insurance company, are you getting health insurance through your employer? I know with my employer when I have had serious issues with Aetna. I have gone to my employer's HR and raised the issue with them. Once I signed the proper HIPAA forms, HR would look at the issue. Every time I have done this, HR has resolved the problem with Aetna to my satisfaction.

 

[DigDog]

need to dispel some myths,

there is no such thing as "the best healthcare on earth".

Until a few years ago, many of the most advanced techniques were being pioneered in the US, but not all. Barnard, who became the world's first superstar surgeon, did his famous first heart transplant at Groote Schuur Hospital, in f* South Africa. In 1967.

And, there is no exact idea of what "best healthcare" means. The most difficult, most advanced procedures are done by very talented individuals, leaders of their field, some of which are in the US, some of which are not. Japan, Dubai, Israel, have phenomenal medicine, the UAE has some of the world's most modern hospitals. Various european countries have talented specialists of note that you may need to fly to, from the US, if your illness requires their specific skills. Italy isn't exactly a world leader, and yet we have extremely advanced specialists in all fields of science and medicine.

Also, many countries manage to do a lot more with their healthcare, than the US does. Once cannot just brush away this by saying "it's here, but you gotta pay for it". And again, while some countries with socialized healthcare tend to have longer wait-times, they also all have private clinics, if you are so inclined. There isn't anything a US private clinic can do, that a equally-private yet less expensive Swiss clinic cannot do, in the same time, with the same level of accuracy.

Finally, there's bad hospitals and bad doctors in the US as well. Obviously it's no comparison to ghastly places like Barbados or Ghana, but they are not substantially better than their counterparts in other places. Lol, Thailand has facilities as advanced as the US have, this isn't the 80s anymore.



In regards to the OP, we've never managed to negotiate down an ambulance transfer. Hospital invoices, those we get them reduced all the time, but ambulances we always wind up paying the full amount. I don't think ambulances need to itemize, or otherwise explain their charges, so they get free pass to charge you whatever they feel like.

 

[GunsMadeAmericaFree]

>In regards to the OP, we've never managed to negotiate down an ambulance t
>transfer. Hospital invoices, those we get them reduced all the time, but >ambulances we always wind up paying the full amount. I don't think ambulances >need to itemize, or otherwise explain their charges, so they get free pass to >charge you whatever they feel like.

Yes, generally ambulance costs are difficult. However, my understanding is that if someone isn't paying, and they sell the debt to a collection agency, they will only get paid about 25% of the bill for it.

In this case, the bill is a little under $3,000 - so the $1k I'm offering to borrow from my parents, if the ambulette company will send me a letter saying they'll accept it as "payment in full", would be about 35%, or 10% more than sending it to a collection agency.

I'm assuming they would rather get paid more money than less, so........


I figure that if I keep sending them the same letter, and being patient, it will work out for the better.

 

[Torn Mind]

Not sure why the OP hasn't gone harder and went through the attorney general by now to trigger mediation or whatever. Or threaten to report Medicaid abuse even if he doesn't have Medicaid....