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Friday, June 11, 2010

Ambulance Ride Charges More Than Orthopedic Surgeon

A few months ago my son injured his leg at baseball practice. He was taken to a local hospital where he was given an XRay and a diagnosis that he had broke his leg (fibia and tibia). They informed us that he would have to be transferred since he is a pediatric patient.

We asked if we could transfer him ourselves to the other hospital, and we were told that he had to be transferred via ambulance only and the service was called. We signed the consent papers and off he went to his new destination 27 miles away. He was classified as a non emergency transport.

A month later the bills began to appear in our mailbox. We were shocked to see the bill from that 35 minute ride. There was an initial fee charge of $800 for a BLS non emergency ride and a charge of $16.50 per mile (27 total) for a total bill of $1245.

Meanwhile, the charge for the orthopedic surgeon's time to do a closed reduction on my son’s leg was $1,168, a procedure that took more time than the 35 minute drive.

This is one example of a service that is overpriced. If we had known the charge was going to be this outrageous, we would have discharged him AMA (Against Medical Advice) and transported him safely ourselves. Is the market not competitive enough to drive these prices down, or has the hospital chosen a high cost provider for their patients for another reason? If the hospital incurred the cost, I expect there would definitely be a lower cost.

Lastly, hospitals need to be more responsible to their community by providing information upfront about fees for each transportation service and providing several affordable alternatives.

Based on experience, what ideas do you have on lowering the cost of health care?

Looking for a Care Star? Take me to the Stars now.

28 comments:

  1. What country/state did this happen in?

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  2. Do what the insurance companies do. Write them a check and a letter stating that the cashing of that check constitutes their acceptance as payment in full and that there will be no further payments.

    See what they do...

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  3. My son was taken by ambulance 8 miles from his school to the emergency room due to an asthma attack. All he was given in the ambulance was oxygen. Cost of the ambulance after insurance $275. Cost of the emergency room and er doctors: $250.

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  4. This happened in Southeast Michigan.
    To Anonymous who's son was taken to the ER via ambulance - how much was the actual charge - pre insurance?

    The charge for the 1st ambulance ride from his school to the nearest hospital 5 miles away by the city's EMS crew - $575.

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  5. 'Write them a check and a letter stating that the cashing of that check constitutes their acceptance as payment in full and that there will be no further payments.'
    Don't write a letter - write it on the check itself. Any BS from them later, the bank has a copy of the cashed check - you can (usually?) get an image of the cashed check on your online banking too.

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  6. I fell unconcious a year ago and my 3 mile ambulance ride cost $1100. I am still paying it off because the local fire company did not accept my insurance.

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  7. If your insurance covers ambulance rides I would definitely contact them and ask how to get reimbursed in part/full for an out of network emergency ambulance ride.

    I don't think I've ever heard of a local fire department not accepting a specific insurance. They would balance bill you since they don't have an agreement.

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  8. $681.00 for a non-emergency 1/4 mile ride from my driveway to the ER.

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  9. Usually, an individual (or guardian in the case of a minor) has a right to refuse ambulance transport, even AMA. (Unconcious, intoxicated, or otherwise mentally impared individuals may usually be transported under "implied consent.") Once you sign that form, however, you're on the hook. Like other healthcare providers, the steep bills are a result of uninsured patients. The burden of profitability then lies on the insured, since duty-to-act laws prohibit paramedics from denying care to anyone, regardless of ability to pay. Despite your experience, the reality is that ambulance service is often very unprofitable (ask a non-fire service medic how much he makes) and that inflated bills are an attempt at recovering considerable losses. Comprehensive health insurance reform is the only cure for this unfair practice.

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  10. What does anyone know about an abmulance being able to charge each of the two patients in the ambulence the same mileage fee. My daughter and I were both taken in the same ambulance 23 miles and each of us had a bill for $1483. $483 of each of those bills was for mileage at $21/mile. Can they really charge us each for the same mileage?

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  11. If only his team member had "called the ball", no hospitalization would've been required.

    Just another case where an ounce of prevention is worth a pound of cure.

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  12. But if you leave AMA, you would have to fight insurance co. to cover any of it.

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  13. Pardon me, but you're contracting several hours of time from two trained technicians during that ambulance ride. It is not merely a taxi service; it's a portable medical station that requires upkeep, restocking, and staffing by trained persons.

    You are never REQUIRED to take an ambulance. It is there for emergencies.

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  14. True, leaving against medical advice is not generally a good alternative either medically or financially.

    Having charge information would be helpful prior to decision making. Health care seems to be the only place that you order and consume something without knowing the price tag.

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  15. In the case of inter-facility transports, protocols require a "continuation of care" that would have necessitated an ambulance ride. Due to legal liabilities, the patient will not able to leave the doctor's care in one hospital and be transferred to another without uninterrupted care from an appropriately certified healthcare professional, usually and EMT-B or Paramedic. Depending on the service provider, you may be able to contest aspects of your bill. Furthermore, bill padding (such as the mileage double-dipping that the anonymous commenter described,) is not unheard of. In the Dallas area, several private ambulance services were charged with insurance fraud (primarily against Medicare) for deceptive practices. Usually, however, ethical billing departments can be flexible with patient's invoices in the interest of capturing whatever compensation they can.

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  16. It should be noted that the EMTs and Paramedics that staff ambulances have no knowledge or control of billing rates and practices. They are trained to treat patients and their charting only reflects patient assessment and care. Bills are generated by trained specialists who comb through charts to assign dollar values to various treatments and supplies. Again, it is absolutely true that patients are captive to these unpublished rates and may only mitigate costs by contacting the provider and contesting their bill after the fact. Without comprehensive insurance reform, these practices will not change.

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  17. PJ is absolutely right. EMTs and Paramedics are often dismissed by the public as "ambulance drivers." They are in fact well-trained and stringently tested certified and licensed healthcare providers specializing in emergency first response. If a taxi ride is what you need, call a taxi... and pay for the service. Likewise, in a genuine emergency, call an ambulance- and expect standard-of-care treatment and equipment... and a bill that will reflect that.

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  18. It would be nice to know the charges ahead of time for such services. Doctors do not post their fees anymore either, as they "up code" to capture as much revenue as possible, and have deals with insurances for discounts. This leaves the private payor in the lurch for the original charges, that no insurance company will pay. The same goes for the ambulance services.

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  19. This makes me appreciate my local volunteer ambulance corp.

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  20. it's $50 in Canada for the ambulance service and medical care is generally free.

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  21. I too fell victim to this when my 4 year old was bit by a spider. We took her to the hospital and the swelling was so bad, they had to get her to a hospital that had a special pediatric unit. This was 40 miles away and they told us she had to go by ambulance. You could imagine my suprise when I received a bill for $3,200 for the ride. So now I pay the collections agency $20 per month.

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  22. Medical care in Canada isn't free by any means. You pay in taxes, wait times and in some cases, maybe even your health.

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  23. I have not read a comment that says the ambulance companies should not be paid for their services. I am sure their overhead is tremendous. I just want to know the cost up front. Let me make that decision. This is the primary reason US health care costs are out of control.

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  24. I owen a Private ambulance company and I see all your point and feel your pain. I would love to be able to charge low rates but when it cost me just over $15,000 in insurances per ambulance, $45,000 to get the equipment for them, the ambulance cost $120,000 or more my last one cost me just under $157,000 and they are only good for about 100,000 miles or 5 years. Then on top of that you have my cost of having a place to put them, taxes, not getting paided. The biggest cost is the BLS and ALS people for them. One medic ambulance staffed 24 hours a day 7 days a week cost me just over $500,000 a year. I know you think that we are making good money but last year was my best year and after paying everything I made just over 18,000 per ambulance and I have four. If we didnt love what we do we wouldnt do it.... Things need to change... We need to be able to buy equipment thats not maked up 300% because it has a stamp on it from the goverment saying its ok for the USA. I just got a defib unit last week that cost us $31,988 and the rep also covers Canada and he showed be he sold the same unit in Canada for 12,599 in US money and was able to do so because it didnt need a sticker on the unit saying that are goverment OKs them for us in the USA... Its a joke... I need 3 more of these with in the next year... Thats were all your money is going, staff, tax, and over priced equipment...

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  25. $2080 for a 15 minute, non-emergency transfer because the ER we went to had no open pediatric beds and they wanted to monitor our newborn for 24 hours... after leaving us in the waiting room for 3 hours.

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  26. My husband had a second kidney stone attack in two weeks time. I drove him to the ER the first time but the second time he was so sick and in tremendous pain that I decided to call 911. I explained to the operator that we did not have insurance and asked if there would be a charge from the ambulance service. She connected me to the dispatcher who explained to me that because of the county we resided in, there would be no charge. Two weeks later I received my hospital bills and discovered that the second charge was $400.00 dollars more than the first ER visit. When I questioned the difference, I was told that the fact that my husband arrived in an ambulance raised the level of treatment that they charged. So the hospital is charging us for the ambulance even though it cost them nothing in the way of extra medical service or personel. I do not intend to pay this extra charge even if it means a smudge on my credit!I don't mind paying for a service but I refuse to be taken advantage of!

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  27. Ambulance can never charge this high. Their main duty is to help patient reach hospital as soon as possible. In India, the just is 300/- (Indian rupees) one way. What you are mentioning is way to expensive. Even orthopedic surgeons in India don’t even charge $1,168 as their first visit fees. They charge almost half of what your ambulance charges are.

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