Emergency transportation is notorious for leaving patients with large ambulance bills. Has this happened to you? Read on to learn how to eliminate surprise ambulance billing.
What Are Surprise Medical Bills?
Surprise medical bills are most common during emergency situations, when you must receive care from the nearest provider in a timely fashion. If you receive that care from an out-of-network provider, however, you may receive an unexpected (or “surprise”) medical bill.
You may also receive a surprise bill if you were treated by a provider who was not contracted with your insurance, even if they work for an in-network medical facility.
In some cases, the provider you received care from, or the out-of-network emergency transportation company you received ambulance services from, will bill you for the difference between the amount your health insurance paid and what is owed. Since you had believed your insurance provider would cover your costs, this bill comes as a surprise.
Health System Tracker estimates that as many as 1 in 5 emergency room visits leads to a surprise medical bill, so the issue is more common than you may think!
What is the No Surprises Act?
The No Surprises Act went into effect in the beginning of 2022 to protect patients from falling prey to surprise medical bills. This act covers surprise bills from emergency services or treatment received at in-network facilities from out-of-network providers, as well as air ambulance services from out-of-network companies.
Under the No Surprises Act, individual and group health plans must apply in-network cost sharing policies to out-of-network emergency (and some non-emergency) treatment. This applies to out-of-network providers at in-network facilities as well.
Why Does Surprise Billing Happen With Ambulance Rides?
Although the No Surprises Act may save you from a surprise emergency bill, it doesn’t apply to ground ambulance services yet! That’s because Congress has delayed their decision on ground ambulance surprise bills until more studies have been done. Therefore, even under the No Surprises Act it is still possible to receive a surprise ambulance bill and go into medical debt.
Because, according to Health System Tracker, 51% of emergency and 39% of non-emergency ambulance rides lead to patients receiving an out-of-network bill, the chances of encountering a surprise ambulance bill are rather high. In fact, in the states of Washington, California, Florida, Colorado, Texas, Illinois, and Wisconsin, more than 66% of emergency transportation rides lead to out-of-network charges!
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How to Avoid Surprise Ambulance Billing
While it may be difficult to avoid surprise ambulance billing altogether, there are a couple strategies to use that will help keep you out of this situation. First of all, you can try not to take ambulance rides for non-emergency situations. If you ride with an ambulance to a healthcare facility in a non-life-threatening state, it is likely your insurance will refuse to cover the cost.
Then, you may also want to check which ambulance providers your insurance is contracted with in order to know who to call in an emergency. The problem with this strategy, however, is that if you’re in an emergency situation you might not have the luxury of picking which ambulance company to use!
What to Do if You Receive a Surprise Ambulance Bill
If surprise ambulance billing lands you with a large out-of-network balance you can’t afford, you may feel the immediate stress of having to negotiate the bill. Luckily, you have a few options available to you.
One is to try to fight the bill on your own. If it results from an insurance claim denial, you can contact your insurance provider and figure out how to appeal the denial.
Navigating your insurance’s denial and appeal process alone can be challenging, so if you’d prefer to get some help when there’s a large ambulance bill at play, you may want to call on a professional medical billing advocate. An expert ambulance bill negotiator can take over and use their understanding of the complex system to get you the outcome you’re hoping for.
Turn to aJust
At aJust, a dedicated team of medical billing advocates is on hand to help you overcome your surprise ambulance billing. Reach out today to learn how aJust can help negotiate your ambulance denied claim. Just start by filling out this form and aJust will take over the rest, using their expertise to increase your chances of lowering an ambulance bill.