Ambulance Charges Me for Transport - Because I'm Out of Network

[kathak]

My question involves an injury that occurred in the state of: Virginia

I hope this is the right area to post this question. If not, I apologize ahead.

I had an accident on April 23rd were I had broken my ankle. I broke my tibia one and fibula twice. I was screaming in pain and not able to move at all so we had to call 911. The hospital is very close, practically in walking distance so it didn't take very long.

Now when I checked my EOB's online I see that I will have to pay $500 for the Ambulance. My insurance told me that the Ambulance was out if Network, the charge was applied towards my Out of Network deductible and I will have to pay the full charge.

I don't think that is right - either from the Ambulance ot the Insurance. There is no way I can make sure to get an ambulance that is in Network with Bluecross Carefirst while being in pain and barely able to talk at all.

Now I found on another forum this quote:
"If I pay my taxes, do I still get a bill for service? No. If you are a taxpayer of the Fire District, the amount your medical insurance(s) pay for a transport will be considered payment in full. The Fire District recognizes that taxpayers already directly or indirectly pay for emergency medical services with a portion of their taxes."

Unfortunately this is about a District in LA. Does any one know if there is something like this for Fairfax County in Virginia?

Thanks for any help.

[cbg]

This is not something that is determined by law. This is something that is determined entirely by your specific insurance policy. The quote you reference is for employees of the Fire District in question. If I gave you something for Fairfax County, VA, it would be only for employees of Fairfax County. The answer is not going to be determined by where you live. It's going to depend on what YOUR specific policy says.

If this is an insurance policy that you have through your employer, talk to your HR department who can explain it to you. If it's an individual policy, you'll need to speak to the insurance company

[flyingron]

A year ago they started billing for all ambulance transports in Fairfax County. The In/Out network thing is spurious. That refers to private ambulances, the county fire department isn't going to be "in" any network. Further, it has no bearing on whether you are a county tax payer. They do this to try and recover additional funds from everybody's insurance/medicare.


Information on the ambulance bills here: http://www.fairfaxcounty.gov/fr/ems_billing/

There is a fee waiver procedure on there, either for the full amount or the copayment.

[SChinFChin]

I have some familiarity with the subject. I'm with a Senior Center, and as part of our social services program, people bring in ambulance bills asking what it is. We also have seniors getting sick, get injured at our center, we call 911, they don't want to go because of the issue of the ambulance billings.

First, the ambulance bills. Here in NYC, the municipality had charged a fee for a number of years, though not that many years ago, it was free. Throughout the country, there is a "no new taxes" mania, so in many places, instead of raising taxes, they impose fees of all types, ambulance fees being one. Another new one is an "accident investigation fee". so if were in an accident. besides hitting the ceiling over your ambulance fees, you'll get a heart attack over this new one to pay for the police to come. Fees are not new, the airlines go for bag fees, banks go for the "over the credit line" fee, and who knows what type of fees they'll think of next.

I don't know the exact number for municipal ambulance fees here, one client mentioned that the Fire Department charged a $300 ambulance fee, but the following occasion, he was hit with $800. After investigating, it was found that on that particular day and time, all the municipal ambulances were unavailable, so a private ambulance was summoned, and this is what the private ambulance charged. I understand the fee was negotiated down, yet the client was quite upset.

I don't know, but what do you you want 911 to do?? Negotiate the ambulance fee while the victim is screaming in agony??

Several times a month, we have to summon 911 to get help to our facility. Many of our seniors know about the fees, and do not want to go. Recently, one man fainted, and when we picked him up, placed him on a chair, he was shaking violently, even after 911 arrived. His shaking subsided, and then he violently refused to go on the ambulance, saying he can just walk 10 blocks to the local hospital. And 911 finally gave up, and after resting around for another hour, he left. But we kept our fingeres crossed since theoritcally we think he can sue us if he injured himself on the way home, even though he refused the ambulance here. I don't know if 911 requested a signed release or not, but we didn't, don't yet have a procedure in place, and it's something we're checking into right now.

Bottomline is, this is just a reflection of changes in our society, as many are welcoming the arrival of the "free market" into our health care system, so I can see fees of all types coming in. Wouldn't that be fun??