Can I Count on Insurance to Pay for my Ambulance or Ambulette Ride?
There are some similarities and differences between ambulances and ambulettes. In short, an ambulance is designed for patients who require immediate medical attention. These vehicles tend to be equipped with emergency medical equipment that may be needed when transporting a patient with severe injuries or symptoms requiring immediate medical attention.
Briefly summarized, an ambulette is a vehicle designed to transport patients who do not require immediate medical attention. These vehicles are most often not fitted with medical equipment but can feature a lift gate or ramp to easily move wheelchair patients in and out of the vehicle without having them leave their chairs.
When it comes to insurance coverage, nearly all coverage is dependent upon the insurance company you use and the policy you hold.
When an ambulance ride is medically necessary, it is common for insurance providers to cover some of the costs.
Since ambulance rides are not covered under New York State’s Surprise Bill Laws, out-of-network providers are able to bill patients for the remaining balance that the insurance company does not cover. For example, if your insurance ride costs $1,500 and your insurance company covers $500 of it, you will be held responsible for the remaining $1,000 balance.
According to the New York City Fire Department, they charge $420 for a ride in a Basic Life Support Ambulance, $535 for a ride in an Advanced Life Support Ambulance, plus $6 per mile and $50 if you are provided with oxygen. However, ambulance rides furnished by out-of-network providers will likely cost much more than that.
Part of the reason why ambulance rides are so expensive is because patients not only pay for the services received, but also for the cost of the ambulance to be willingly available in the service area. Not only that, but patients also pay for the training that service providers receive in relation to medical services in the vehicle. In addition, there is a minimum of two service providers for every patient, which is not the case for emergency room visits. Ambulance rides are highly labor-intensive.
Local and state regulatory requirements must also be met, which drives up the cost of maintenance. New York state is also able to impose surcharges on patients, which helps drive up the total cost.
Patients who ride in an ambulance are charged one way or another: either for basic life support or advanced life support. Costs are not always itemized for ambulance rides as they are with other medical treatments. Base charges vary from provider to provider, insurance coverage, and location.
Patients who ride in an ambulette are billed similar to the way ambulance billing occurs, but at much lower rates.
Ambulette ride costs include base rates, mileage fees, wait-time fees, and additional attendant fees. Wait-time fees are assessed if the ambulette is required to wait for the patient to finish receiving care at the hospital so the patient can also receive a ride home. These fees are usually assessed on 15-30 minute time blocks.
According to the industry-leading web-based transit scheduling software company, Ecolane, there are various ambulette base rates that are dependent upon the day of the week, time of the day, holidays, and services rendered. For example, the average ambulatory base rate on a weekday during business hours is between $25-$30. If a stretcher is required and the ride occurs on a holiday, the base rate prices jump to $150-$250.
If you require an ambulette ride to a medical facility, don’t put it off. According to a study published by Health Services Research, veterans who had to wait 31 days or more for an ambulette ride to a medical facility had considerably higher mortality odds than those who waited less than 31 days for medical care.
Insurance coverage for ambulette rides varies just as much as it does with ambulance rides. It is difficult to say how much of an ambulette ride will be covered by insurance because it is largely dependent upon the insurance provider and the policy the patient holds.
Some insurance companies offer a Non-Emergency Medical Transportation (NEMT) program that helps cover the costs of ambulette services for policyholders. This can help cut costs that the patient is responsible for.
Can I Dispute High Ambulance or Ambulette Costs?
If your ambulance or ambulette bill seems unreasonably high, there are a few ramifications you can take.
If you received an itemized bill, review it in full for errors. If you do not receive an itemized bill, request one. Keep your eyes out for duplicate charges, incorrect service dates, or inaccurate mileage. If you do find errors, contact the billing department immediately.
If you don’t come across any errors on the bill, it is still wise to contact someone in the billing office. Speak to someone who has authority and can negotiate your balance. Keep in mind that Medicare and insurance companies almost never pay the massive costs that consumers are charged. Most insurers negotiate deals with providers so that they pay a small fraction of the total cost of care. According to a study conducted by NerdWallet, Medicare enjoys a 73% discount on the average hospital bill. Even though as a consumer you will most likely not be awarded a discount quite as hefty, it is beneficial to know the discounts awarded and to whom before attempting any negotiations.
Contemplate how much of your bill you are truly able and willing to pay. If the ambulance or ambulette service won’t deduct much from your bill, decide on an amount that is equitable and justified for the services rendered. If you’re able to negotiate a lower price, it may be mutually beneficial since the majority of bills in collections are never actually paid in full.
In addition, if you are able to set up a discount with a formal payment agreement, be sure you get it in writing. Even though verbal agreements are legally binding, they are much harder to prove.
It is not simple to negotiate the costs of an ambulance or ambulette service, but it’s also not impossible. Be insistent. Keep your cool. Don’t take no for an answer.
If all else fails, call your lawyer. The attorneys at Koenigsberg & Associates have more than 20 years of experience, have successfully handled thousands of cases, don’t charge legal fees unless compensation is recovered, and provide personalized, results-driven service.
Call Koenigsberg & Associates today at (718) 690-3132 to speak with an attorney about your potential case.