What guidelines are there for ambulances that are not in network Atul Bhingarde asked 8 months ago
What guidelines are there for ambulances that are not in network

Last year I had to call ambulance using 911, the ambulance that came and picked me up and dropped me at emergency room was AMR. Insurance is is not ready to pay in full, as per them the service provide is not in network. They paid partial, and asked me to pay rest of the amount.

Help me understand how can I dictate the terms to 911 who should come to pick me up in an emergency? It is almost impossible to do that.

Where should I appeal, against this anomaly?

Need guidance.

Thanks

 

1 Answers
Answer for What guidelines are there for ambulances that are not in network United Policyholders Staff answered 7 months ago

Dear Atul,

We are sorry to hear about your situation and agree that your insurance provider should cover an emergency medical transport. There’s been quite a lot of media attention on this issue. Your state’s Surprise Billing Act appears to expressly exclude the cost of ground ambulances, and it’s an ongoing fight. https://www.investigatetv.com/2023/09/11/costly-care-patients-their-families-face-unexpected-often-hefty-bills-after-using-ground-ambulances-during-an-emergency/

We recommend you contact the Georgia-based non-profit “Georgians For A Healthy Future” may be able to point you in the right direction. https://healthyfuturega.org/

You should also file a complaint (no charge) with the Georgia Department of Insurance https://oci.georgia.gov/file-consumer-insurance-complaint. Hopefully you can negotiate the cost down further.