If you plan to use a Douglas County ambulance, you probably should plan on honing your negotiating skills, as well.
When an ambulance crew from Lawrence-Douglas County Fire and Medical arrives on a scene, you won’t need to negotiate with them. But Fire Chief Mark Bradford said you very well may want to haggle with your insurance provider after the fact.
Bradford shed some light on the relatively unknown aspects of ambulance bills after a Journal-World reader contacted the newspaper with questions about how the local ambulance provider deals with insurance companies.
Bradford stands by how Lawrence-Douglas County Fire and Medical deals with insurance companies. But he said county residents should also know a key piece of information before they deal with their insurance companies: Don’t pay the ambulance bill you receive without first calling your insurance company to plead your case.
“Customers need to tell their carriers we are the only shop in town,” he said. “There’s nobody else to call. You can’t shop around.”
With that knowledge, insurance companies are usually willing to reduce the balance due, Bradford said.
Fire Chief Mark Bradford said several different ambulance prices are charged by Lawrence-Douglas County Fire and Medical. Here’s a look:
• $547 for a basic ambulance transport in which no treatment is required.
• $643 for an ambulance transport in which basic care is provided. If the ambulance crew arrives on the scene and provides basic care but does not transport a patient to the hospital, the same $643 fee is charged.
• $712 for an ambulance transport in which more advanced life support is provided, which could include multiple intravenous and monitoring devices.
• $8.49 per mile is charged on all ambulance transports.
The Journal-World had received a question about why the local ambulance service doesn’t accept insurance from several major carriers. The questioner, who declined to give his name, was frustrated by the amount of money he had to pay out of pocket for an ambulance call, despite the fact his family has insurance through a major employer in town.
But Bradford explained it is inaccurate to say the ambulance service doesn’t accept insurance payments from major carriers. In fact, the ambulance service will send a bill to any major insurance carrier. But how the ambulance service differs from Lawrence Memorial Hospital, for example, is that the ambulance service doesn’t have negotiated price contracts with major insurance companies. The only exception: The ambulance service does have price contracts with Medicare and KanCare.
Bradford said the ambulance service doesn’t have the resources to negotiate contracts with the many other private insurance companies. Those private companies typically will pay a percentage of the ambulance bill, but it may not be as much as patients expect. That’s why Bradford said residents should call before paying the bill. Bradford said informing the insurance company that Lawrence-Douglas County Fire and Medical has a monopoly on ambulance service in the county can be helpful in getting the insurer to pay a much larger percentage of the bill.
With the exception of helicopter transports, no other ambulance service is allowed to transport Douglas County patients to Lawrence Memorial Hospital or hospitals in other counties, Bradford said. Fire and Medical also is the only service in the county allowed to transport patients from county locations, including LMH, for out-of-county treatment, he said. Other ambulance services can transport patients from out-of-county hospitals to LMH or to nursing homes or rehabilitation centers, he said.
How the ambulance service deals with insurance companies is different from how many hospitals and doctors offices deal with insurance companies. Many hospitals and doctors offices have negotiated price contracts with many insurance companies. Consumers generally see that by noting whether a provider is “in network” or “out of network.” Seeing a provider “in network” generally results in a lower out-of-pocket cost because of the negotiated price contracts.
However, Douglas County’s ambulance service is not alone in how it deals with insurance companies. Deb Stanton, office manger for Johnson County Med-Act, said Med-Act also only has service contracts with KanCare and Medicare. It, too, bills insurance providers, with patients expected to cover any unpaid balance. It wasn’t immediately clear what insurance practices are used by ambulance services in other area counties.