Ambulance Services – Are you ready to pay?


Earlier this year, I had the good fortune of being helped by a professional crew of paramedics from the Cedar Rapids Fire Department and Area Ambulance, and transported in an ambulance to the hospital … all in a timely manner. Thank you!

A few weeks later, I had the bad fortune of receiving a bill for my out of pocket costs associated with my ambulance ride, i.e., my out of pocket cost with insurance was over $1,000.oo In Linn County, only two ambulance service providers are in-network providers for Wellmark, i.e., the Hiawatha Fire Department and the Mount Vernon-Lisbon Ambulance Service. Those two providers are not viable service providers outside of their service areas.

One solution is for the County’s insurance administrator – Wellmark – to negotiate with the ambulance service providers within the County to obtain discounts for all of the residents of the County. Another solution could be for County and/or other large employers to negotiate a contract with one or more of the ambulance service providers. I have suggested both solutions to the Linn County Board of Supervisors (BOS) in an effort to encourage them to address the issue on behalf of the County’s employees. To date and to my knowledge, the only action taken is the email below from Linn County Human Resources.

Today, at the BOS meeting, I once again asked the BOS to initiate contract talks with local ambulance service providers because I do not want employees being motivated by out of pocket cost considerations to avoid taking ambulances when they should be taking an ambulance. I volunteered to initiate the contract talks with the ambulance providers on behalf of the BOS, if the BOS does not want to initiate contract talks with the ambulance providers.

Out of network providers of ambulance services could charge you whatever they choose when they are not under a contact with your employer and/or your insurance administrator. And unlike the cost of epipens, the cost ambulance services could double or triple without notice – and you will incur a cost for those services – and you will not know about your out of pocket costs until after you have used the services.

What is your employer doing to control the costs of ambulance services for its employees?

Joel D Miller, Auditor

From:
Sent: Thursday, September 01, 2016 2:41 PM
To: !!Everyone – Countywide
Subject: Ambulance Services

Please share with employees who do not have access to email.

All area ambulance services are not created equal at least when it comes to whether they participate in Wellmark’s network or not.

Attached is a list of In-Network Ambulance Providers within a 50-mile radius of Cedar Rapids. An In-Network Provider is required to write off the provider savings and accept the insurance allowed amount as settlement. The member is responsible for the deductible and coinsurance to the provider.

Out-of-Network Providers do not write-off provider savings and the member is invoiced this amount as the billed charge (plus deductible and coinsurance). This creates an additional liability to the member referred to as Balance Billing. The Out-of-Network Ambulance providers within a 50-mile radius are:

Fairbank Fire Department, Buchanan County

Stanwood Ambulance Service, Cedar County

Clarence Community Ambulance Association, Cedar County

Town of Colesburg, Delaware County

Oxford Junction Volunteer Ambulance, Jones County

Area Ambulance, Linn County

Center Point Urbana Ambulance Inc, Linn County

Attached is an Ambulance Claim Payment sample comparing the difference in payment between an In-Network Provider and Out-of-Network Provider. Members can discuss a balance billed amount with their provider.

This is not a NEW arrangement, however, it has come to our attention recently that not all employees were aware of the cost difference depending on the Provider used.

If you have questions, feel free to contact our office at 892-5120.

Ambulance Email.pdf

Ambulance – Payment Example.pdf

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One Response to “Ambulance Services – Are you ready to pay?”

  1. Auditor’s report 8/23 – 9/7/2016 | JoelMiller.us Says:

    […] Taxpayer – Watchdog – Transparency Advocate – Educator – Veteran – County Auditor – Candidate « Ambulance Services – Are you ready to pay? […]

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