The Liberal Gun Club Forum

So I had a truly scary attack of diverticulitis with explosive bloody diarrhea and of course it was over a long holiday weekend and at night. Called 911 and was taken to my local hospital where I was admitted almost immediately. Several days, many IVs and a transfusion later they took a long look where the sun don't shine but deemed me dischargeable.

Now the really interesting part.

I got a bill for nearly $2000.00 due immediately from the EMS company. There was a note saying that payment within 30 days MIGHT qualify for up to a 60% reduction.

I'd presented the folk with Medicare and Supplemental insurance IDs and signed the forms authorizing billing medicare so there was absolutely no reason for such a bill.

Called my Insurance company and they confirmed 'Do Not Pay' then called the billing department number on the invoice.

First response was that there were many reasons Medicare could not be billed and then 'there needs to be a valid signature on file' and the dance continued. Eventually though it was established that they did have a signature and the correct name and correct birth date and the correct Medicare Member number and that they would bill Medicare.

But how many folk actually go ahead and pay such bills? How often do such people actually get reimbursed? How many folk call and agree to pay early so they get the discount and are happy? How often do the bills get sent to Medicare even when they have been paid by the individual?

Balance Billing is how much of these ancillary services--Ambulance, EMT, Anesthesia--milk and ROB the patients who are in distress and simply squeeze every drop of blood out of you. How? Because they won't sign contracts with the insurance companies, and they are funded by venture capitalists who don't give a flying fuck about bankrupting patients.

I got balance-billed about $3,500 for a ONE MILE ambulance ride! (out of about $4,400) My insurance company, and much hassling back and forth with the ambulance company, owned by Atlantic Health, and finally paid them most of the full amount, and I had a few hundred to pay. But this is a common problem and yet ANOTHER one that ReThugs in the House and Senate won't solve. This is why EVERY excuse they make against a National Health Service collapses. Anyone who tells you we have THE best health care in the world is simply full of shit.

Had a similar problem with EMS a few years back - was told upfront Medicare/Supplemental wouldn't pay and were demanding I pay $750.00 (don't recall total cost). I didn't and bill was eventually paid by Medicare/Supplemental.

Going round and round now with another company that supplied an ILR (Insertable Loop Recorder) heart monitor. Received a letter from them last year that they were no longer monitoring and it would be monitored by my electrocardiologist - yet they are still billing Medicare $1000.00 monthly - CMS pays a portion, then BCBS pays their share ($56.95), then I get a bill for the $56.95 from company no longer monitoring even though I have paperwork showing BCBS paid. Trying to get the cardiologist group billing dept. to call to discuss has been like pulling hens teeth. No progress. I suspect fraud - CMS not much better getting sorted.

My heart felt sympathy on diverticulitis - have suffered from same for years. They keep threatening taking about 6" of my colon, but have dodged that bullet so far. Good luck.

Sounds like a private contract EMS entity that is having cash flow problems, probably due to all the COVID cases. The state EMS authority is probably getting complaints about them.

Years ago wife was at work and started having Chest Pains. The EMS was called and the ambulance took her to the hospital where the Dx wasn't heart problems. Ambulance Company billed $1,250 for the IV and ride. Wife had insurance through her work at the college and it is the Texas State college insurance. The Insurance refused to pay because the contract city ambulance Medstar was not in their network of providers. We wound up paying the bill after much arguing. What was bad that is the city contract ambulance and Fort Worth is a one horse town when it comes to EMS services.

As for the diverticulitis. I suffered with it for years, even with watching my diet and following the rules I would still have flareups. Working as a Home Health nurse I saw patients that had done the same thing as I was doing and still had one of the diverticula rupture. Then they have surgery and a permanent colostomy. That is if they get to you in time and the peritonitis doesn't spread and kill you first. I elected to have the colon resection and the doctor remove seven inches of colon. I am happy I did that as I have had no issues, no flares, and eat what I want.

The billing practices for private and public ambulance services are almost always the same. Most fire departments outsource their billing to private billing services so they don't have to have a 40 person billing office, and VERY expensive AR software.

Keep in mind, there is ALWAYS recourse for a "bad" bill. If someone is over 40 and has chest pains, its exceptionally difficult for an HMO to wiggle out of paying that.

Since 911 ambulance services are dedicated to a single provider for a geographic location, you CANT choose your 911 ambulance provider. So the HMO has to pay it. They can refuse, but it's a very tough one for them to beat.

For less life threatening "emergencies", you might want to familiarize yourself with the procedures of your HMO. Some do have non-emergent ambulance contracts that work outside of the 911 system for non-life threatening issues.

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FrontSight wrote: Mon Sep 20, 2021 11:50 am The billing practices for private and public ambulance services are almost always the same. Most fire departments outsource their billing to private billing services so they don't have to have a 40 person billing office, and VERY expensive AR software.

Keep in mind, there is ALWAYS recourse for a "bad" bill. If someone is over 40 and has chest pains, its exceptionally difficult for an HMO to wiggle out of paying that.

Since 911 ambulance services are dedicated to a single provider for a geographic location, you CANT choose your 911 ambulance provider. So the HMO has to pay it. They can refuse, but it's a very tough one for them to beat.

For less life threatening "emergencies", you might want to familiarize yourself with the procedures of your HMO. Some do have non-emergent ambulance contracts that work outside of the 911 system for non-life threatening issues.

In her case Chest Pain is considered life threatening till proven otherwise. She was not in an HMO it was standard BCBS from the State of Texas for State and Community Colleges. Also the Medstar Ambulance is a quasi government owned ambulance service. The problem was with BCBS saying they didn't contract in network with Medstar even when it is the only ambulance service in town. BCBS just pulled the usual crap. Later we found out that Medstar had an annual payment plan of fifty dollars a years for family that allowed no cost emergency ambulance service in Fort Worth and surrounding contrasted cities. We paid that every year when we lived in Fort Worth.

TrueTexan wrote: Mon Sep 20, 2021 3:13 pm
In her case Chest Pain is considered life threatening till proven otherwise. She was not in an HMO it was standard BCBS from the State of Texas for State and Community Colleges. Also the Medstar Ambulance is a quasi government owned ambulance service. The problem was with BCBS saying they didn't contract in network with Medstar even when it is the only ambulance service in town. BCBS just pulled the usual crap. Later we found out that Medstar had an annual payment plan of fifty dollars a years for family that allowed no cost emergency ambulance service in Fort Worth and surrounding contrasted cities. We paid that every year when we lived in Fort Worth.

Membership... There are a ton of ambulance and especially air ambulance services that offer that. For someone young and healthy its a waste of money. But for someone who may need an ambulance once or twice a year; it's worth every penny and then some.

Glad you're doing better, Sig.

wings wrote: Mon Sep 20, 2021 6:24 pm Glad you're doing better, Sig.

Me too but it's been an experience.

lurker wrote: Mon Sep 20, 2021 6:57 pm

sig230 wrote: Mon Sep 20, 2021 6:41 pm

wings wrote: Mon Sep 20, 2021 6:24 pm Glad you're doing better, Sig.

Me too but it's been an experience.

https://www.google.com/search?q=are+you ... yEhVJXjJVM

Yup. I actually got to see him back in the late 60s.

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Only time I ever needed the paramedics was many years ago when I was working, it was for a breathing problem (asthma). It was resolved by the time they arrived, they just checked me over. It was a city ambulance/fire service, don't remember ever getting a bill.

This prompted me to recheck EMS services in my area. The town I live in is covered by county EMS and fire services, as soon as I leave the town limits coverage is by a private non-profit membership service ambulance.

lurker wrote: Mon Sep 20, 2021 7:15 pm

sig230 wrote: Mon Sep 20, 2021 7:06 pm

lurker wrote: Mon Sep 20, 2021 6:57 pm
https://www.google.com/search?q=are+you ... yEhVJXjJVM

Yup. I actually got to see him back in the late 60s.

he and janis were both dead before i became fully aware of them. orlando fl was a backwater.
lesson learned: no matter how cool you (think you) are, some drugs will kill you. choose carefully.

I think I'm younger than you, Lurker, but growing up in commuter reach of NYC (my dad commuted in and my brother did until Covid), I was exposed to lots of that stuff and was familiar with the music of Jimi, Janis, and Jim Morrison well before their premature demises. I do remember something about Hendrix having a cardiac issue before Woodstock and it being iffy if he was going to even appear. It took me many, many years to fully appreciate the depth and power of his primal scream version of the National Anthem.
(Trivia note: For most of our history we had no national anthem and it was only rectified when Ripley's Believe It or Not electrified the nation by publishing that in November of 1929!)

I was three years younger than my sister who got to see Jimi and The Doors along with a couple other great bands I never got to see. Yup, they came to Tucson I was so pissed my parents wouldn't let me go.

The Doors in Concert, 1968
Memoirs of the Times and a Special Evening Under the Desert Sky with the Doors
http://articles.waiting-forthe-sun.net/ ... ncert.html

My pitiful teenage prayers were answered when I was actually given permission to go to a Doors concert. This was the kind of happening that every teenage music lover dreams of, and in those days, it was actually affordable, and you didn’t have to be in a lottery to get a ticket. Tucson in the Sixties had a lot of drugs to offer but not a lot in the way of music venues. I saw Jimi Hendrix, Frank Zappa and Steppenwolf perform in a Roller Skating Rink, for God‘s sake! You know back in the day, it was REALLY about the music. Looking back, I realize that we were damned lucky to see the huge names we did. Now, it seems the music industry generally targets only the cities that will guarantee a huge financial return. There were no corporate sponsored mega-venues then, especially for the likes of Tucson. We sometimes went to Phoenix, where there was “The Coliseum” to see groups if we were lucky, but as typical down-on-our-luck teenagers, we could barely maneuver arrangements to get a ride to the local dance, let alone a 120 mile drive to Phoenix.

The Doors played in Tucson at Hi Corbett Field, a baseball stadium not more than a few miles from where I live (we’re not talking a big stadium here). The field is situated in the middle of a large city park.

highdesert wrote: Tue Sep 21, 2021 8:33 am Only time I ever needed the paramedics was many years ago when I was working, it was for a breathing problem (asthma). It was resolved by the time they arrived, they just checked me over. It was a city ambulance/fire service, don't remember ever getting a bill.

This prompted me to recheck EMS services in my area. The town I live in is covered by county EMS and fire services, as soon as I leave the town limits coverage is by a private non-profit membership service ambulance.

In most areas you only get a bill if you are transported.