Going over some old records the other day, kaylasmom and I found a reference to an ambulance charge that has us somewhat confused.
Background: In early March, kaylasmom, a Type II diabetic, had to go to the hospital by ambulance. The copy of the bill we later saw (which had been successfully submitted to the insurance company for payment) showed a charge of $1095.00.
We’re curious to know what comes in a 1.25 mile ambulance ride, with an IV insertion and (possibly) a blood glucose check, and what are considered reasonable and customary charges for the services. The ambulance company has been unwilling to show us any kind of itemization of the bill, but it really bothers us to not know.
Any ambulance drivers or ambulance company billing personnel around who know what’s what in Orange County, CA?
I can’t speak for Orange County, but I spent some time in the billing department when I had a (work-related) knee injury.
That actually doesn’t sound out of line. The service that I worked for at the time charged a $700 base rate for and ALS ambulance trip (paramedic in the back instead of an EMT-B). On top of that were separate charges for any procedures- an IV and a blood glucose level would each be charged separately. There would also be separate charges for (hypothetically speaking) oxygen, heart monitor, and any other medications. It adds up quick. Mileage billed out at $12 and change/mile. Following standard billing procedures, your 1.25 miles would round up to 2.
I believe these are all standard billing practices, as the company processed bills for services in multiple states (although not CA, as far as I know). According to the billing staff, American Medical Response (AMR) has similar charges in this area, and I know AMR provides ambulance service in Orange County. I hope all this helps!
<hijack> Please don’t call us ambulance drivers. It’s EMTs or paramedics. EMTs is fine as a general term.</hijack>
St. Urho
Paramedic
ETA: The base rate included things like linens, gloves and other PPE, and cleaning the ambulance.
We also had a similar base rate for any call. At the time our mileage was only $7/mi.
When you pay for ambulances you are paying for availability. Sometimes these crews sit around playing cards all day, sometimes an airliner lands on your lap. You didn’t pay $1000 for a 1 mile trip, you paid for a company to have enough money to keep crews on station ready to roll on a moments notice even when they are not needed.
If you don’t like paying for down time, look at the opposite way. Companies would not be able to pay for standing coverage and people would be dying over the $500 it would have cost to have another staffed ambulance available for a day.
St. Urho and drachillix beat me to it again.
I work for a private ambulance company, and we bill at a base rate of $300 for EMTs, and $700 for paramedics. There’s an additional charge for an IV stick, oxygen, and any other procedures. Then add in the $11-per mile charge.
Keep in mind this is the Baltimore Metro area, and what I’m quoting is for private ambo service. If you called 911 and got the county-paid medics to take you, you would not be charged.
You are also paying for fully trained paramedics. No matter if you have a hangnail or are dying from a heart attack, the first responders are trained and ready for anything.
It’s expensive, but better than when the local mortician sent over the hearse to take you to the ER…
Back when I was in grad school, I went on a river tubing trip (Guadalupe river in New Braunfels, TX if you’re interested)
After 8 hours floating on the river, which was down and not going too fast, we went out to eat, and I had a “vaso-vagal response” and got queasy, got up to go to the bathroom to barf, and ended up laying down on an empty table so I wouldn’t faint.
My wife (girlfriend at the time) freaked out and called an ambulance, who dragged me to the hospital and when all was said and done, they told me that essentially, I’d almost fainted, and that they see it all the time at that hospital with all the river tubers.
Final cost: Somewhat over $2000 dollars, of which about 60% was the ambulance ride.
And for a more expensive perspective, if you need an AMR ambulance in San Francisco, send your insurance company a Christmas card or something.
One year ago, we were billed a total of $1403 for a six-mile trip. Base rate is $1171, and miles are $22.96 per.
Amusingly, there’s a line item of 35 cents for a “dressing - minor.” In other words, a band-aid. For 35 cents, I’m surprised it’s not in the base charge.
Another part of why the costs are so high, it seems that AMR’s billing department is staffed by beagles who can’t press the right keys on the computer. They transposed some digits the first time around and sent the claim to the wrong insurance company. By the time they figured out what they did, my insurance company denied the claim because they waited too long to file. So, once in a while, they have to eat the whole bill.