Chasing my ambulance bill

[twinturbo]

Time to put the batsignal up for FARE? They have seemed more with it than in the past and historically even FAAN showed strong advocacy for EMS compliance or legislation.

[Macabre]

That's exactly what I'd love to say. 

Instead, I left him a voice mail asking him to fax my records, which I believe indicated an allergic reaction, to the insurance company. I volunteered to pick them up and fax them myself (and of course, part of me would much rather do this--I want to see what he says.

I do hope this is mostly over with.  I left my number.  I said I'd call back tomorrow to see if they'd been able to take care of this.

[YouKnowWho]

Doesn't the epi instructions say to seek medical attention immediately?  Are you supposed to wait for a cab to be dispatched.

[Janelle205]

The last time I used epi, the EMTs asked me if I wanted to go to the hospital.  (I was pretty symptom-free when they showed up except for just a few hives.)  I told them that while I would rather not, it's doctor's orders that I go by ambulance.


The hospital docs were much better about it.

[becca]

No advice, except to have the ambulance company change the code, which they can do.  they certainly can re-submit with *proper* coding.  But you have tried asking for that. 

[catelyn]

Holy cow that is a lot.

Its $45 here if its medically necessary and $240 if its not. 

[MandCmama]

In Pennsylvania, a trip to ER after epi has to be via advanced life support. Basic life support ambulances do not carry epi. It's even on the boys' action plans to call 911 and request ALS.

Last reaction we had both show. Symptoms were much improved by the time they arrived and they basically drew straws in the front yard to see who had to transport us. Literally. While a stood there holding him and waving our AP at them.

Be a squeaky wheel McC.  If you don't get anywhere with the fire chief faxing, tell the insurance company you want to pursue a formal appeal. It involves you stating your case (over the phone) while you're recorded.  Good luck!

[momtoAidenDeclan]

 A couple of things from a friend who used to do health ins....

If the emt isn't responsive, talk to the emt's suprerior in regards to getting it coded differently - any code that shows you couldn't have used other transportation will work (i.e., you were not using the ambulance as a cab)
Copy of dr's orders about what to do if you epi
Copy of er's diagnosis and the fact they re-epied you

[Mezzo]

I have no advice, but I am disgusted with that guy for acting like he knows better. I hope you get some resolution soon, because that is a ridiculous amount for them to expect you to pay.

[ajasfolks2]

This is where your language in all communications needs to be VERY FIRM.

You have them, but I get you want them to be educated as to def of anaphylaxis.

Get your bill paid first via insurance.

Make the education as to anaphylaxis secondary -- once you have primary care doc and/or allergist who might help.

Looks like FARE needs to be onto things once dust has settled -- bring this whole situation to their attention and get them to do campaign as to def of anaphylaxis . . . not just for epi treatment but for standard insurance coding . . . after appropriate care!

Be sure you miss no deadlines for any requests for review and/or disputes of nonpayment so far as your insurance.  Missing any deadlines/gates is typically non-negotiable.

[ajasfolks2]

Completely off topic of this off topic subject -- when we were in ER waiting room with son and possible ana reax, I was at intake desk trying to get the intake person to give us some priority and up strode some "I know everything" doctor (had on hospital ID but was NOT on duty) who insisted that

unless my son had obvious breathing difficulty,

he was most def NOT in anaphylaxis.

(Son had vomiting, hives, and impending sense of doom . . .  was exposed to unknown something at school)

That was 2009.


(I nearly choked the guy and then he would have been in asphyxiaxis -- word made up).


That was in big name hospital in supposed big name state with whoo-wah medical.


~ ~ ~

My point being,

DEFINITION of ANAPHYLAXIS and

RECOGNITION

and

TREATMENT

needs some gosh-darned standardization and there needs to be BIG ed push as to medical care:  FARE?

[Macabre]

You're darn tootin' right.

Actually, I know I've seen on twitter in the last few months one of the allergy docs post something about a study of ERs and anaphylaxis.  About protocol a d it NOT being followed. I was trying to find that. Clearly my ER follows protocol fairly well.

Yesterday I called my insurance to see if things had been faxed. Nope.

Ugh.

[BensMom]

Did you get it taken care of? I'm chasing mine now. Insurance didn't pay for the hospital to hospital transfer back in November for dd. Insurance had stopped paying for hospital #1, but agreed to pay if we moved her to hospital #2. They didn't pay for the ambulance because they said it wasn't pre-authorized. I'm not really sure what to do. I had nothing to do with it. I didn't arrange for the ambulance. The hospital ordered it. If it needed to be pre-authorized, they should have done it. They were certainly in close contact with the insurance company during all this. I've contacted the case worker at the hospital to ask her who I should talk to about this. I'm hoping there's some documentation about the transfer being authorized and something about how dd would be transported.

[Macabre]

Oh no! 

Yes, they should have done that.

When I called my insurance company, the ambulance company hasn't called them.  I'll call this coming week. I was sick and last week I had so much to do for my mom. But I'll get back to it this week. Not looking forward to talking with that man again. Really not.

[Macabre]

Sticking this here. It's what I was looking for

http://www.ncbi.nlm.nih.gov/pubmed/22712745


Some pretty scary features in that survey, particularly for those of us with older kids that don't present with typical anaphylaxis.