My son has epilepsy so we are regrettably fairly familiar with ambulances. Their billing practices are just the worst. They’re so bad I am reluctant to call them and try to do everything I can to avoid relying on them. But if he has a seizure and I’m not there to handle it, whoever is with him is obviously going to call the ambulance every time. And my first thought when they call me to tell me he’s had a seizure is always “oh great. Now I have to deal with the ambulance billing hustlers.”

They are all out of network of course. They always charge WAY more than the Medicare rate which is what they know my insurance is going to pay them. Then they send me “bills” with no due dates but with threats to send me to collections. My insurance out of network advocate doesn’t consider this a bill and won’t engage them until they send me a due date. The ambulance billing knows this but they continue to send me these extortion letters. Until one day months later, they’ll send me a “FINAL NOTICE” with a due date within a couple of weeks. Sometimes they’ll even just go straight to collections without telling me. Then the collections racket starts. Then I have to scramble to get my advocate to engage. This can drag on for a few weeks with repeated phone calls I have to respond to.

It always ends up with me not paying a penny out of pocket but only after months of a game of chicken with my insurance company with me in the middle.

What is the point? It doesn’t have to be this way. But they know that they will scare enough people or confuse them enough that they’ll just cough up the extra payment.