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Comment by 1123581321 | Hacker News Reader

$7k doesn’t sound right. If you were to pay cash (no insurance) for a bog standard ambulance ride, it would typically be several hundred. And likely written off, but that’s beside the point.

My family’s most expensive ambulance bill before insurance was $6k, but that was intensive care transport for our newborn. I believe we paid $250 out of pocket for that.

It’s true that having to pay anything out of pocket affects when people call for ambulances.

Also, keep in mind high car ownership rates mean most people drive or are driven to the ER. Ambulances are typically only used when there was on-scene medical care provided, that continues on the way to the hospital, or when transporting a patient between facilities. A minority of Americans use ambulances because they don’t have personal transportation.

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Search “American Medical Response” and terms like “thousands” and you’ll find story after story of 4-5k bills, some of those from 7+ years ago.

Here’s one: https://www.reddit.com/r/personalfinance/comments/16ixoc8/i_...

And another which links to the California Assembly Bill to try to prevent this: https://calmatters.org/health/2023/12/surprise-ambulance-bil...

I didn’t receive any notice of the bill until nine months later and was told it would go to collections in 30 days. My insurance company decided to reconsider whether they would pay anything after I called them, and they told AMR they would review the case which put the clock for collections on hold for about six weeks until the insurance coughed up $3k or so.

There is studied pricing data available. For example, Fair, an organization working against surprise bills, tells us average pricing by charge code. Before insurance, basic transport averages under a thousand. Mileage and cost of living accounts for the variation.

People with huge bills before insurance are either receiving advanced care (like my infant daughter) or being transported long distances.

CMS has negotiated average basic transport down to a few hundred. I’d like to see this proliferated. Dispatching keeps ambulances from refusing service in the way CMS pricing dries up proactive care availability.

Certainly share your pain dealing with medical bills and receiving them after they’re overdue. I’m good at it but I know most aren’t, and they come at an overwhelming time. Also, many ambulance companies use crappy overbooked billing call centers so it’s hard to talk to someone. Reforming medical communication is part of the whole solution.

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