Medical Malpractice

Cost of ambulance ride in NYC?

While visiting NYC in late December 07, I started feeling ill (heart palpatations, sweating, nervousness, etc). Unaware of my situation, I called 911 and they sent an ambulance. Once they came and explained my situation, they took me to the Roosevelt Hospital only after asking them that this was necessary (they said, "sure"). In the end, it was just a panic attack. I was treated and discharged within a few hours. The services have yet to be billed to my insurance provider. While reading through the benefits listings in the insurance handbooks, they said ambulance rides are paid for (except for the deductible) for emergency cases only. Assuming that my insurance doesn't deem my situation to be a true emergency, what can I expect to pay?

Public Comments

1. It depends on what they did to you (start an iv, put you on oxygen, etc) and weather they went code 2 or code 3 (code 3 is with lights and sirens turned on). If they didn't do anything fancy with you, and didn't turn their sirens on, and didn't have to drive very far, it'll wind up being (I think) between 500 and a thousand dollars, if it was a private company that took you to the hospital. I think that if a municipal fire ambulance took you to the hospital, I don't think they bill (it's all taxpayer money) but don't hold me to that.
2. This all depends on how the system bills. Some systems bill a flat rate per mile transported for advanced life support care (ALS), and basic life support care, respectively. ALS care would be if they hooked you up to a cardiac monitor, started an IV, and such. BLS care would be just like taking vitals and blood glucose and such. Or they may bill by the procedures they do, plus a flat rate per mile for transport. Generally speaking any ambulance ride with out insurance paying any it is going to be AT LEAST $500
3. With all due respect to the above posters, it's obvious neither of you have worked in NYC. Whether or not the ambulance uses lights & siren to transport the patient is not a directly billable item, only the care that was rendered. And as far as I remember my NYC REMAC protocols, blood glucose readings are only obtained by ALS providers. While it may be the way you describe in your system, FDNY EMS is a little different. To the OP, the cost of your ambulance transport will be billed to your insurance if the crew obtained your provider's info. If not or if it's not sufficient to properly process a claim, they will send the bill directly to the address you provided when they collected your demographic info such as your name, date of birth, social security number, etc. Your insurance company doesn't decide whether or not your situation was an emergency. If the ambulance crew felt your situation was better served by your being transported to the hospital, it should be covered. If, however, you requested to be transported to the hospital after being told that it wasn't necessary, your insurance may be able to refuse either all or part of the bill. When your insurance provider mentions ambulance transport billing coverage, they are speaking of emergency cases (like your transport to the emergency department) versus hospital to hospital transfers. Whether it be for specialized services not available at the sending facility or to another hospital of equal capability that may be for preference or proximity to home that can make the difference in covered amounts. Most coverage problems can be resolved by requesting pre-approval. If I were in your position and they refused to cover your ambulance bill, I would appeal to your human resources department where you work. I can't imagine any company that would want their employees to question whether or not to seek medical care in an emegency out of fear of lack of coverage. They can also act on your behalf if the insurance provider that they've chosen to offer you is being unreasonable or acting in contradiction of your outlined coverage. Whatever happens, good luck. Edited To Add: To ACEMT44 - The OP asked about NYC, they are not as progressive as a lot of systems. In SC where you live, (I also lived in SC for a brief time, in Charleston. I loved the downtown area. Anyway...) they are obviously more trusting in their basic providers. A former co-worker recently relocated to Lee County, Florida and they, like you, are able to start IVs, obtain BGLs, secure an airway by ET, etc... Unfortunately, the protocols are written for the lowest common denominator, and both you & I have met ALS & BLS providers that make us understand those limitations. Hopefully, they are not our partners. Have a laugh... http://www.nycremsco.org/ Just click one of the buttons on the left.
4. I dont live in NYC but I can tell you I was involved in a car accident in sept and it was basically just a transport, only 2 miles down the road for me and my daughter. They did nothing to use but ask a few questions and take my BP. It was 800.00 per person. And if you thought it was a emergency then your insurance will cover it. When I was pregnant, I was throwing up and was weak. So I called 911. Found out I was onlt dehydrated, my insurance covered the trip. I have blue cross blue sheild.
5. So, i work in EMS also in the great state of SC. I actually took a ride on an ambulance for the company i work for and the insurance (throught my job) denied to pay!! Some insurance companies will pay for an ambulance ride only if you are admitted to the hospital. Anywayz- Each system or company has their own way of billing. Where i work it doesnt matter if you go w/o lights or w/ lights. Now, here we cant itemize the items used to treat the pt. ( monitor, iv, o2, drugs, ect...) We have a base ALS or BLS fee and a fee for mileage. BLS is cheaper then ALS- so if you were put on a monitor ur getting charged for an als call.. but if you were just given O2 and maybe an iv it will probably be BLS. Now to the person that said BGLs were an als skill..here in sc its a basic skill...it all depends on S.O.P's..everything varys by state. Here as an intermediate i can push D-50, blg, tube adult and pediatrics. Basics could tube adults only that were in cardiac or respiratory arrest..Anywayz- my bill ended up being about 550.00.