How to Get a Surprise Bill on Your Way to the Hospital

An Arm and a Leg

Society & Culture, Medicine, Health, Health & Fitness, Documentary

4.8 • 1.1K Ratings

🗓️ 27 July 2023

⏱️ 20 minutes

🔗️ Recording | iTunes | RSS

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Summary

For a year and a half now, the No Surprises Act has protected patients from some of the most outrageous out-of-network medical bills. But Congress left something pretty crucial out of the law — bills from ground ambulances.

We look at just how wild ambulance bills can be, with a story about three siblings who took identical ambulance rides — from the same car wreck to the same hospital — and got completely different bills. (Thanks to Bram Sable-Smith who reported the story for the Bill of the Month, a series from NPR and KFF Health News.).

And we find out how ambulance bills ended up being so random — a story that takes us back to the 1970’s.

Plus, what you can do if you get hit with an out-of-network ambulance bill:

See if you can negotiate a better deal
See if you might qualify for financial assistance. (Here’s some detailed guidance from Jared Walker of Dollar For.)
See if you’re protected under state law. At least ten states have passed laws protecting some patients from surprise ambulance bills. Check here to see if yours is one of them.

Want to share your thoughts on how Congress should deal with out-of-network ambulance bills? A federal advisory committee wants to hear them. You can email them here.

Here’s a transcript of this episode.

Send your stories and questions. Or call 724 ARM-N-LEG.

And of course we’d love for you to support this show.

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Transcript

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0:00.0	Hey there, I have been following the world of medical bills for more than four years now,
0:04.6	which still makes me a newbie, really. But here's one thing that has surprised me,
0:09.6	beyond how much there it's known, and how deep the problems go. It's this. Sometimes,
0:17.6	some things do actually change for the better. Like, when I started, one of the most outrageous
0:25.0	problems was something called surprise bills. This is when you go someplace like a hospital that
0:30.3	takes your insurance, and then surprise you get a bill from somebody there who says they don't take
0:35.5	your insurance, and they feel free to charge you any ridiculous amount they want. And your
0:41.2	insurance may cover a little of it or none of it. At the start, I was like, I will be making
0:48.4	episodes about this outrage for a long time. Except, at the end of 2020, about two years in,
0:55.9	for me, Congress actually did something about this outrage. They passed a law called the No
1:01.5	Surprises Act, and it said, if you went somewhere in network, someplace your insurance covers,
1:07.0	then any bill you get from anybody there, you should be covered as if they were in network.
1:13.0	So they don't take your insurance, not your problem. They've got to work something out with
1:17.9	your insurer, and if they can't, an arbitrator steps in. That law went into effect at the beginning
1:24.3	of 2022, and surprise, in a lot of ways, it's working. One study shows that it's preventing a million
1:33.0	of these surprise bills every month, a million every month. Except, of course, you know, nothing's
1:41.2	perfect. And there's a lot of nuances we could look into, but one thing really stands out,
1:47.6	because there's actually a hole written into the law of it. You could drive an ambulance through.
1:54.3	We're going to look at how that hole got there, what it means, and what maybe you could get done
1:58.4	about it. This is an arm and a leg show about why healthcare costs of freaking much, and what we
2:04.9	can maybe do about it. I'm Dan Weissman, I'm reporter, and I like the challenge. So our job on this
2:10.4	show is to take one of the most enraging, terrifying, depressing parts of American life, bringing
	...

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