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Home > Topics > EMS Management
November 20, 2012

Calif. man, 84, charged $3,000 for ambulance ride next door

"For less than $3,000, I could get a round trip ticket to North Carolina to visit my grandchildren"

Huffington Post

SACREMENTO — Tom Kosta complained of dizziness when he went to see the doctors at his local medical center. But his head really started spinning when he was sent an eye-popping ambulance bill over $3,000, CBS Sacramento reports.

After going to the medical offices at Lodi Memorial, Kosta, an 84-year-old man from Lodi, Calif., was told that he had to go next door to the hospital for an MRI. When Kosta said he could get there himself in a wheelchair, doctors insisted that he ride in an ambulance. Kosta was then sent a bill for $1,500 — the portion of the ride that wasn't covered by insurance.

“For less than $3,000, I could get a round trip ticket to North Carolina to visit my grandchildren,” Kosta told CBS Sacremento. According to a spokesperson from Lodi Memorial, it's hospital policy to transport patients via ambulance no matter the distance in order to ensure safety.

Full story: Tom Kosta, 84-Year-Old Calif. Man, Charged $3,000 For Ambulance Ride Next Door

Comments
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Robb Quinn Robb Quinn Tuesday, November 20, 2012 9:33:23 AM While 3000.00 is a ridiculous price for any ambulance trip, it should have been billed to the medical center if the patient did not want the ambulance and it was "hospital policy".
Robin Daghlian-Curasco Robin Daghlian-Curasco Tuesday, November 20, 2012 10:06:29 AM Insurance gouging at its best... How much did the Drs office recieve from that 3000$ for the "referal".
Leslea Stovall Adams Leslea Stovall Adams Tuesday, November 20, 2012 10:07:54 AM AMR
Ed Hillenbrand Ed Hillenbrand Tuesday, November 20, 2012 10:20:54 AM I want to know how he got Medicare to pay more than $378 for an ALS trip. Talk about price fixing!
Kelly Sutton Baur Kelly Sutton Baur Tuesday, November 20, 2012 10:30:37 AM What is it called again when you MAKE someone go by ambulance that doesn"t want to go ambulance? Isn"t it called KIDNAPPING?
David Ford David Ford Tuesday, November 20, 2012 10:34:28 AM Your all missing the point. Step back and look at the bigger picture.
Patrick Coffey Patrick Coffey Tuesday, November 20, 2012 10:45:06 AM Not surprised AMR is in the picture XD.
Desiree Satterwhite Desiree Satterwhite Tuesday, November 20, 2012 12:10:11 PM only if the medics forced him. they didnt. the dr's office insisted, you call, we haul. he had only to tell the medics, no i dont want to go by ambulance. then they wouldnt and couldnt make him unless he was AMS
Robert Gift Robert Gift Tuesday, November 20, 2012 12:22:41 PM I recall a hospital calling this "Horizontal elevator" or something like that.
Tony Garcia Tony Garcia Tuesday, November 20, 2012 12:26:10 PM Look in the background amr says it all
Kevin Carnes Kevin Carnes Tuesday, November 20, 2012 12:31:21 PM That is a policy or ridiculously epic proportion
Ashley McDougald Ashley McDougald Tuesday, November 20, 2012 12:58:42 PM where I am from. We had a doctor office next to our hospital. and on several occasions elderly people could walk from doctor office to hospital. Either a nurse from doctor office would wheel you over in a wheel chair or a nurse from hospital would come get you and wheel you over.
Ashley McDougald Ashley McDougald Tuesday, November 20, 2012 1:00:22 PM elderly* COULD NOT* walk from doctor office to hospital.
Mike Ledgerwood Mike Ledgerwood Tuesday, November 20, 2012 1:32:52 PM I think many people mis understand the fees associated with ambulance transport. An ambulance is not a taxi and you are not paying for just a ride. My assumption would be that the patient was undergoing some form of treatment that the doctor required to have monitored during transport. This would have increased costs, especially if it was IV monitoring or EKG monitoring. The other aspect to consider is what did the medics do for the patient? For $3,000 I am certain that there was more done for this patient than just a ride to the hospital next door. Sounds to me like the patient had a high co-pay that he was unaware of.
John Legg John Legg Tuesday, November 20, 2012 2:39:37 PM Simple. He doesn't have Medicare.
John Legg John Legg Tuesday, November 20, 2012 2:56:44 PM Frankly, this has Nothing to do with AMR. They just happen to be the particular provider present in this situation. This is standard practice. Is the practice wrong? Absolutely. However this goes beyond the obvious. Ambulance providers know full well this is the circumstance. Each company makes the conscious decision to take these types of transfers, weighing the chance that someone complains versus the money received. This is a stupid policy. If a competent adult states they can make the trip themselves, what right does the sending facility have to deny that right to the patient. The patient is told they HAVE to do what the facility says because it's their policy. It is not common practice to inform the patient they have the right to say NO. Does saying NO to a ludicrous policy automatically place the patient into the AMA aka insurance isn't going to pay for anything since you said NO category? Nope. So be a patient advocate where others have failed. Take the time to remind your patients they are completely in charge of what happens to them, as long as they are competent. This means the right to deny particular procedures they don't understand, the right to be informed of the true benefits and risks involved, the alternative options, etc. We can't fix everything in the world. We CAN pass our knowledge onto to those who are being fleeced. Step up and do what's right for the patient. Inform them. Pretty tough for your company to discipline you for doing what is RIGHT for the patient. Even AMR. (ask me how I know).
Jake Stein Jake Stein Tuesday, November 20, 2012 3:12:12 PM Desiree Satterwhite But, if the guy disobeyed the physician's or hospital's policy, this would have been AMA and therefore the insurance, including CMS would no have to pay for ANY expenses. The facility and physician would also reserve the right to NOT continue any medical care for this patient and he would be stuck finding another physician without the blessing of insurance. NEVER tell someone to give up their insurance coverage just because you don't feel like transporting.
Ed Hillenbrand Ed Hillenbrand Tuesday, November 20, 2012 6:45:29 PM At 84? Everyone has Medicare that worked. He may have had a supplemental but that generally pays only the 20% + co-pay difference, not nearly $1,100. Just curious.
Rob Norton Rob Norton Wednesday, November 21, 2012 5:40:06 AM Damn you AMR! I'm shaking my fists as I write this post. It sounds like a billing error which I'm sure can be resolved.
John Oscar John Oscar Wednesday, November 21, 2012 12:46:09 PM Dizziness going for a MRI of the head means he will be on a cardiac monitor (seperate charge) and running IV (seperate charge if on a pump, and tubing for that pump), oxygen+ ALS charge. Very small mileage charge. It was mostly likely a "wait and return", meaning he paid for the paramedics to stay there with him. It actually sounds pretty reasonable given the current billing rates of most privates. Right or wrong, the news story said he didn't have Medicare B, but private insurance. Many times these patients can be wheeled across the parking lot in a wheelchair, but thanks to lawyers, no one will take that liability. The ambulance companies and their employees need to earn a living too.
Justin Bland Justin Bland Wednesday, November 21, 2012 2:17:22 PM I don't see the problem here. Ambulance rides are not a free service. The distance is irrellavent. An EMS crew had to be dispatched, taken out of the system to run the call, spend time, use supplies, and transfer care. The doctor may insist, and I would too with those symptoms, but the patient almost always reserves the right to refuse service. The patient consented to EMS care and transport by agreeing to go.
Alter Ego Alter Ego Wednesday, November 21, 2012 2:40:52 PM This is a prime example of what's wrong with our healthcare system. 1. The hospitals, clinics and doctors are afraid to NOT use the ambulance. Imagine what would happen if the patient suffered a cardiac arrest between the office and the hospital... "Someone is neglegent for letting this happen." "They should have used an ambulance." Negative stories in the press and lawyers lined up to file law suits. 2. The ambulance service has to pay for expensive ambulances, expensive equipment, buildings, the crew in the ambulance, plus administrative and billing staff, insurance, fuel... the list goes on and on... and don't forget that since this is a private ambulance, the shareholders have to make a profit. Also, remember that the charge has to cover the cost of having an ambulance ready to respond... not just the time it took to transport. Oh, and don't forget the time for the crew to do their paperwork, clean, restock and re-fuel the ambulance. 3. The ambulance service charges what's allowed, which in this case seems excessive, because on so many occassions, they have to take a big write-off for Medicare & Medicaid and an even bigger write-off for the patients who can't or won't pay. Had this been a Medicare patient, the patient's portion of the bill probably would only have been $100 to $200. If Medicaid, the patient's portion would have been Zero. So, the ambulance service (and most other healthcare providers as well) shift the costs to the ones that they can bill. 4. Yes, it's a screwed up system, but you can't put all the blame on the Hospital, Doctors Office or the Ambulance Service. They are just working within the system as best they can.
Timothy Johnston Timothy Johnston Wednesday, November 21, 2012 2:48:02 PM My mother has same thing happen, about 7 - 8 years ago, she went to see Dr. for annual check-up, her Dr. office is right across street from St. Elizabeth Medical Center, in Edgewood, KY. Dr. came see me and tell me she need go to hospital for check-up for her slow heart beat, then I told Dr. I can take her to hospital but Dr. said no, he said it's has to be by amulance, I got mad and ask for explain why, Dr. said it's hospital rules, had to wait about 75 minutes before private ambulance show up. I can take her to hospital less than 30 seconds, her bill was $1800, insurance paid part of it. I know St. Elizabeth is rip off.
Melissa Tiede Hyde Melissa Tiede Hyde Wednesday, November 21, 2012 8:57:09 PM Wow, that suprises me. My service charges $900 for ALS with IV, cardiac monitor, and a 20 mile trip.
Melissa Tiede Hyde Melissa Tiede Hyde Wednesday, November 21, 2012 9:15:22 PM "Generally, ambulance fees for someone Kosta's age would be paid for by Medicare, CBS reports. But Kosta still works full time, and therefore has private healthcare coverage."
Bob Kellow Bob Kellow Sunday, November 25, 2012 6:00:59 AM So much altruism, so little understanding of EMS economics. Perhaps medic compensation should be based on the staggering amounts of revenue derived from 911 street calls. OE-40's and crack cocaine in lieu of salaries and wages. Yeah, that's the ticket!
Bob Kellow Bob Kellow Sunday, November 25, 2012 6:14:15 AM Accusing a physician of such an act is serious business. It constitutes violations of the Stark Law and the "Anti-Kickback" statute, which are federal felony crimes. Do you have any credible evidence?
Steve Morgan Steve Morgan Sunday, November 25, 2012 5:11:54 PM I wasn't an accusation. It was a question, to which the answer could be "nothing".
Steve Morgan Steve Morgan Sunday, November 25, 2012 5:12:50 PM Maybe he's retired from Congress.
David Wilson David Wilson Monday, December 03, 2012 4:12:09 PM Well just look at the logo on the ambulance and it tells all.

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