Many transport bills include a patient portion after insurance. As noted in Modern Healthcare on June 27th, a patient’s balance after insurance grew dramatically from 2012 to 2017. Medicare patients also saw an increase. But the increased financial burden and requirement to collect is just part of the problem. We need to get better at how we communicate prices and costs to patients.

Since I’m no longer in my twenties, I tend better to my health with preventive services. I’m privileged to have insurance, but, like many, it comes with co-payments and deductibles. Recently, I went for a routine procedure. I signed the authorization forms and saw a paragraph that referenced balances for which I bore responsibility after insurance. Okay, I understand I must pay after insurance, but I wanted to know how much I would have to pay. That meant I needed to know the cost of the procedure. Here’s where it got interesting – the hospital representative did not know. I refused to sign until I knew what it cost. There was much consternation – whispers among staff members and finally escalation to a supervisor.

The supervisor was courteous but regretted she did not know the price. But, she had confidence my insurance would cover the service. I already knew insurance covered the procedure; I wanted to know the price, so I could calculate my share. She told me the price varied, depending on who was billed.

Ambulance services face the same issue – many times their services are covered, but that does not mean insurance will pay the full amount charged. Price transparency is not one of our industry’s best subjects. The amount of uncompensated care is growing. In the meantime, consumers of healthcare have more interest in knowing where those costs come from as noted in the June 26th article in Healthcare Dive, which detailed a survey stating healthcare providers are not doing as well as they could in how they bill and how they communicate their pricing:

“Progress is mixed in other areas as well….One of the areas where healthcare organizations perform the worst is pricing strategy. Just 5% of organizations are considered tier 1 for aggressive pricing strategies and price transparency…”

Billing offices still get pushback from patients. Patients don’t have a clue what it costs to bring a fully staffed, equipped and ready mobile intensive care unit to their doorstep. So, let’s tell them! Use websites and social media to detail the costs involved in rendering service. Post the price for service. Make note that Medicare beneficiaries have a 20% co-payment (which may be covered by a secondary insurance) and that Medicaid may also have certain co-payment requirements.

Providers must remain compassionate in their billing and arrangements with patients. Therefore, make abundantly clear that you will work with insurance, that you will make payment arrangements, and that you accept credit cards and PayPal. As healthcare continues to become more “consumer-driven,” our response is important.

Finally, if we let the world know the price of service, we help put a value on that service. Perhaps if consumers better understood what’s involved in what EMS does, support could grow for the vital work of this industry.

Let us know if we can help!

About the author:  Maggie Adams is the president of EMS Financial Services, with 25 years’ experience in the ambulance industry as a business owner and reimbursement and compliance consultant. Known for a practical approach and winning presentation style, Maggie has worked with medical transportation providers and billing companies of all kinds to provide auditing, billing assessments and training, and documentation training efforts. “Like” EMS Financial on Facebook, follow us on LinkedIn or for more info, contact Maggie directly at maggie@ems-financial.com or visit www.ems-financial.com