Last September, Peggy Dula was driving with her brother and sister when their car collided with a pickup truck. The Illinois resident, who recalled the crash and its aftermath on "CBS Mornings," said that she and her siblings were each transported separately from the site of the accident to the same nearby hospital. Dula was shocked when they received three very different bills — for identical ambulance rides.
Dula's injury, a bruised sternum, was the least severe among the siblings.
"And my ambulance bill was $3,606, which I thought was really high," she said. "I couldn't even get anyone to offer an explanation as to the different pricing."
Each ambulance was from a different taxpayer-funded Illinois Fire Protection District and charged a different rate for medical services and mileage driven. Dula was charged more than twice as much as her siblings for medical services during the ambulance ride, plus $30 per mile for the transportation alone, while others were charged $10 per mile.
"So, I called the paramedic billing service and asked them about the bill," Dula said. "They basically told me there was little they could do, that the rate was set by the fire district."
Dula said that she repeatedly tried to contact the Pingree Grove and Countryside Fire District, but the fire chief had not returned her calls.
"I felt really powerless, actually, to do anything … to change anything," she explained. "I don't have a tremendous amount of money, and that's a sizable amount for me."
Dula's medical insurance covered 60% of what they deemed to be the "reasonable and customary rate" for the services she received, according to her plan. She was left with a remaining balance of over $2,700.
All three siblings have since recovered from their injuries. Nearly a year after the accident, Dula told "CBS Mornings" that multiple attempts to negotiate her charge with Paramedic Billing Services were unsuccessful, and, despite her $40 payment of good faith, the bill was sent to collections.
Paramedic Billing Services Vice President Michael Tillman said patients must dispute charges directly with the ambulance service that provided their hospital transport. The Pingree Grove and Countryside fire chief did not respond to a request for comment from "CBS Mornings," but told Kaiser Health News that the charges are consistent with the federal Ground Emergency Medical Transportation program. The GEMT program offers reimbursements from Medicaid to help offset costs associated with emergency transport services.
Dr. Elisabeth Rosenthal, the editor-in-chief at Kaiser Health News, told "CBS Mornings" that people in need of ambulance rides have little control over which services are offered to them, or how much they will later be asked to pay.
"Ambulance services can charge whatever they want, and they can join whichever insurance networks they want. And you know what? These days … many, if not most, ambulance services decide to join none," Rosenthal said.
"You're kind of a sitting duck," she continued, adding, "You're not even able to ask for which ambulance. … You don't know where they're from, whether they're in your network, what they're going to charge you."
Rosenthal said that, in retrospect, Dula might have been better off asking a family member to drive her to the hospital, or calling an Uber herself. She also said it's "unlikely" that an ambulance will take someone to a hospital of their choice just because it's in-network, although people can refuse an ambulance ride if they choose.
"Of course, if you have a head injury or you feel really bad, you should just get in and not worry about the cost," Rosenthal said. "But, you know, it's really so unfair to patients."
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