My mom is at the very end-stage of Alzheimer's and I had to get her in the Emergency Room several times. Even with mom being unable to walk due to urinary tract infections, Medicare has refused to pay for her 911 EMS rides to the Emergency Room. The ER doctor even wrote as part of her medical diagnosis as threat to life. I appealed this -- several times-- to both Medicare AND her Tricare-for-Life and both are still refusing to pay for it. Is this some kind of death panel they don't want mom treated and just let her die??
Although I am power of attorney (POA), when mom eventually dies I refuse to pay thousands in ambulance services which Medicare and Tri-care are refusing to pay. Can the Ambulance services turn on me for payment? Do I have to pay for her unpaid medical bills when she dies? You are talking about several thousands of dollars when it is nearly $700 for a single ride to the Emergency Room.
What does Medicare and Tri-care expect from me??? Do they just want me to not get mom treated and let her die? I told them both when mom gets a UTI she is so profoundly sick she can't walk to the car, and I cannot lift her up and carry her out to the car. Medicare and Tri-care For Life don't care and just give me the run-around. Tricare even said I filed too many appeals and it was costly administrative time. Then I get a letter from them saying I have to refile the appeal. Seriously! I must have sent them at least ten letters. They are so messed up it is beyond description.
I only pray I do not live as long as mom since Medicare does not like paying for ambulance services. I think they just want a person to die. A friend told me I will not be responsible for her medical bills after mom dies even with me being POA since they are her bills -- just fax them her death certificate. I am wondering if that's true or if someone had something similar.
Some areas have memberships to EMS services. In my area it is $50.00 a year. With that fee paid, any emergency transport is not billed, included in the membership. EMS here uses it as a fund raiser for much needed equipment, and well worth the cost!
(In my area we don’t have membership fees for ambulance or fire services)
"Part B covers emergency ambulance services if: An ambulance is medically necessary, meaning it is the only safe way to transport you. The reason for your trip is to receive aMedicare-covered service or to return from receiving care. ... And, the transportationsupplier meets Medicare ambulance requirements."
I guess they feel a UTI is not an emergency. Maybe if she had been kept overnight?
You will not be the one sued, Mom will be. If u aren't worried about her credit score, don't pay. Or in "good faith" set up a payment plan and pay what Mom can afford monthly, lets say $50. That goes for any medical bills. But get it in writing. Years ago my Aunt set up a payment plan and the hospital still sent her to collections. TG it was a lawyer. She told him and he said just continue paying him the agreement.
When Mom passes the debt is hers and the estate is responsible for the bills. No money the bills go unpaid. POA stops and the Executor takes over.
If Mom is low income, you may want to apply for Medicaid health insurance. What Medicare doesn't pay Medicaid does.
Those would seem to be serious issues that could cause harm to others or the patient.
I don't know the ambulance trip is separated from the rest of health care. It's so frustrating!
All insurers will reject a claim if they can, and it doesn't help to take it as an unfeeling, personal affront. But they do have to say why they're rejecting it and then you know what to challenge.
Your POA ceases on your mother's death, and you cannot be personally liable for her bills anyway. But her estate may be, and her executor would then use the money from her estate to settle outstanding debts.
and changed the codes for the ambulance.
I found out the hard way that I coud not just call the ambulance company for a transport. I had to call our non-emergency help number.
What Executor does - in my experience as 1 now 3 times- is as a Executor you or probate atty reviews all properly filed claims against Estate to determine where each claim falls in priority as to payment and then balance that against assets of the Estate. If they actually die with liquid assets - like a large banking balance or an life insurance that has the Estate as the beneficiary - there will be cash $ to Pay creditors who have filed a claim against the estate however probate laws require. The how laws require is important as usually there is a specific order. Secured creditors are up first & foremost, like Mortgage co. That ambulance co. along with credit cards, MERP, utilities, etc. are not secured creditors & they have to wait.
But before this point, Creditors have to file their claim & file in a format as per probate and do so within a limited time frame from the published in a newspaper NOC (notice to creditors). My experience is most independent businesses DO NOT FILE; it’s too cumbersome to do plus has costs to do so gets written off as uncollectable bad debt. It’s the CC, communications co., bigger health care providers that do & they tend have a local or regional collections firm that in turn has independent contractor runners who actually pick a stack of filings up and then the runner goes to the courthouse to fill out the specific probate court info to enter into the docket paperwork for each one, pay usually cash for each filing & get a receipt for each filing. The runner gets paid by the # of filings & reimbursed for parking, mileage & filing fees. Most runners are year 2 or year 3 law students or grad students at whatever Univ that has a law school. It’s a good gig for those with a car & ocd organized. Filing a claim against the estate tends to be something that still done by a person and not via on on-line portal to the CH as that’s usually for attorney of record for the court. Also this way it’s done in real-time with receipts and no lost in the mail story drama. I’ve been in the file your probate stuff here line at more than 1 CH basement with runners, they may have 100+ filings... like 50 AT&T, 40 TMobile and the rest from QuestDiagnotics (this outfit is relentless), & they hit couple of different County CH in a good day & turn in receipts to collections firm by EOD & get paid in short order.
If estate has no liquid cash - like it’s assets is a house or land or a business to get dealt with - it’s maybe months or years till there’s $ to ever pay claims.
Because of that, imo, The smaller debtor kinda needs to do whatever to have bill paid ASAP or get responsibility moved to a still alive family member so they might be able to get bill paid. Otherwise bills kinda toast.
Yes, let it go to collections!!!
Ccertainly she isn't working on her credit.!!!
Poa, that was me..
We had no outstanding Bill's....but
Let ambulance co. Try to figure out you have POA! THEY do not have time or staff to go to that length...
FRUSTRATING? YES!!!
just ignore bill...or send $5-
I needed help getting my patient up off floor.. yep I got a bill.
Did I pay it? No!!!
plz don't worry too much... they will even return if you call..
Cindy
UTI is a serious situation, but you could have probably brought your Mom to the Hospital ER without the ambulance; like a Medi-Car/Cab service with a wheelchair.
You should be able work out a payment plan with the EMS.
Here in BC there is one Ambulance service for the Province and there are medical transport companies, that provide patient moves in non emergency situations. Those are private companies, but there generally is only one company per region except in a big city.
I once went to bat with the fees we were charged, my husband broke his leg in a remote location. He had 6 different Ambulance rides, from the point of rescue until he got to the hospital where he had surgery. I was able to argue that the first 4 were to get him from the accident location to the first hospital and the second two from the first hospital to the one that could do the complicated surgery. My appeal was accepted and the bill dropped from $300 to $100. Back then a patient paid $50 per ride, now I believe it is $80 per ride.
In a lot of areas there will be city or country run EMS supported by tax dollars & community block development grant $. These are easier to deal with imo as they have a system thru city/ co health dept to get paid and can waive the copay on Medicaid patients. (These are outfitted $$$$ vehicles that can be a mini ER or triage unit). It’s the private ambulance services that are much harder to deal with. Lots of places have ambulance co you pay an annual fee to belong to. Kinda like having AAA if you drive a lot. Where we are, it’s Acadian Ambulance and like $100 annual for family plan. I’ll probably do it once we both retire as it’s a good & affordable option just to have.
Imho a lot of the private ambulance bills are inflated semi-scams. For my mom, her 1st NH called City EMS to take her to ER when she appeared to have had a TIA & MediCARE paid. But the return trip after her 36 hr “observation” at hospital was by private ambulance that NH had on call as an outside vendor. It was a transfer run & so not covered benefit by the M&Ms. Ambulance co billed her like $800 which was sent to her at the NH address. Not to me as her DPOA at my address nor to the address that both the M&M had on file for her. Couple months later, another TIA run & a repeat of the above & then a 3rd. In speaking with others this was super common & done way way too much imo., even to get X-rays they would do an ambulance run. This plus other issues, so I moved mom out of this NH to another at abt month 9. Her second NH rarely called ambulance service as they had portable X-ray co to the NH & had couple of isolation rooms they would put residents in for an interim point instead of send to the ER via ambulance as a knee jerk to anything. They did call city EMS though if needed. But I digress, bills finally surfaced almost 2 years later. I told them she was on hospice at the new NH and never heard back or got another bill. Sent them a letter when probate opened and they didn’t file a claim.
When I look back on all this, my gut feeling is majority of private ambulance co NH runs are really just transfers. If I’m accurate, then they are making out like bandits from the bills that do get private paid. Like from hospital door (which has employee to load then into the vehicle) to my mom’s first NH was maybe 30 minutes. Then once at NH, a NH aide met the ambulance & put her into a wheelchair or got her walker so she could get to her room. The ambulance driver really does little. It’s not a driver with a certified EMT in the unit doing O2 or other life saving stuff. It’s not a fully equipped EMS vehicle which is very $$$$. It’s a retrofitted extended van by & large with a driver. Kinda Specialty Uber. My mom sat in a seat from all her “under observation” returns. Add an hr for scheduling & return. So maybe 2 hrs time out tops. If 4 out of 10 not covered by insurers bills get private paid, they are making $.
Its probably a good ? to ask prospective NH as to just how they deal with residents needing services not provided for at the NH as to how they get to those services or appointments. If at all possible you want them in a facility that has mobile units under contract to the NH.
If I ever have to call 911 again, I'm getting a copy of the medic's report asap.
I had a similar experience with a GP's report, to which I ended up attaching a closely-typed page of addenda, corrigenda and clarifications - 20 questions, virtually every one answered wrongly or incomplete.
But wouldn't it be nice to look that EMT in the eye and say "well? Explain?"
if they attempt to harass your Mom (I guess you pick up the phone). Tell them. “It is not alright to contact Mom with phone calls...ever.” Let them write letters.
you will never be responsible for those bills.
once she has died....they can try to collect from her estate if there is one. They will know because they will watch the probate court calendars. BUT, again, you are not ever responsible for your Moms bills
Active duty military and their dependents use a different level of tricare.
If medicare does not recognize or approve of the charge then tricare seldom pays.