That's the part I just don't understand. They have to keep their "list price" high because the insurance companies want to negotiate down, I guess.

However, if you walk in with cold hard green cash, they act like you're a bad customer.

How much labor and resources does it cost them to bill the insurance company?

How much does it cost them to send you a bill later when the insurance comany denies the claim because they were incompetent in submitting it correctly?

How much does it cost them when I call them and put them on a conference call with my insurance company and between the two of them they still can't figure it out?

How much does it cost them to sell your debt at pennies on the dollar to a collections company because you refuse to pay an invalid bill?

C'mon! I'm HANDING you cash TODAY!

In most of the hospitals that have employed me, the folks at the patient services window have been at the absolute bottom of the finance division food chain. Nice folks, but generally new at the job, generally not very experienced. (When they develop experience/seniority, they leave the direct customer service jobs and get a nice quiet cubicle away form irate patients). The front line folks are often not deemed sufficiently reliable to handle cash-they generally don't have a cash register, cannot make change, may not even have a safe place to put the money. Their superiors hassle them if they do take in cash. They would be happier to accept lab specimens than to accept money-they know where to take the specimens.

My sister says the people hired by hospitals are carefully interviewed to discover if they are any kind of threat to the current manager of that department. The intelligent, experienced ones who might be are not hired.

Interesting.

My ambulance is county

Your sister is a woman of deep insight. There are sometimes some bright lights passing through on their way to something better-medical and nursing students working their way through school-but the lifers tend to be either less smart or smart enough to keep a low profile. Often this takes the form of working nights and weekends, when there aren't very many suits around. I try to follow my old man's advice-"it's useful to be smarter than you look; the easiest way to accomplish that is to look a little dumber than you are."
Maybe we need another Forum: "Surviving in the health care system" or "Around the gurney". This is more likely to be a challenge for most of us than is survival in the boreal forest.

Which county?? You might need to check again. Some places/providers, like LA County Fire Dept (and parts of Orange County Fire Authority), subcontract private ambulance companies to do the actual transports. Those companies function like I mentioned.

If it truly is municipal-based, I would think that taxes would handle the charge, and it should be free. Then again, if they don't get tax money, they would charge.

California has a complicated system, huh?

Municipal or county EMS bills can vary greatly from place to place.

DS had to make a ride in a Chicago suburb do to heat exhaustion at a hockey game. Long story and unnecessary ambulance call by the rink operator's S.O.P. later, came a $5,000.00 bill.

Same soup, different bowl here in the home town area cost me $385.00.


Now if I could just get him to listen about drinking the proper fluids in the hours leading up to the games.

Lots of taxpayer-funded county or municipal fire/rescue or EMS providers charge for ambulance transportation.

Typically, there is no charge if they don't actually transport you. Often, billing is handled by private contractors who are paid a percentage of their collections. They can get aggressive.

Some fire departments may charge for certain services. Crash rescue calls may be billed to auto insurers, and some fires are also being billed, depending on the cause. Around here, some law enforcement agencies are even billing non-residents a fee for their services at motor vehicle collisions (not to mention the inevitable citation, a.k.a. "ticket")