Omaha sends a cardiac patient bill for the remainder of the cost of the ambulance ride
OMAHA, Neb. (WOWT) – In the panic of a life and death emergency, most wouldn’t worry about the cost of an ambulance. However, there is a fee for a rescue team, and some health insurances may not cover the entire bill.
Now a patient owes the city money even though he has full cover.
“I went to my house and felt light-headed,” said heart patient Randall Sedlak. “I knew something was really wrong.”
With a history of heart problems, Sedlak feared that his time was up. He called 9-1-1 during an episode a few months ago and an Omaha Fire and Rescue team arrived quickly to take him to a hospital.
Fortunately, his medical emergency didn’t turn out to be serious, but Sedlak said his blood pressure skyrocketed when he went to the mailbox and found an Omaha city bill for the ambulance because his insurance company didn’t pay for it all.
The city charged him $ 985 for the call, but Bright HealthCare insurance doesn’t pay that much, so Sedlak has a bill of nearly $ 400 to cover.
“But I had hit my pocket out of pocket before the 9-1-1 call, so I knew I should be 100% covered. Of course I’ll call 9-1-1 and get help right away, ”he said.
However, Bright Healthcare does not have a contract with Omaha, so a rescue team call is made outside the network and the insurance carrier only pays 60%.
“I’ll be scared of calling 9-1-1 for medical transport if I think I need to go to the emergency room quickly,” Sedlak said. “I’m going to knock on my neighbors’ doors.”
But friends and family may not take you to the right hospital.
“Survivability is literally decreasing by the minute,” said Dr. Eric Ernest, ER of Nebraska Medicine. “If you end up in the wrong hospital and need an advanced procedure that isn’t available in this hospital and we end up convicting you, all those minutes in between are killing off part of the brain.”
Omaha’s first responders clearing company processes about 600 fees a month, and most insurance companies don’t pay full for some because the city isn’t a participating provider.
“Most agencies are willing to work with people on payment plans,” said Dr. Ernest. “I’m not going to call anyone about their service if I can’t pay for their service.”
The city has a hardship program that is fair and consistent with rescue patients struggling to pay the fees.
Sedlak said he expected Bright’s insurance to cover the entire bill for his transport to the emergency room rather than putting him in financial distress.
“I paid for the insurance,” he said. “I just want what I will come – no more; not less.”
A Bright HealthCare representative confirmed that Sedlak has qualified for full medical emergency coverage. He said the company had been appealed for failing to pay Omaha’s full rate and the lawsuit had been re-filed.
Sedlak said he bought the policy through the Affordable Care Act, so 6 News contacted the federal agency overseeing the program, but they are unable to comment.
A complaint has also been filed with the Nebraska Department of Insurance.
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