They told me Medicare would pay

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    • #3703
      Bessie
      Participant

      I was having heart problems. At home heart monitor verified something wasn’t right. Heart rate is right then suddenly falls to 42bpm. This was ongoing for a couple hours. I called ambulance. EMT assured me Medicare would pay for transport. I asked because I knew there were changes in medical that I didn’t know about so I asked. Medicare denied payment. Er didn’t find the problem. My doctor when informed put me on a 48 hour halter and discovered I had electrical conduction problems in my heart which caused the sudden drops or sudden dramatic increases(up to 140bpm) in my heart rate. Seems ambulance co. only mentioned the initial symptom of nausea in report and that info wasn’t correctly given. I had to repeal the decision and before repeal was answered ambulance co. turned debt over to collection. Also ambulance co. refused to send info asked for until it was too late. Now collection says I need to contact them to confirm or deny the debt and they gave me a time limit. Does it make a difference or do they just want to know that I am getting their mail? I was once told that if you make even one payment on a disputed debt that its a mistake. What do you say? Thank you in advance.

    • #3709
      Lex
      Keymaster

      Medicare, just like private insurers, will refuse coverage if the provider has not entered the right key for the service provided. Is that what happened? Did they simply say, in effect, ambulance service was used for a case of nausea?

    • #3713
      Bessie
      Participant

      I was told that certain key or code wasn’t entered and it did sound like it was simply for nausea for a short while when on potty. It wasn’t even while I was at potty. Report was inaccurate and tremendously brief only stating nausea. What does a person do? I sent Medicare a page from hospital records that said an x-ray was done due to chest pain. They also did an ECG which I didn’t send because someone from Medicare said they didn’t want all my records and to make it brief. I felt reason for x-ray showed there was chest pain. I also sent letter from my cardiologist stating tests reveal I already had one heart attack and anytime I have chest pain I should take an ambulance to hospital.
      I told Ambulance provider Medicare said there was a key or code not provided. They simply said, ” They always say that.”
      How can they do that when EMT assured me Medicare would pay. Then they refused to send trip sheet to Medicare when asked. After I got second denial trip sheet was sent in, same day they mailed letter of second denial telling me trip sheet was not received. If trip sheet is what I think it is, one of papers I asked Provider for, it said stretcher was used and transport reason was for breathing. But report given me only mentioned nausea while on potty. It said reason for call in was because pulse ox showed HR at 140 bpm. Appreciate any help or understanding you can give. My heart settled in ambulance but at home their monitor confirmed the reason I called was accurate. It showed the sudden dramatic fall in heart rate. Seems they didn’t include the recordings in my home. Don’t know why. Thank you for any advice.

      • This reply was modified 3 years, 2 months ago by Bessie.
    • #3717
      Lex
      Keymaster

      From our experience the insurer will not do anything until the provider keys the claim properly. We have spent literally hours on the phone going back and forth on this. It boils down to a total impasse that can only be breached if someone from the ambulance company re-does the claim.

      It also seems that once a provider turns the account over to a collection agency, they no longer care. They are now going to write the bill off and it isn’t worth their while to take any action.

      And yes, to answer your question, a partial payment can be considered an acknowledgement of the debt. To the extent you are being asked whether you want to deny the debts, then by all means do so.

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