Ambulance Debt Lawsuit, Fraud?

[ottoreload]

What is the name of your state (only U.S. law)? Washington

Hello,
My question requires some background so I will try to be as concise as possible. First please know I have no issues with paying debt I owe, however I have a tendency to resist being bullied because I despise it.

The Facts;
I live in Washington State, was in a motorcycle accident in Jan of 2009. As a result of the accident I was transported (via private ambulance) to the hospital where I stayed for 5 days with a concussion, broken ribs, and collapsed lung (requiring a chest tube).

I know the amounts are not much however my reason for not pay is…. I called my insurance company and told them that the ambulance company’s (AMB Co.) bill didn’t match what was billed to the insurance and that the AMB Co. wanted me to pay a higher co-insurance. I was told that my insurance had paid 100% of the billed charges (minus my co-pay), that I didn’t owe what AMB Co. was charging me, any new charges need to be submitted to have them paid. I relayed conversation to AMB Co. & never heard back. Bill was sent to collections, I relayed the above conversation. Now 9 months after the accident and only 4 months after sending the bill to collections I have received a summons & complaint for $237.68 + unlisted court and attorney fees (civil suit, not small claims court).

Since I’m being sued I have been studying the billing and I’m wondering if the billing may constitute fraud;

- There are false charges on the bill (way to many to list and I can prove most of them)

- Besides charges that were never turned into my insurance that I’m being told to pay, there are charges that were not documented by the paramedic (treatment things like IV fluids when I never received any, nor is there any reference to IV fluids being given in the trip documents), and the big discrepancy that was billed to my insurance and paid for is broken out below-
* I was charged an “ALS Base” fee.
- ALS defined by RCW (Revised Code of Washington) 18.73 "Advanced life support" means invasive emergency medical services requiring advanced medical treatment skills…”
* I was also charged a “Cabulance” fee.
- As defined by WAC (Washington Administrative Code) 296-17A-1405 Classification 1405, 1405-00 Ambulance services; “…cabulance service (transporting patients who DO NOT REQUIRE PRE-HOSPITAL CARE to and from medical facilities).”

I can’t possibly be charged for both because their legal definitions are opposite of one another.

Is this insurance fraud or has some consumer protection rule been broken, what counter claim do I have grounds to file?

[ecmst12]

Pay the bill and submit to your insurance company for reimbursement.

[ottoreload]

Originally Posted by ecmst12

Pay the bill and submit to your insurance company for reimbursement.

Pay the bill even though it is fraudulent? They sent me and my insurance company two totally different bills that don’t even agree with the written charges the paramedic claimed at the time of service. Am I to just take the “hit” because I have insurance and a job?

[ecmst12]

Since it's already in collections, you are going to have a hard time negotiating with the ambulance company now. If you'd been persistent with them PRIOR to it going to collections, you might have had a chance. Or you could have sent the bill to your insurance company and let them deal with it then. Now you are being sued. Go to court and present whatever evidence you have that the bill is incorrect, but don't hold your breath.