The Ambulance Billing Appeals Process

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Health insurance schemes rarely cover the entire cost of ambulance bills. One should familiarize themselves with the ambulance billing appeals process since insurance companies reserve the right to either partially or fully deny paying ambulance companies for any of the following reasons:

  • Ambulance is not among the covered services as per the insurance agreement

  • The ambulance did not take the patient to the nearest hospital

  • The use of an ambulance was not medically necessary

However, just because your claim to get reimbursed for an ambulance bill has been denied does not mean that you cannot recover your money. Most insurance companies provide for an ambulance billing appeals process. It may be useful to actually go through the appeals process before you decide which insurance company you get.

Before you begin the ambulance billing appeals process, it is important that you research what exactly the deadline is for filing the appeal. In the case of Medicare, an appeal must be filed within 120 days of receiving the denial. However, this figure may vary from one company to the next.

Part of the ambulance billing appeals process involves proving that ambulance transport was in fact necessary. A letter from the physician who treated you at the hospital can go a long way in convincing insurance companies that you needed an ambulance medically. You should also send in your medical reports, which can be obtained from your hospital for a small fee.

The exact ambulance billing appeals process varies from one insurance company to another. If you take the time out to look through your insurance deed, you will find out what exactly you need to provide to them. If you have Medicare, you will need to fill out the Medicare Redetermination Request Form that can be found on its website. Other insurance companies have similar paperwork that requires you to highlight why exactly you are appealing their decision not to fully compensate you for your ambulance bill.