Ambulance Debt Lawsuit, Fraud?

by Kevin

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?

Comments for Ambulance Debt Lawsuit, Fraud?

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Nov 02, 2009
Ambulance billing fraud?
by: Gerri


I am truly floored that you are being taken to court over this small bill. They must really be hurting or incredibly incompetent - or perhaps both.

You have several options right now:

Caveat: I am not an attorney and this is not legal advice. Only an attorney in your state can provide you with specific legal guidance.

1. Call your insurance company and see if they can offer any advice. Health insurance companies often have a department that investigates fraud complaints. I know you've already talked with them, but it may not hurt to see if they can provide any further advice. At a minimum, ask them for a written confirmation that the bill has been paid in full per their agreement with the ambulance company.

2. Try to head off the court date. Send a certified, notarized letter to the company filing the lawsuit against you with a summary of the situation and describe the evidence you have to back it up. Ask for them to withdraw the lawsuit and to provide you confirmation in writing that there is no balance. Send a copy this letter to your state attorney general's office.

3. Consult an attorney. We would strongly recommend you talk with a consumer law attorney with experience in debt collection cases. Find out how to get a FREE consultation with a consumer law attorney here.

Here's the good news. If the company violated the Fair Debt Collection Practices Act in pursuing this debt (and I suspect they did), then you may be able to sue them. And you may be entitled to attorney's fees and damages. There may be other laws they broke here, and an attorney can help you determine that.

4. Show up in court and show the judge your evidence. My concern there is I don't know the procedures in your state. Even if you don't hire an attorney, you may be able to get some general feedback on representing yourself in civil court.

Whatever you do, do not fail to show up on the court date unless you have written documentation showing the complaint has been dismissed and/or your attorney tells you otherwise. If you don't show up, the company will be able to get a default judgment against you and that will open up other avenues for them to collect this bogus debt.

Please do let us know what happens - I am really anxious to hear how this turns out for you. (Comment on your post when you get to a resolution.)

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