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Dwayne B.
Dwayne B., Attorney
Category: Legal
Satisfied Customers: 32154
Experience:  Began practicing law in 1992
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On 4/30/16 I went to Summa Wadsworth Rittman hospital with

Customer Question

On 4/30/16 I went to Summa Wadsworth Rittman hospital with stomach pain. After a CAT scan I was diagnosed with diverticulitis, a condition I had a few years back, was diagnosed at Wadsworth, given a prescription for antibiotics, sent home, and the condition was successfully treated. When I went this time I was pretty sure I knew what the problem was.
After this diagnosis I was told they wanted to admit me and give me IV antibiotics but since they no longer admit patients at Summa Wadsworth I would need to go to Summa Barberton. I told them I would drive to Barberton citizens. The attending physician insisted it would be best to start my IV now and send me by ambulance. I was in no more pain than I had been in for the last two days and I had already been to the grocery store and back that morning with the intention of going to the emergency room when finished. At this time I was also told that arriving by ambulance would save me a couple hours sitting in admitting waiting for a room. What I was not told is that this convenience would cost ne over $1700.00 for a 13 mile (non-emergency) ambulance drive that I wanted to make myself.
They had all my insurance information they should have known what this ride was going to cost out of pocket. The ambulance service was also considered out of network, just how much are you expected to know before you put you trust and take the advice of a medical professional. What I did know at the time is that I could have easily drove myself the 13 miles to Barberton, what I didn’t know was the tremendous cost to me for taking their advice and not doing it myself.
The providers charge for a 13-mile ride is $2041.41.
The non-covered charges come to $1225.96.
The plan allowance covered charges are $815.45.
My coinsurance is $61.32
My deductable is $508.87.
My health plan paid $245.26 leaving me with an ambulance bill of $1796.15.
Do I rally owe this for a ride I didn’t want or need?
Submitted: 3 months ago.
Category: Legal
Expert:  Dwayne B. replied 3 months ago.

Hello and thank you for contacting us. This is Dwayne B. and I’m an expert here and looking forward to assisting you today. If at any point any of my answers aren’t clear please don’t hesitate to ask for clarification. Also, I can only answer the questions you specifically ask and based on the facts that you give so please be sure that you ask the questions you want to ask and provide all necessary facts. Please note: This is general information for educational purposes only and is not legal advice. No specific course of action is proposed herein, and no attorney-client relationship or privilege is formed by speaking to an expert on this site. By continuing, you confirm that you understand and agree to these terms.

At this point, yes you would owe for this service.

In the papers you sign at the hospital they all have a document stating that you understand that insurance may not cover all or a portion of the bill and that you agree to pay for whatever it does not cover.

However, you can file a lawsuit and ask the court to make a Declaratory Judgment that the service was not "reasonable and necessary" and therefore you don't owe the money for this.

In addition, you can sue for the attorney's fees you incur in this.

You can also file a complaint with the state licensing agency for hospitals and/or physicians but they don't actually have any power to declare that you don't owe the money.

If your question has been answered then I'd offer my best wishes to you and ask that you please not forget to leave a Positive Rating so I receive credit for my work.

Of course, please feel free to ask any follow up questions in this thread. I want to be sure that all of your questions are answered. In addition, once you issue your Positive Rating the question will lock open and no longer time out so you can come back to it anytime in the future if you think of any follow ups.