New Pa. law falls short to solve insurance billing gaps for ambulance rides

A new Pennsylvania law aims to help emergency responders capture elusive reimbursement checks, but rescue squads say the legislation leaves them in a financial emergency, according to Philadelphia Business Journal.

As of Jan. 1, emergency responders can directly bill insurance companies instead of having to request payment from out-of-network patients, who typically receive a reimbursement check from their insurance companies.  

The lump-sum checks confuse many policy holders, and "thousands of dollars are lost each year as insurance payments are not properly sent from the patient to the provider," Timothy Hinchcliff, managing director of Burholme EMS in Philadelphia, told Philadelphia Business Journal.

Under the new direct billing legislation, ambulance companies can avoid nagging patients for payment.

However, some ambulance workers argue in-network reimbursement rates are not enough to cover costs, and will leave companies financially worse off than before.

Thomas Topley, chief of the Bensalem Rescue Squad, said he lost $60,000 last year to policy holders who kept their insurance checks. But he'd likely lose even more if he took the reduced in-network rates, Mr. Topley told the journal.

Insurers, however, believe the legislation takes an important step toward protecting patient's pocketbooks. "We need to make sure our policyholder is not gouged," Samuel Marshall of Insurance Federation told Newsworks.

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