Superior Ambulance Service

My experience with the EMTs were horrible! They picked me up at Midwest Express in Munster, In., on 09/19th. Very rude behaviour...apparently they get too many no real emergencies from the clinic because of their protocol he said , so their way of not taking any responsibility for ones health...anyway he asked me to stand up and walk and states, Oh you can walk, I never said I couldn't walk, plus he acted like I was more of a burden than anything. I was saying in the ambulance that I would not have went by ambulance if it were not for my daughter and the doctor and the man behind me said, we're not making you go, I said I did not say you...then when the EMT was putting the needle in my hand I never had anyone hurt me so bad ever in my life putting a needle in..they were rough, had no compassion...never will I ever deal with them again! And I would tell anyone the same thing!

If there was a 0-star option that would be my choice...
My dad fell in the Jewel parking lot in Dyer, and a bystander called 911. Superior ambulance came to the scene, looked at my dad, and said he seems to be stable, and to avoid a big bill my mom could just take him to an urgent aid. We decided to have my mom drive him to the hospital, where they determined he had a broken back and subsequently passed away a week after the fall.
Superior billed my mom $900, they coded the bill initially as an airlift transport, and we have tried to fight the bill, but they refuse to waive the bill. They did not take his vitals nor did they transport him, but are threatening my mom to take her to collections over their fraudulent bill.
Obviously, my mom is distraught over the loss of my dad, and each bill that comes in from Superior added to the complex grief she is facing.
Avoid Superior Ambulance at all costs, they are not a professional, caring organization.

Initial Business Response / [redacted] (1000, 5, 2015/06/23) */ Contact Name and Title: [redacted] Contact Phone: XXX-XXX-XXXX Contact Email: [redacted] @superiorambulance.com In reviewing the account, the documentation from the crew as well as the discharge planner didn't have enough information to support medical necessity in accordance with [redacted] guidelinesThe EOB from [redacted] does not state this is not collectible from the patientAll patients receive the same statements and letters requesting payment or to contact our officeAfter initially receiving a payment from [redacted] they requested a refund stating the transport was not medically necessaryThe patient's family has been in contact with our office as well as appealing to [redacted] Yesterday the family contacted us and said it was our fault that we notified [redacted] the transport was not medically necessarySince there was not enough supporting documentation to show this trip was necessary [redacted] demands that we add a code to the bill stating it is not a covered serviceWe have contacted [redacted] on behalf of the patient on several occasions and have asked to do a second level of appeal on this transport on 6/23/reference [redacted] At this point, we are awaiting for the results of the appealTo clarify ambulance billing to [redacted] is very different than hospital or physician billing, it demands medical necessity at the time of transport, not a history of the patient's healthBecause of that difference, it is difficult to educate clinical personnel to the special requirements for ambulance services (as well as the fact that [redacted] regulations are stricter every year)Unfortunately it is very common to receive incomplete documentation to support a transportThe path the family has taken is very proactive and correct and unfortunately the patient is placed in this awkward position, but they did receive the service, as well as other medical services, which we all do not like to pay for, but unfortunately are required to respondI hope that the appeal has a posititve outcome, but if not, we are more than willing to work with the family Initial Consumer Rebuttal / [redacted] (3000, 7, 2015/07/02) */ (The consumer indicated he/she DID NOT accept the response from the business.) The paramedics from Superior ambulance did NOT ask me any questions regarding ***'s ability to walk or maintain posture (or any other pertinent or relevant questions regarding her medical conditions to properly evaluate her medical needs for transport) NOR request further information from other hospital staff at the time of transport that I am aware of...they took her without informing us of anythingThere was NO DISCLOSURE of their determinationMy understanding from her Doctor is that there are many reasons why the run would be considered medically necessary by [redacted] standardsthis process was not fully completedI received a call from [redacted] after filing the first medicare appeal (myself) from [redacted] (NGS) indicating there was an error in billing on Superior's partHe stated this was CO contractor obligation since they returned the checkSince then, further documentation to support medical necessity has been forwarded to the [redacted] appeals department and is still pending initiated by our familyI am unaware of any further "assistance" for further medical review initiated by Superior to benefit *** The issue at hand is that Superior and their employee paramedics were too quick to decide services were not coveredThe NGS agent for medicare was shocked they returned the check [redacted] did NOT decline services NOR request the check backThe returned check was initiated by Superior which we believe was a tactic to decline medicare dollars so that the billing department can forward a bill to the patient of five times the amount that would have been received by accepting the [redacted] check under contractThe [redacted] Summary Notice sent from [redacted] DOES indicate that the maximum you may billed for this service is zeroOur family contacted them to stop billing us during the medicare appeals process and quit threatening further collection activitySuperior did finally agree to stop billing during this process however, they still are refusing to accept that this run is medically necessary per documentation presented thus far

Unfortunately, we do not have any control of what a patient's policy will or will not cover for ambulance servicesThe insurance the patient has does not contract with any ambulance provider in the state of IL, which unfortunately leaves the patient with whatever balance they deem is reasonable,
but does not include what it actually cost us to transport a patient, in this case over miles to another hospitalIn reviewing the account, the insurance paid $which doesn't not cover the cost of the transportWe have seen payments from this insurance run from a low of $to paying a balance in fullSince we are not part of the process when creating these policies, we do not have any input for their paymentsThe spouse did contact our customer service department who did review the account and negotiated a patient responsibility of $which includes a maximum discount for these servicesThis also takes into account the fact that the patient will pay in either one or two payments in order not carry on a balanceOur policy offers a choice of either payment plans for up to months or a year, or a prompt pay discountWith the rising cost of care the past few years, many other healthcare providers no longer offer discounts on their billsMany patients do not hesitate to complain about an ambulance bill, but accept the costs of physicians and hospitals because they consider it acceptable for servicesMost do not realize the cost of transporting a patient in a "portable ER"Unfortunately we are in the same situation as the physicians and hospitals when it comes to the rising costs of healthcare, but insurance policies cover these services under a different section of their policy hence a different co-pay and deductible

Complaint: ***
I am rejecting this response because:With the mounting medical bill from the patient's surgical operation earlier this year we were glad we finally met oursuper high insurance deductible and anticipate the medical benefit we insured can start kicking in now we are bombard with another huge bill not mention that we are still struggling paying all our deductible from the hospitalI still believe the ambulance provider could have infomred us up front the potential cost entails and their no-contract situtaion with our insurance so we can figure out other option at that time especially when the patient was still consciousness and the relative was with her all the timeWe honetly don't have any idea what cost is involved reletively to the patient transportation but please do consider we are still trying to meet our other medical bill obligation and in the meantime feeding our kidsI am willing to pay off in two months.
Sincerely,
Rong *** ***

Complaint: ***
I am rejecting this response because: they are missing the point entirelyYes when I called on Monday I asked to speak with management it was because this was the third callYou need to review the previous two phone calls in July and AugustYou need to review the fact that according to your management rep the file was already under investigation and you need to review why your company sent a disputed debt to collectionsYou also need to explain how you are correction your errorsI am not arguing with you but I now have to respond to a collection agency due to these errors
Sincerely,
James ***

Unfortunately sometimes the information we receive from a facility (in this case a hospital) can cause confusion or possibly more than one individual with the same nameIt is possible that this is the issue here and since there was no confirmation when we requested identifying information to
confirm that this was incorrect, we can only make assumptionsI will attempt to identify the correct information and in the meantime, you will not be responsible for any bills

Run number ***I can't express enough our apologizes because you are absolutely correct, you should have received your refund weeks ago and I will personally bring this to our director, who will address this with our executive teamThe past few months there has been changes as to how refunds
are processedwe hired an individual to review all our credit balances so we can send refunds more timelyUnfortunately this created an avalanche of refunds, and our finance (and company owners) questioned the validity of these refundsTo confirm we were sending these refunds properly our IT department created a reporting function to assure these were proper refundsTo add to the complicated matters, our company changed banks in November, which did not go smoothlyI realize that this doesn't help your situation, but I wanted to give an explanation as to what was happening in the backgroundTo let you know what has happened on your specific refund: your account shows that you called in at the beginning of October to try and put a stop payment on the checkWhen that didn't work you called on 10/26/requesting a refund and again on 12/23/(I'm not sure about the status of the refund on 10/16/15)On 12/29/two customer service reps transferred calls and inquires about the refund to our patient advocate, ***, who forwarded the request to the department manager *** (no information on calls to "***" (a different person then myself))On 12/29/*** approved and forwarded the request for a refund to Finance ("the 4th floor")I also see a call into *** on 1/11/As I mentioned, I will personally speak to our director, Finance and our owners and try to get a check out to you this week, as well as getting back to you with an answerAgain, I cannot apologize to you enough for this delay

If there is a discrepancy between what I wrote and what was discussed on the phone, it is because I responded after reading what was written on the account, which said that the caller refused to give his personal information and requested to speak to management. I will listen to the call to confirm what you stated. Please understand, I'm trying to help and not arguing a point. My goal is to fix the problem so it will not happen again, which will also stop any of these other concerns as well.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID 10975398, and find that this resolution is satisfactory to me.
Sincerely,
Adriane [redacted]

Our run/account number [redacted]. This transport was provided by us on 10/5/15. As a courtesy, we have billed this out to the patient's insurance, [redacted] in Indiana. Since we don not have a direct contract with [redacted] when we bill for services, the patient is paid directly instead of the...

provider of services. Since we provided services, we are looking for timely payments when a patient receives a payment. We first confirm that the payment has been sent to the patient and then contact the patient to obtain payment. Many times if we do not contact the patient as soon as they receive the check, they will spend the payment and told they do not have funds to pay us. In this case, one of the customer service representatives, followed the procedure and contacted the patient who received our services and out payments. The family confirmed that they did receive the payment from the insurance, but made no commitment to pay us. We feel this complaint is a moot point because we are not asking for anything out of the ordinary, but a payment for services rendered which the insurance agreed and paid.

Initial Business Response /* (1000, 5, 2015/06/23) */
Contact Name and Title: [redacted]
Contact Phone: XXX-XXX-XXXX
Contact Email: [redacted]@superiorambulance.com
In reviewing the account, the documentation from the crew as well as the discharge planner didn't have enough information to...

support medical necessity in accordance with [redacted] guidelines. The EOB from [redacted] does not state this is not collectible from the patient. All patients receive the same statements and letters requesting payment or to contact our office. After initially receiving a payment from [redacted] they requested a refund stating the transport was not medically necessary. The patient's family has been in contact with our office as well as appealing to [redacted]. Yesterday the family contacted us and said it was our fault that we notified [redacted] the transport was not medically necessary. Since there was not enough supporting documentation to show this trip was necessary [redacted] demands that we add a code to the bill stating it is not a covered service. We have contacted [redacted] on behalf of the patient on several occasions and have asked to do a second level of appeal on this transport on 6/23/15 reference [redacted] At this point, we are awaiting for the results of the appeal. To clarify ambulance billing to [redacted] is very different than hospital or physician billing, it demands medical necessity at the time of transport, not a history of the patient's health. Because of that difference, it is difficult to educate clinical personnel to the special requirements for ambulance services (as well as the fact that [redacted] regulations are stricter every year). Unfortunately it is very common to receive incomplete documentation to support a transport. The path the family has taken is very proactive and correct and unfortunately the patient is placed in this awkward position, but they did receive the service, as well as other medical services, which we all do not like to pay for, but unfortunately are required to respond. I hope that the appeal has a posititve outcome, but if not, we are more than willing to work with the family.
Initial Consumer Rebuttal /* (3000, 7, 2015/07/02) */
(The consumer indicated he/she DID NOT accept the response from the business.)
The paramedics from Superior ambulance did NOT ask me any questions regarding [redacted]'s ability to walk or maintain posture (or any other pertinent or relevant questions regarding her medical conditions to properly evaluate her medical needs for transport) NOR request further information from other hospital staff at the time of transport that I am aware of...they took her without informing us of anything. There was NO DISCLOSURE of their determination. My understanding from her Doctor is that there are many reasons why the run would be considered medically necessary by [redacted] standards... this process was not fully completed. I received a call from [redacted] after filing the first medicare appeal (myself) from [redacted] (NGS) indicating there was an error in billing on Superior's part. He stated this was CO contractor obligation since they returned the check. Since then, further documentation to support medical necessity has been forwarded to the [redacted] appeals department and is still pending initiated by our family. I am unaware of any further "assistance" for further medical review initiated by Superior to benefit [redacted].
The issue at hand is that Superior and their employee paramedics were too quick to decide services were not covered. The NGS agent for medicare was shocked they returned the check.. [redacted] did NOT decline services NOR request the check back. The returned check was initiated by Superior which we believe was a tactic to decline medicare dollars so that the billing department can forward a bill to the patient of five times the amount that would have been received by accepting the [redacted] check under contract. The [redacted] Summary Notice sent from [redacted] DOES indicate that the maximum you may billed for this service is zero. Our family contacted them to stop billing us during the medicare appeals process and quit threatening further collection activity. Superior did finally agree to stop billing during this process however, they still are refusing to accept that this run is medically necessary per documentation presented thus far.

Patient was transported via a "Critical care" ambulance with a RN as requested by the doctor. Not only did the patient have a fractured arm, but the hospital was concerned due to symptoms of tachycardia, hence the high level of care. The mother also mentioned that no other services were given during...

the transport. we are very thankful that no other services were required, but the reason for a critical care transport, is in the event higher services are needed, they are available. Hindsight is always easy to explain a situation, but at the time, families are very thankful that all these services are available, but then are upset after seeing the costs. Healthcare is an unusual business because it is the only business that cannot predict what services are required, until that moment in time. The mother also stated that she felt that what the insurance paid was adequate to cover the costs of services. Unfortunately it is not realistic to in any business to have the consumer say, "I believe this is what this service will cost, so this is all I will pay". The healthcare and insurance business is no different. In this particular case, the patient's insurance has a contract with us that states, if you as the consumer use this business, will will discount your rate as a "preferred provider", and if you use this provider, you will need to pay a deductible as well as a co-insurance portion as part of our agreement. Well this service have been discounted in accordance with her insurance plan, and now the difference is $1438.15, $520.19 of which is her deductible which she would have had to pay to ANY healthcare provider, it just so happens that our bill went to her insurance prior to any other provider. The remaining balance of $917.96 was her 20% co-insurance as instructed by her policy also. Non of this was listed " as usual and customary" and to compare this CCT service to a basic service level with 2009 rates, is unrealistic. As an attorney, she should also see the rising cost of healthcare when she works with clients. However all that has been said we will be willing to work with the patient's mother and charge her only the deductible of $520.19, which she would have been responsible for with any healthcare provider. This is an unusual offer, because we have already discounted the bill because of our contracted rates. I have spoken with our director of Accounts Receivable and she has agreed with this offer.