Emergency medical services can be expensive and navigating the billing process can be challenging. For example, ground ambulance services can cost $2,000+ per trip, while an air ambulance flight can cost even more.1* These costs can be influenced by factors such as distance, the level of medical care provided, and the type of transportation.
If you're a MASA member, your membership can shield you from emergency medical transportation bills. But what about those other medical bills? We've created this guide to help you understand how medical billing works and what you can do to help lower or eliminate those costs. Here are some steps you can take once you’ve received your bill:
Review your bill carefully
Thoroughly review your bill to ensure all charges are accurate. Look for and note any errors on your bill, such as duplicate charges or services that were not provided.
Check your insurance coverage
Before negotiating, understand what your health insurance covers and what it doesn't. Reach out to your insurance company to confirm the details of your coverage and determine how much of the bill they will pay. You can contact most insurance companies via their toll-free customer service phone number, their app, or their online portal. Carefully compare your bill to your insurer's plan documentation, such as an Explanation of Benefits (EOB) — which will establish your cost-share maximum for the service rendered — and note any discrepancies.
Contact the service provider
Speak with the ambulance company or emergency medical provider directly. Request an itemized statement and ask about their policy on negotiating bills. Search online for information about the billing codes listed on your bill, so you can understand what services and supplies those codes represent.
Research comparable prices
Use the Hospital Cost and Utilization Project databases to search for comparable prices or contact other local providers and ask what they charge for those services.
Now that you've prepared your strategy, you're ready to negotiate:
Negotiate the amount
Be polite but firm. If you can pay promptly, offer to pay a lump sum that is lower than the total amount due or request a discount. It's worth it to ask if the provider has a financial assistance program, especially if you can demonstrate financial hardship. Be aware that providers may be prohibited by law from discounting rates or adjusting cost-share amounts, including for Medicare and Medicaid beneficiaries.
Appeal and dispute
If your initial attempts at negotiation are unsuccessful, consider disputing the claim decision by filing a formal appeal. Provide evidence of any errors or issues with your billing, such as duplicate charges or services that were not provided, and submit a written appeal to the provider or insurance company. You may also appeal denials if you believe they are in error. Requesting additional written explanation from the provider may be useful for appealing denials. Finally, there are instances where the provider is required to dispute a denial on behalf of the patient. In these cases, the provider will process the dispute through a federal or state-appointed independent resolution commission.
Need financial aid?
Look into any available financial assistance programs that might help cover emergency medical costs. For example, if you are Medicaid-eligible, depending on your state, you could access retroactive coverage.
Hospitals and ambulance services often have charity care programs or sliding scale fees based on income. Some states have charity care laws that actually require hospitals to provide free or discounted care to patients meeting certain requirements or based on income.
Consider seeking help from a patient advocate
You may also want to contact a patient advocate. A patient advocate could help you apply for financial assistance and connect you to more resources.
Negotiating emergency medical claims may be a viable option for reducing the financial burden of unexpected medical emergencies. By closely reviewing your bill, understanding your insurance coverage, and directly engaging with service providers, you may be able to lower your expenses or arrange a manageable payment plan.
And remember, if you're a MASA member, you already have the most useful tool you can have to help protect yourself from out-of-pocket emergency medical transportation costs. When you receive your medical transit bill, skip the negotiation steps and submit it through our member portal. We’re there to help, when you need it most.
1: MASA claims data compiled Jan. 2025
*Based upon the enactment of certain legal protections regarding surprise medical billing, actual member liability may be less than the provider's charges.
