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msdaizy Asked March 2013

Has anyone received bills for ambulance denied by Medicare after death?

I received a bill from AMR that was ordered by Hospice when mom went to the Hospice house. From what I know about Hospice is that everything is 100% covered by medicare. But now this bill comes 2 months to the day of my mom's death? Has anyone received bills after your loved one dies and who is responsible for payment if Medicare denies? Mom is gone and the bill is in her name. What do I do?

ACnobug Apr 2018
I'm about to deal with this same issue. I have two words for all of this: SINGLE PAYER.

If we all lived in Canada, this would not be happening to us.

lstuscany Mar 2018
Msdaizy, I can only relate your experience to one of my own, somewhat similar. I had an occurance where my wife’s back broke due to extreme osteoporosis as a symptom of her advanced MS. I called 911, she was transported to the hospital by the fire dept (FD) ambulance. About 6-8 months later I rec’d an invoice from the FD for $1075 for the 6 mile ride. My wife has been with Medicare since 1996. I’ll shorten this a bit. I spoke with a Medicare operator who was so frustrated with the prevalence of these bogus charges, she filled me in on the scam that Medicare doesn’t care about. The documentation for the transportation has a code, a single letter to designate the transport to be medically necessary or not. Internally, the FD noted a code for necessity. When their contracted billing company sent the invoice to Medicare, they added another letter after the FD letter. This letter noted to Medicare that the transport was, not medically necessary. The final letter is the only letter Medicare looks at. Medicare bounced it back to them as not covered due to the, not medically necessary, letter. When the bill was denied by Medicare, the billing company was free to invoice the $1075 to my wife for transport charges, due in full. I repeatedly was told the invoice will be adjusted, that their was an error. I was then threatened with collection. They do this as Medicare only pays about $300 as full payment, and Medicare denial, gives them the right to full payment. The Medicare operator told me to google, L.A. times and refer to this situation. I found a well written, and extensive article on this. FD’s across the US, per this operator, are also complicit in this scam. It’s illegal, fraudulent and unethical. These are the needy being scammed and have no voice. The operator said she wasn’t allowed to give me this info, but she didn’t care anymore. I shake with anger when I think of this. I feel your pain.

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JoAnn29 Feb 2018
I am pretty sure Moms transport from the NH to Hospital and back was paid for before Medicaid. I don't remember any large amt being billed. Call the transport company and explain this was a Hospice thing. It may have been coded wrong. Call Hospice if you can't get it resolved. If found you owe it it needs to be paid out of the estate. If no money then they will have to write it off. You r not responsible.

lristh1230 Feb 2018
My husband died May 2017, received several ambulance bills in the mail, didn't open them sent them back with return to sender DECEASED. Now tax time, and I received a letter from the state that I owe this $700+ debt to our City for the Ambulance. I am still paying for bills I can't even afford. And to top it off Health Care coverage is too expensive to get so I got a penalty for not having that as well.

MommaHolt Jun 2017
Medicare refused to talk to me without a document from an attorney that would cost me $750!!!

MommaHolt Jun 2017
YES!!! The same thing has happened to me with my father! What can be done about this?

msdaizy Mar 2013
Just wanted to update this thread because I wanted to get this down so that if anyone ever receives a letter such as this can learn from what I have learned. I did some calling first with Medicare to see why the bill wasn't paid? The gal told me that it wasn't paid because it was not ordered by the attending physician and that it had to be a medically necessary transport. I then told the Medicare person that my mom was dying...and I didn't know how much more medically necessary they needed than that. Anyhow...I called my Hospice social worker, very nice lady who worked with me and mom. Carolyn right off tells me..Oh that's our bill. We will take care of it. So she had me send it to her office and they would take care of the bill. So please if you receive bills that are denied payment from medicare or any insurance. Don't just pay them...investigate and don't hesitate to call for answers. God Bless you all.

bookworm Mar 2013
Our hospital requires that you sign the form of responsibility whenever mom or father goes in. SIL found this out after her mom spent months in the hospital and then died. They went after her to pay for her mom's debts. The last time I took mom to the ER, I signed it but I may have done it wrong. I need to word it a certain way. I Googled the info. I think I'm suppose to sign as "Representative for xxxxx Xxxxxx" Something like that. I will need to refresh my memory.

Medicare will only reject coverage if the doctor is not specific enough.

Also, I watch HLN Clark Howard. As long as you didn't sign a form saying that you're responsible, then your mom's debts are hers alone. If they keep insisting you pay, write a letter explaining the situation, make a copy of it, and send it be registered mail (with a return receipt for delivery). Sorry, I get these mixed up - certified or registered. Just remember, any billing that comes along, you are not responsible for it. One caller said that the credit card company kept harrassing him. Even spoke to a family member to tell him to pay. Clark got angry. Later in another episode, he updated us. Clark got the credit card company info, went straight to the top and made a complaint. The bank apologized. And the harrassment ended.

msdaizy Mar 2013
I do have 3 extra original copies..Thanks for the advice. I really do appreciate it.

igloo572 Mar 2013
MsDaisy - what i'd suggest is that you order several of mom's death certificates.
I'd say at least 6 - 10 of them. Most insurance companies, medical practices, etc require a death certificate in order to close a file. Then whenever you get a bill for her, you send them a note stating that she is deceased and attached is an original death certificate and that you are not responsible for any of her debts and that she died in hospice and has no assets. This will probably stop most of the letters and phone calls. The debt collectors can be relentless so you may have to do this more than once. Keep all this in a file so you don't go loco on dealing with it.

msdaizy Mar 2013
Mom had no estate...she lived on a very little income. She had very little in the bank but enough that wouldn't qualify her for Medicaid. She was living in a senior living apartments that was Gov. subsidized due to low income. I don't have anything of mom's that would be of any type of assets. She had no car..didn't drive ever. I don't think I ever signed something that said I was responsible for her bills if medicare didn't pay. I called Medicare they are sending out statements and reasons for the denial. I can only hope that this is the only bill they denied. As I have no job to pay for her medical debts. I'm struggling on my own with all the paperwork of moms. She luckily didn't have any other credit card debts. Only the medical. So I sure hope I don't get bombarded with denied payments from Medicare.
The lady on the phone said that it the denial was because of the reason for transport had to be medically necessary. What??!!! Dying wasn't a medical necessary reason for the transport? She was transported to the Hospice House January 4th and died the 9th. Ugh! I hate dealing with this 2 months after the fact.

igloo572 Mar 2013
2 much - this is so spot-on right on how Medicare needs the justification so they can code to pay anything.

Msdaisy - if mom is deceased, then the debt is a debt of her estate. So that should mean that her estate goes to probate. Any debtor has to go to probate court and present the debt. When probate is opened, there needs to be published at least 3 times an announcement in the paper in the Legal Notices section, to any and all debtors regarding the deceased probate hearings. If they don't get the bill into the line at probate court for her estate, then it's JUST TOO BAD.

Now if you all don't do probate, it's another issue. But either way:
You are not responsible to pay for anything. It's her debt.

anonymous100919 Mar 2013
Not after a death and I don't know what AMR is but I've had the same problem under Medicare with a hospital to home discharge needing medical tranport.. What happens is the facility who deemed transportation necessary did not provide the company with the necessary paperwork (doctor's order, diagnosis justifying need) . The drivers don't bother to check the paperwork and then they try to go after the patient. I resolved it by first appealing to Medicare. Medicare did not care. They said no paperwork, too bad. So I went back to the company and the hospital and told them both - if the hospital failed to do the proper paperwork, that's their negligence, not the patient b/c the patient did not order the tranport, the hospital did. and they failed to get a signed
Advance Beneficiary Notices of Noncoverage (ABNs) where the patient agreed to pay if medicare did not pay.
So between the hospital and the company, they apparently decided to write it off I guess. So the next time I was in this same situation with a family member I insisted on seeing the paperwork of the order. I noticed on the paperwork that there was no justification for the request, so I made the discharge nurse get the doctor to put one down so when it went to Medicare it would not be denied for that reason. Then I got a copy of the paperwork in case I had trouble. So months later when it got processed, it was paid this time with no problem. Don't know if you have the same facts but you can try to appeal it with medicare. When you appeal it they do contact the provider and ask for documentation.

there is a publication www.medicare.gov/Pubs/pdf/11021.pdf
that might help you if this is a medicare payment issue.

if the link doesn't work do an internet search for

medicare coverage of ambulance services

msdaizy Mar 2013
I think I will look into this.. Because Hospice ordered it and under the medicare criteria anything under Hospice is covered. But I am thinking is that AMR did not try and collect this until after medicare suspended her account due to death. I had a friend who also received a bill from AMR that was sent to collections. She paid it and a few months later it was sent again. Something fishy about all of this. I am going call on Monday and see what can be done. Thanks

jeannegibbs Mar 2013
Assuming it is a valid bill, your Mom's estate is responsible. But check with Hospice. Perhaps you should appeal the ruling.

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