In January’s bitter cold, Mrs. Cole, a frail 85-year-old woman, was blown over by a strong gust of wind. She cracked her head open when she hit the sidewalk, and lay bleeding, unable to get up and in need of immediate medical attention. Fortunately, a Good Samaritan called 911 and she was taken by ambulance to the local emergency room where she received the necessary care. Unfortunately, Mrs. Cole’s ordeal didn’t end at the emergency room. It continued with the wrongful denial of coverage for the ambulance ride that saved her life.
After being treated and released, Mrs. Cole received a large, unexpected bill from the ambulance company. It had submitted her claim to Medicare as “non-covered,” a billing code that ensured an immediate denial. The company then billed her directly and threatened to turn her over to a collection agency. When Mrs. Cole contacted the Center for Medicare Advocacy, one of our Good Samaritans, an attorney with years of experience advocating for Medicare beneficiaries, was there to help. Our attorney listened to Mrs. Cole’s story and appealed this wrongful denial.
As always, our work didn’t stop with responding to Mrs. Cole’s immediate needs. Mrs. Cole and callers like her prompted us to begin working with legislators to stop the regular, inappropriate use of Medicare’s “non-covered” billing code for ambulance services. Our ability to move from individual assistance to systemic change is a key reason the Center for Medicare Advocacy continues to be a leader in advancing fair access to Medicare and health care.