Trauma of unpaid ambulance bills

INLSA

ER24 has promised to find out why the company did not contact accident victims to tell them they owed them money before handing them over to legal debt collectors. However, ER24 has since written off their debts. Picture: Sizwe Ndingane

Imagine if you’re involved in a car accident and you’re transported from the scene of the accident to hospital.

You have medical aid, and you don’t receive a bill from the ambulance service – or any demand for payment – so naturally you assume the bill was sent directly to your medical aid, which settled it.

Then, more than two years later, you discover the bill was unpaid, and you receive an SMS out of the blue, demanding payment – or you apply for credit and get turned down, because of an adverse credit bureau listing relating to an unpaid ambulance service bill.

In the space of five days I received pleas for help from two people – Bonani Mona of Pretoria and Steve Meyer of Durban – whose ER24 experiences dating back to 2009 were remarkably similar.

Meyer was totally unconscious as a result of a car accident in Durban when he was transported to a private hospital by an ER24 ambulance team in April 2009. He was admitted to the intensive care unit.

An employee of a listed SA company, he assumed his medical aid had settled the ambulance bill, that is until he applied for vehicle finance late last month, and was turned down on the basis of a “blacklisting” due to the unpaid ambulance bill.

He made enquiries and was sent two sets of documentation by ER24’s attorneys, backing up their claim. It appears the original ambulance bill was “short-paid”, leaving a balance of just under R2 000, which was handed over to the attorneys in April 2010.

With interest, and the cost of sending Meyer an SMS every month, as well as regular phone calls, that amount had swelled to about R3 500 by the end of February this year.

Meyer emphatically denies ever being phoned or SMSed about the amount allegedly owing.

“Both ER24 and the attorneys had my current phone numbers, both my cellphone and work. I didn’t hear from them – not once.”

In the second case, Bonani Mona, a member of the SANDF, was transported to hospital after injuring her back in a car accident on the night of September 23, 2009.

Her two young children, who were with her in the car, but were not injured in the accident, travelled with her in the ambulance.

Like Meyer, she never received a demand for payment for the ambulance service, and assumed the SANDF medical aid had settled the amount owing.

Then, last month, she received three SMSes, each reading: “An unpaid medical account needs your urgent attention, for more info and to arrange payment, contact…”

She replied, saying the SMS must have been sent to the wrong person. She was then phoned by the attorneys and told the account was for ER24 ambulance service transportation, which had not been paid by her medical aid.

“I told the gentleman that I am in the military and asked him to send me the invoice for the ambulance service so that I could follow up with my medical aid,” she said.

“There was no record on the military health system of such an invoice being sent.”

Despite a string of e-mails between Mona and ER24’s attorneys asking for ER24’s invoice and clinical report, these were not provided – only the statements.

“ER24 has never phoned or sent me an account, telling me that my medical aid had not paid, and asking me to pay.

“How can I be handed over without being notified first of the debt?”

She has since discovered that she was charged for the treatment of both her children in the ambulance – more than R2 000 each, the same charge as for herself – but insists they were not injured at all, and received no treatment.

“One of them was sitting on the lap of one of the paramedics,” she said. “I witnessed this, because while I was strapped to a stretcher, I was 100 percent conscious.

“And there are no hospital records of the children being treated that day,” she said.

I took up the cases with ER24, asking whether the company had attempted to contact them about the amounts outstanding before handing them over to their attorneys, and whether the attorneys could prove that the SMSes sent – and charged for in Meyer’s case – were in fact sent.

Responding, ER24’s communications manager Werner Vermaak said in Meyer’s case, his medical aid only covered a portion of his ambulance transport fee, despite the fact that, as he was admitted directly to the ICU, the ambulance was regarded as a prescribed minimum benefit and therefore the medical aid should have paid the transportation cost in full.

As a result of this mistake on his medical aid’s part, Meyer became liable for the shortfall, Vermaak said.

ER24 has since been in contact with both Meyer and his medical aid, and the latter has agreed to cover the outstanding balance.

“We understand that the client has since been blacklisted and we have given instruction to remove the client from any ITC records,” Vermaak said.

Regarding Mona’s case, Vermaak said it had been thoroughly investigated on receipt of my e-mail, “and it was found on patient report forms that all three patients were treated in the ambulance after the collision”.

However, the case was incorrectly billed to the SANDF, he said. “And we have found that there was a lack in communication with the client regarding this case, and would like to apologise for this.

“We have agreed with Practice Relief that the account will be written off and Mrs Mona’s adverse listing will be removed from all ITC records.”

As for Meyer’s allegation that he was not contacted by either ER24 or their attorneys in the three years since his accident, and Mona’s allegation that she was also not contacted by ER24 in any way before being handed over, Vermaak said the communication issues were being “addressed”.

“We are in the process of reviewing the communication policies to identify why they were not contacted,” he said.

In a third case, Samantha Hartmann of Somerset West wrote to Consumer Alert last week about her trip in an ER24 ambulance to Sunninghill Hospital last October after a car accident in Johannesburg.

She was later taken by state ambulance to Johannesburg General Hospital after it was established that she was unemployed, and not a medical aid patient.

As she was drifting in and out of consciousness immediately after the accident, she doesn’t recall if she was asked by the ER24 paramedics whether she had medical aid.

She then received an ER24 account of R6 021, a sum which was discounted to R4 000 when Hartmann explained her circumstances. She was told she had to settle this within three months, which she was unable to do.

Consumer Alert submitted this case to ER24 with the other two, and Vermaak said after a review of the case, the outstanding amount had been written off in full.

The former two cases raise quite a few issues: clearly consumers have a right to be informed by a company that they owe money, and given a chance to pay the amount or contest it, before their accounts are handed over to attorneys.

And you have the right to be informed if a company intends to report negative information about you to a credit bureau.

It’s worth checking, also, after an ambulance trip, that the account has been settled.