Dispute between ambulance company and insurance company leaves customers in the middle

ORLANDO, Fla. — An Orlando woman has received a barrage of bills and texts demanding hundreds of dollars for a five-minute ambulance ride that her insurance carrier assured her was in-network.

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Now, Investigative Reporter Karla Ray has uncovered an even bigger dispute between one of the largest private ambulance companies in the country and one of the largest insurers in Florida, and how this could happen to any of us.

Florida Blue and ambulance company American Medical Response scheduled a meeting for this week to try to work out a deal, after 9 Investigates brought concerns to them and the two sides realized a year-long dispute between the companies hadn’t been resolved.

Unlike other states that have mandated cost caps for ambulance rides in cases like this, there are no protections for Floridians; if you call 911, you’re at the mercy of whatever ambulance shows up, whether they’re in your network or not.

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Hayes Traficante is a healthy, happy baby who is hitting all his milestones. It’s a relief after a planned homebirth led to an emergency trip to the hospital, as Hayes’ heart kept slowing down during labor.

“When my midwife told me that we would have to call an ambulance, and transfer to the hospital because of the heart decelerations, I broke down,” Morgan Traficante said about her baby.

The family lives in Delaney Park, a very short trip to Winnie Palmer Hospital, and she didn’t think twice when a private ambulance company, American Medical Response, showed up after a 911 call.

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“I was really scared for my baby, and I just wanted to make sure he was going to be okay,” Traficante said. “I was coherent, I was just emotional. I didn’t think twice about what was on the side of the ambulance.”

That kicked off what’s now been a multi-month dispute over who should pay the bill. AMR has sent Traficante a bill notification every few days by email and text since February; a bill her insurance provider, Florida Blue, assured her she didn’t owe.

“They told me, we paid out your claim, they’re an in-network provider, you only owe $34 and change,” Traficante said. “I said, well, that’s weird, because the ambulance company is sending me a bill for $670-something dollars, and they’re telling me they are not an in-network provider.”

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AMR told us the same thing, explaining in a statement: American Medical Response (AMR) became an out-of-network provider for Blue Cross Blue Shield (BCBS) Florida in March 2023 after BCBS declined to offer in-network reimbursement rates that adequately cover the rising costs of first responder wages, supplies and other operational needs.

It appears that BCBS has not updated its system to reflect AMR’s out-of-network status and continues to erroneously pay us the insufficient rates. Further, they are misrepresenting the coverage to their customers. AMR has notified BCBS of this matter, and they have failed to correct the issue. Unfortunately, AMR is unable to correct BCBS’s continued misrepresentations to their members and there is little to no legislation protecting patients from these unfair tactics imposed by insurance companies.

AMR has taken a leading role in helping drive changes that will protect patients and healthcare providers. During the 2024 legislative session, we advocated strongly for SB 568 and HB 639, two bills that would have taken patients out of the middle of billing disputes and require commercial insurance companies to provide adequate reimbursement for ambulance services. The bills unanimously passed three committees in the Senate and House. We look forward to helping secure protections for patients during the 2025 legislative session.

AMR provides the highest level of prehospital care available, without regard to the patient’s insurance status or ability to pay. We understand the complexities that arise after an emergency illness or injury and that is why we have a dedicated team of Patient Advocates who are committed to assisting patients through this process. AMR also offers a Compassionate Billing program, where our patient advocates work with individuals and families who may qualify for reduced payment or balance forgiveness.

In response, Florida Blue told us: American Medical Response (AMR) notified Florida Blue in early 2023 of its intention to terminate the longstanding network agreement between Florida Blue and AMR, and demanded exorbitant rate increases that are out of step with others in our network. Network decisions are not taken lightly, and Florida Blue remains committed to keeping health care affordable for our members and the communities we serve. We have attempted to work with AMR to resolve this issue and regret members being put in the middle - and will continue working to resolve this matter.

“One of the problems with ambulances is that it’s such a patchwork around the country of what kind of companies are even running the ambulances, combined with a national EMT shortage,” Caitlin Donovan with the nonprofit Patient Advocate Foundation said, pointing out a federal law known as the ‘No Surprises Act’ prevents this type of issue for most other medical procedures, and even air ambulance rides, but ground transportation was left out of the legislation due to the range of providers varying from one jurisdiction to the next.

Several states have closed that gap, but a measure that would have done so in Florida died during this year’s legislative session.

Florida Blue told 9 Investigates the company is hopeful to get this issue resolved for any other customers caught in the middle.

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