Balance Billing in Washington state
My wife and I had our first baby and we had to go to UW medicine for the birth due to it being a high risk pregnancy. UW medicine and Seattle children’s hospital are both in-network facilities. (UMR insurance)
She was scheduled for C-section and everything, and right after baby was born he was getting transported to Seattle children’s hospital via ambulance. Everything went great, no issues.
We’ve already hit our maximum out of pocket. But now we’re getting an ambulance bill of $5,270. Our insurance said they paid $1,200 of it but the ambulance can charge more than what the insurance is allowed to pay?
We’ve talked to both the ambulance service, and our insurance (UMR) and both said to appeal it, but in opposite directions.
I’ve read that as of January 2025 balance billing is illegal in Washington state under the balance billing protections act.
Confused about what to do/who to call.