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In absence of express contract, how much is the patient obligated to pay for medical services?

Los Angeles, CA |

Paramedics were called to take a patient, who broke his hip, to a hospital. They said Fire Department does not allow other ambulances to transport emergency patients and called FD ambulance, which did the job that the first ambulance was fully capable of doing.

The problem is that FD ambulance charged at least 3 times more than other ambulances in the neighborhood.

At the same time, all ambulances gladly accept even lower payment from the Medicare patients. Medicare rates are, in fact, so attractive that the federal Anti-Kickback Statute had to prohibit ambulances from offering discounts for referrals of Medicare business.

There was no written contract. Is the patient legally obligated to pay the bill in full, pay the predominant rate or the lowest rate FD ambulance willingly accepts?

Basically, I am asking if there are any rules or guidelines how to determine the fair price of the services.

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Attorney answers 2

Posted

You are obligated to pay the full amount. Most of the time, they will negotiate. But if not, they could sue you. If that happens, you might get a judge to agree that the fee is excessive.

Asker

Posted

Mr. Spirtos, thank you very much for responding. Could you, please, substantiate your answer? Yes, it is implied that the patient must pay fair price, but he did not promise to pay whatever they charge no matter how high is the bill!

Nicholas Basil Spirtos

Nicholas Basil Spirtos

Posted

I am not sure what you mean, specifically. But, to put it simply, you received the services, they were necessary and apparently an emergency, and you are obligated to pay at least the reasonable value of the services. That might be an amount less than they are asking.

Asker

Posted

Thank you again, Mr. Spirtos. Are there any rules or guidelines how to determine the reasonable value of the services?

Posted

Try negotiating with them to reduce the amount you have to pay.

Asker

Posted

Mr. Parikh, thank you very much for responding, but you did not answer my question.

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