by Andrew Walden

According to a source at HMSA, Honolulu Emergency Medical Services (EMS) has neglected to bill “over 1,000” patients for ambulance rides starting July 1, 2022.

A patient transported by EMS in July, 2022, tells Hawai’i Free Press he first received a $2,000 ambulance bill in September, 2023.  His HMSA claim was then denied because the lateness of the submission.  He then appealed the denial.  The appeal is on hold pending discussions between HMSA and EMS.

The source at HMSA informs Hawai’i Free Press that over 50 cases are on appeal and the cases begin with the July 1, 2022, start of the fiscal year.  HMSA and EMS are now in negotiations to pay for some of the ambulance services.  The source informs Hawai’i Free Press that instead of attempting to collect from patients, EMS may write off the medical debts due to their own failure to timely bill patients.

According to the EMS website, July 1, 2022, is the date, EMS took over its own billing from its previous billing contractor, Digitech, LLC.

The EMS website prices ambulance rides at $1,995 and up.  If 1,000 were not billed, this would indicate a loss to EMS of at least $2M. 

EMS' website indicates crews responding to 8,000-plus calls per month.  Twelve months of billing failure equals 96,000 calls times $2,000 equals $192M. 

Of course, not all responses lead to ambulance rides -- and a substantial portion of rides are homeless drug addicts who won’t be paying anyway unless they’ve been signed up for Medicaid by the hospitals.  If Medicaid were billed directly, EMS could get some clawback for operating the 'homeless merry-go-round', but billing them personally would be useless because they are of no account.

It is not clear when (or whether) EMS began correctly billing ambulance patients.  EMS is not a ‘provider’ with HMSA, hence the billing direct to the patient instead of the insurer. 

EMS PIO Shayne Enright tells Hawai’i Free Press she is unable to provide comment by deadline.  We will update if a comment is received.

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