‘Everything about it told me that I had to pay’: After complaints, city ambulance provider changes its paperwork

Complaints that San Diego’s new ambulance provider, Falck USA, has been sending some patients mailings that look like bills have prompted Falck to add cover letters to the mailings this week that aim to reduce confusion.

Critics say the forms — which are not bills but requests for patient signatures Falck needs to seek payment from Medicare or insurance companies — are deceptive because they list an amount owed and several options for how to pay.

“It’s confusing because there’s no reason to give you seven different ways to pay when the thing is not actually a bill,” said University City resident Irwin Rubenstein, who received one of the mailings in April — four months after Falck transported his wife to a hospital.

Rubenstein said he worries that some of the roughly 200 people who Falck says it sends the roughly 200 signature-request mailings each month may end up paying the amount listed, even though they owe nothing.

“It made me wonder whether they are trying to generate revenue they aren’t entitled to,” Rubenstein said.

Falck spokesperson Jeff Lucia said Wednesday that company officials are not aware of any signature-request mailings having prompted someone to pay money that person wasn’t supposed to pay.

“Falck continuously looks for ways to improve, and we value customer input and feedback, which is why we’ve added greater clarity in our correspondence that now includes a cover letter explaining why signatures are required for insurance reimbursements,” Lucia said.

Falck, which took over the city’s ambulance service in November 2021, agreed to begin including the new cover letter in July, after aides to Mayor Todd Gloria raised concerns about the mailings.

But Lucia said Falck won’t start including the cover letters until Friday — nearly three months after agreeing to start sending them — because of some unspecified technical issues that needed to be worked out.

Matthew Griffin, a community representative for the mayor, sent Rubenstein an email July 15 about the new cover letters.

“Staff met with Falck and discussed their billing process, agreeing that the document was confusing,” Griffin wrote. “Falck cannot bill the insurance company without a patient’s signature. Falck executives are formulating a cover letter to explain the document and clarify the request for a signature.”

Two months later, when Rubenstein followed up with a Sept. 19 email to Griffin seeking an update, Griffin said he could not provide one. Rubenstein then contacted the San Diego Union-Tribune.

Rubenstein, 91, said older people like him and his 85-year-old wife, Ina, are especially vulnerable to confusing mailings that seem to be demanding money.

While the mailing Rubenstein received says “This Is Not a Bill!” and provides a phone number to call with questions, it also says in three places that there is a balance of $465.92.

In addition, the mailing says “please make check payable to San Diego Falck Mobile Health Corporation” and gives options for paying by mail, by phone or over the internet.

“I saw where it said ‘This is not a bill,’ but everything about it told me that I had to pay it,” said Ina Rubenstein, who was transported by Falck to a hospital in December after she had fainted in connection with a heart issue.

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Falck has struggled to meet city response time goals since taking over ambulance service from longtime provider American Medical Response.

Company officials said last month said they would try to boost response times by mandating overtime shifts for paramedics and revamp operations at the U.S.-Mexico border.