Patients being sent to collections as Florida Blue, AMR continue contract dispute

ORLANDO, Fla. — A well-known local attorney is taking on one of the largest insurers in the state after 9 Investigates uncovered a major billing dispute between Florida Blue and American Medical Response. AMR is one of the largest private medical transport companies in the country.

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Investigative reporter Karla Ray first reported on patients being put in the middle of those negotiations months ago, and now she’s learned some patients are being sent to collections.

One of those patients is the Orlando woman whose bill first alerted us- and seemingly Florida Blue- that the issue was not resolved. Her father happens to be an attorney who represents local governments all over the state, and he believes she could be one of countless others, potentially ripe for a class action lawsuit.

Another patient facing collections is Leslie Ryan, who lives in the Tampa area. After an ambulance ride last fall, she thought she was in the clear after she claims Florida Blue representatives told her she did not owe anything.

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

“Then I started getting text messages and tons of letters in the mail, statements, saying I owed $816. And I was like, well, that’s not zero,” Ryan said.

Each time she called to question the bill from American Medical Response, she was told not to pay. Now, she’s facing collections.

“The only reason I’ve ignored it for as long as I did, is because BlueCross told me, you don’t owe it. Just ignore. Just ignore it,” Ryan said. “And then I found your article.”

She’s referring to the first story we aired in May of 2024, after Orlando woman Morgan Traficante flagged the dispute between Florida Blue and AMR.

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

Read: Florida leads the way for fraudulent medical insurance policies, costing taxpayers billions

Traficante was sent to collections last month, and that’s when she called in reinforcements; her dad, attorney Cliff Shepard.

“This is clearly a problem,” Shepard said. “I called it fraud. I think it is fraud, when you tell your consumers that something is true that you know to be untrue. And if your own employees, if I assume they weren’t lying, didn’t know what was true, that’s a problem.”

Shepard sent notice to Florida Blue that, as of the time his daughter was sent to collections, Florida Blue still listed AMR as an in-network provider online. That’s information he says people rely on to be accurate when choosing insurance.

“I think there’s possible class action certainly against Florida Blue, and their entire Blue network all over this country, for incorrect provider information,” Shepard said. “Class actions for this kind of thing are being considered all over this country, and I won’t be the first to that party, but I certainly won’t be the last either.”

It’s a major problem that has its own name, dubbed ‘ghost networks’. Congressional leaders have called on insurance providers to update their databases, noting delays in care, inappropriate treatment, and unnecessary costs for patients unknowingly visiting or using out-of-network providers; something you have no control over when it comes to an ambulance ride.

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“I didn’t really think about it, to be completely honest,” Ryan said. “I was in so much pain, they could have sent anything, and I wouldn’t have really thought about it at the time. It wasn’t until later that I was surprised.”

A Florida Blue spokesperson provided this statement about the ongoing issue: “We are nearing a settlement proposal with AMR. In it, AMR has agreed to remove members in collections and any outstanding balances. While we await the settlement agreement terms to be finalized, we have requested AMR to stop all collection efforts for any of our members impacted.”

AMR responded by telling us: American Medical Response (AMR) was glad to receive the first settlement proposal from Blue Cross Blue Shield (BCBS) Florida on Tuesday, July 30, 2024.

We look forward to reviewing their proposal and ultimately coming to an agreement to resolve this issue, which occurred when BCBS did not update their system to reflect a contract termination with AMR.

We are working to identify impacted patients so we can start to pause our billing process, but that will unfortunately take some time. Regardless, AMR remains highly motivated to find solutions to these unnecessary issues for our patients and BCBS members, all while our talented emergency medical care providers continue to provide life-saving interventions for our community.

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