Am I Crazy, or Is Healthcare Actually Broken? How a $5,000 Ambulance Bill Proves You’re Not the Problem
Vol 1, Issue 11
Disclaimer: All experiences and opinions shared here are personal and should not be taken as professional medical, mental health, or financial advice. For decisions related to healthcare, insurance appeals, or any treatment, always consult a licensed healthcare professional and carefully review your specific policy details.
Realization #1: It’s Not All On Me
Not too long ago, I found myself holding a stack of Explanation of Benefits (EOBs) and quietly asking, “Wait, am I just not getting this, or is the system actually insane?” That internal question had been building for a while, but it came to a head the day I called my insurance three times, got three different answers, and ended up feeling like I was the incompetent one. Let’s be real: I’ve navigated hospital exec halls, advocated for patients, and dealt with insurance reps at every level—yet here I was, second-guessing my own sanity.
That’s when it clicked: I’m not the problem. The system is. This “Aha” moment was both freeing and infuriating. Freeing, because I realized it wasn’t my fault I was confused. Infuriating, because I realized how many people out there end up feeling powerless, stuck, and gaslit by the very structure that’s supposed to help them get well.
A Look Behind the Scenes: Cynthia’s Ambulance Dilemma
A few weeks later, I got a frantic message from Cynthia, a mom of two in her early 40s. She’d taken an ambulance ride after a severe allergic reaction—one that felt life-or-death in the moment. Fast-forward to the bill: $5,000. For a ride lasting less than 10 minutes. After insurance, she still owed thousands out of pocket.
“Am I missing something?” she asked me, totally rattled.
Insurance said: “It’s an out-of-network ambulance service. Nothing we can do.”
Hospital said: “We billed appropriately. If insurance won’t cover it, talk to them.”
Ambulance provider said: “We’re not contracted with your plan. We set our own rates.”
Cynthia was left in the middle, feeling like she’d made a catastrophic decision by calling for help in what she believed was an actual emergency. She started blaming herself—“Should I have just driven myself? But I literally couldn’t breathe!” It’s a ridiculous question no one should ever have to ask. Yet, there she was: questioning her own logic in a potentially life-threatening situation.
If you’ve ever found yourself thinking, “Wait, am I crazy for expecting a straightforward resolution here?”—this story should confirm that the real madness lies in a system that tangles people up in red tape, then shrugs when the bills balloon.
How We Tackled Her Ambulance Nightmare
After hearing Cynthia’s story, I laid out a plan to push back on that daunting balance:
Detailed Written Appeal
We drafted a clear, concise appeal letter to both the insurance company and the ambulance provider, highlighting the emergency nature of the situation and referencing the policy’s emergency exceptions clause.
Cynthia included notes from the ER physician confirming that immediate ambulance transport was necessary, not optional.
Itemized Billing Request
She requested a full breakdown of charges from the ambulance provider. This forced them to justify each cost and opened the door for possible coding adjustments.
By questioning things like mileage rates and added “service fees,” we got them to reconsider part of the balance.
Escalation to a Higher-Up
We calmly but firmly asked to speak with a supervisor at her insurance company who specialized in emergency claims.
That person realized the claim hadn’t been coded with the correct urgency modifiers. Once re-coded, it qualified for partial in-network consideration.
Outcome
After about six weeks of back-and-forth, Cynthia’s $5,000 bill dropped to $800. Still not trivial, but far more manageable. She set up a short payment plan to knock it out without wrecking her monthly budget.
Most importantly, she regained peace of mind—knowing that calling 911 was the right choice when her breathing was on the line.
Why This Story Is Your Story, Too
It Undermines Self-Trust
The moment you realize you’ve spent hours on a “simple” inquiry—like an out-of-network question or a billing dispute—only to be more confused, you can’t help but wonder if you’re the one who’s not following directions. This self-doubt is exactly what keeps people from challenging the system.Financial Anxiety is Real
Surprise bills, insane deductibles, and contradictory insurance statements can create a swirl of panic. It’s not a minor inconvenience—it’s financial stress that can upend your budgeting and personal security. That kind of anxiety leaks into other areas of your life, too: relationships, work performance, mental health.It’s Even Tougher for Young Adults
Picture a 19-year-old college student, or a 22-year-old working their first full-time job. They don’t have the life experience or confidence to push back when they’re told “sorry, you’re not covered.” They might just accept the first bill, or worse—avoid care altogether. That’s part of why Lumani Health directs a portion of our program proceeds toward youth mental health research and care coordination. If adults are overwhelmed, teens and young adults risk slipping through the cracks entirely.
5 Strategies to Handle “Am I Crazy—or Is the System?”
Here’s the good news: while we can’t fix the entire structure overnight, we can arm ourselves (and each other) with practical strategies that poke holes in the chaos.
1. Document, Document, Document
Why It Matters: Every phone call, every reference number, every “I spoke with so-and-so” is a breadcrumb in a trail that proves you did your due diligence.
Quick Tip: Keep a running note on your phone. After every call, jot down the date, time, rep name, and summary of what they said. If you end up in a dispute, these details often force the other side to resolve things faster.
2. Ask for an Itemized Bill—Always
Why It Matters: Generic bills can hide all sorts of random charges, like $45 for a gown you never wore or an upcharge for a “room fee” while you sat in a hallway.
Quick Tip: When you see a suspicious line item, call it out directly: “Could you explain why I’m being billed for this specific code?” They have to prove its legitimacy or remove it.
3. Challenge Contradictions
Why It Matters: If one rep tells you your deductible is $500 and another says $1,000, don’t just shrug and move on. That discrepancy can cost you hundreds or thousands.
Quick Tip: Use your documentation to confirm: “On [Date], Rep A stated my remaining deductible was $X. Why is Rep B saying $Y?” A lot of times, they’ll re-check their records and correct the mistake—or at least escalate you to someone who can.
4. Request a Supervisor (Calmly)
Why It Matters: Basic-level reps often have limited authority. Supervisors or specialty teams can override incorrect denials or authorize re-coding that solves your billing nightmare.
Quick Tip: Don’t make it about the rep being incompetent. Just say, “I really appreciate your help, but this is complex. Could you connect me with a supervisor who might have more tools to resolve this?”
5. Remember: It’s Not Your Fault
Why It Matters: The system thrives on confusion and self-blame. If you feel crazy, you’re less likely to keep pushing for clarity.
Quick Tip: Repeat this mantra: “I deserve to understand my bills and coverage.” If you sense the conversation going nowhere, regroup, call back, or seek outside help. You’re not failing—the system is failing you.
Keep the Conversation Going
Feel like you could talk about these “WTF” healthcare moments forever? Same. That’s why I share stories and insights like this weekly on my Substack, Lumani Unfiltered—the behind-the-scenes of real billing disputes, caregiving 101, plus the occasional meltdowns (because sometimes all you can do is laugh at the absurdity).
Masterclass & Workbook: Coming Soon
I’m also working on a pre-recorded masterclass and companion workbook designed to make sense of the nonsense. Think:
A step-by-step approach to tackling your top healthcare pain points
Scripts to use when calling insurance or billing reps
Real-world case studies (like Cynthia’s ambulance saga) and how we solved them
Best part? A slice of every purchase supports youth mental health—because if we’re baffled by the system, imagine the barrier it creates for a 20-year-old who’s just trying to figure out adulthood, let alone an endless insurance phone tree.
VIP Circle Waitlist
Want a safe space to share your outlandish medical bills or contradictory insurance letters? Enter our VIP Circle: a community where we swap success stories, vent, and learn from each other’s experiences. Plus, 15% of every membership supports mental health care for young folks who really need a break from the chaos. Hop on the waitlist now for first dibs. Sign up here!
You’re Not Alone, and You’re Definitely Not Crazy
So, if you’ve spent an hour reading an EOB only to realize you understand it less than when you started—no, that doesn’t make you inept. If you feel an underlying dread every time you see “Unknown Caller,” worrying it’s another insurance fight—no, that doesn’t mean you’re paranoid. The system has turned ordinary people into amateur detectives just to access basic care. Let’s call that out for what it is: an overhaul that’s long overdue.
Until next time, stay curious and advocate for yourself. Remember, you’re not losing your mind—this really is a broken machine. But broken doesn’t mean unbeatable. With documentation, second opinions, calm-yet-firm phone calls, and a belief in your right to clarity, you can push back and claim the healthcare answers you deserve. And as we join forces—through Substack articles, masterclasses, the VIP Circle, and our collective experiences—we’re making sure the next generation doesn’t have to ask, “Am I crazy, or is the system just incredibly broken?”
They’ll already know the answer—and they’ll be equipped with better tools to handle it.
—Steph
Founder of Lumani Health
(P.S. If you know someone drowning in medical bills or bizarre insurance runarounds, share this article with them. A little knowledge—and solidarity—goes a long way in saving both our sanity and our bank accounts.)
