Retired Air Force veteran Eddie Faires learned a hard lesson when he got an ambulance ride in late 2023 from Logan Fire. He was hit with a $2,600 bill and threatened with collections for most of the year because Logan Fire hadn’t filed paperwork with his TriCare insurance — despite being assured it was covered. (Video: Cimaron Neugebauer)
LOGAN – On a Sunday night in December 2023, retired Air Force veteran Eddie Faires’ leg locked up while he was in bed.
Since he was unable to walk, his wife called an ambulance to pick him up.
The Logan resident says he learned a lesson.
“If my knee was to lock up again, I would probably call some friends to take me to the emergency room,” the 24-year Air Force veteran said.
Faires spent the past year fighting a $2,600 ambulance bill with the constant threat of being sent to collections because his ambulance ride was considered out-of-network.
“I’d like all veterans on TriCare to know they are going to get stuck with an ambulance bill because the city won’t take care of some paperwork,” he said.
His biggest concern for veterans getting an ambulance ride, is that they may have to pay for it until Logan City and other agencies get their credentialing done.
Logan City Fire is not considered in-network for TriCare, the military insurance. Only three Emergency Medical Service (EMS) providers along the Wasatch Front are in-network. But LCFD assures military veterans even if they aren’t covered, it will work to cover them.
Faires was surprised to learn his ride was not covered by his medical insurance, TriCare, even though he and his wife were assured by first responders multiple times it was.
“TriCare recipients can be reimbursed for ambulance rides whether the ambulance company is in the TriCare network or not,” a representative with TriCare wrote in a statement to Cache Valley Daily and suggested the individual submit a claim.
Faires said the billing problems began after a claim was made.
In January 2024, Faires got his first bill.
A lot of things happened at that time, according to Logan Fire Assistant Chief Rod Tomkinson.
TriCare changed vendors and new forms needed to be submitted, due to a data breach.
“This caused ambulance services in the entire country to be unenrolled,” Tomkinson said, adding that the issue was compounded because Faires “received services from LCFD during the credentialing process, causing delays in the billing process.”
He called and the billing office told him, “Oh ya, this is an issue, we’ve had the same problem down in Park City, we’ll take care of this, don’t worry about it.”
But every month he kept getting a bill.
By August, Faires decided to contact Logan Fire directly and thought that would take care of it. In September, he got another bill saying he would be sent to collections.
So Faires emailed Logan City’s Mayor and two administrators with Logan Fire for a resolution.
“We assured the patient that we would continue to work with him to resolve the issue,” Tomkinson said.
Tomkinson responded back saying the TriCare credentialing had been filed and the bill was taken care of. However, Faires checked online through TriCare and saw the claim was denied two more times because paperwork had not been filled out.
The required paperwork was submitted in February, but was not recorded and needed to be resubmitted. That didn’t happen until July by LCFD’s billing company Gold Cross.
He hasn’t gotten a bill since September, but also hasn’t received any documentation indicating he has no balance.
As of the end of December, Gold Cross was still working with TriCare on the credentialing process “as there are still some discrepancies in coverage,” Tomkinson said. “In the meantime, we will always work with TriCare subscribers to ensure that they are covered.”
Faires suggests the out-of-network issue doesn’t just affect veterans, but also family members and other dependents.
“If their son or daughter was to have to call an ambulance service, their parents are going to get stuck with that bill,” he said, adding that, “TriCare has told me that they wish that more states would start looking at this, because they’re not credentialed.”
He says bringing awareness to local leaders might be the next step for him and other veterans who are concerned.
“If we need to maybe we will go to a city council meeting to ask the mayor what is going to be done about this,” Faires said.
Logan Fire hasn’t been credentialed for over a decade, mostly because Cache County EMS and Logan had a contract. That contract ended in 2021. New paperwork needed to be submitted to credential Logan Fire with TriCare, but it wasn’t until a need arose.
“Insurance providers are not automatically credentialed until it is needed based on subscribers using our services,” according to Logan Fire Assistant Chief Rod Tomkinson.
In 2021, Logan City Fire Department ended its contract with Cache County EMS and began using Gold Cross to handle all its billing.
“LCFD works closely with the Utah State Chiefs Association and State lawmakers to ensure that we are using best practices in services and billing,” Tomkinson said.
Since that time, Logan Fire hadn’t yet provided service to a patient with TriCare, Tomkinson said, until December of 2023 when Faires’ insurance filed a claim.
While Logan Fire is a licensed ambulance provider through the Utah State Bureau of EMS, it is not considered in-network for TriCare.
Logan Fire is not the only EMS considered out-of-network in Northern Utah. Cache Valley Daily confirmed with TriCare there are only three Emergency Medical Services (EMS) that are approved along the Wasatch Front: Lifeflight, South Weber City, and Park City Ambulance.