YOUR CARE INCLUDED AN AMBULANCE TRANSPORT

Who should I call with questions?

Start by calling Royal Ambulance at the number listed on your most recent statement. This ensures you reach the right team who can see your account details.

Royal Billing Department | 📞 (510) 343-2780 | ✉️ billers@royalambulance.com | Hours: Mon–Fri, 8 am–4 pm

Why did I get a statement from Royal Ambulance?

Ambulance transport is a medical service, separate from hospital care. You were transported in an ambulance because it was medically necessary, for example, transferring you to another facility for radiation therapy, mental health care, surgery, or a critical 911 emergency.

Royal Ambulance provides only the transport. The hospital does not cover our portion of your care, which is why you see a separate bill.

What happens next:

Royal bills your insurance directly.
If insurance covers everything, you owe nothing.
If insurance leaves a balance (copay, deductible, or non-covered service), you’ll get a statement showing what remains.

Why is Royal separate from the hospital?

Ambulance providers are licensed as independent healthcare organizations. Even if the hospital arranges the transport, Royal Ambulance is a separate provider with its own staff, licenses, and billing requirements.

This means:

You may receive bills from both the hospital and Royal.
Insurance requires each provider to bill separately.
Payments to the hospital will not cover your ambulance bill.

What is an Explanation of Benefits (EOB)?

An EOB is a summary your insurance sends after a claim is processed. It shows:

What was billed.
What your insurance paid.
What, if anything, you might still owe.

Important: An EOB is not a bill. Wait until you receive a statement from Royal before making payment decisions.

Why is my insurance sending me a check?

Some insurance companies send payment for ambulance services directly to patients instead of to providers. If this happens:

Call our Insurance Team at (844) 472-9769.
Endorse the check to Royal Ambulance.
Mail it to: Royal Ambulance, 14472 Wicks Blvd, San Leandro, CA 94577

Why this matters: Until Royal receives that check, your account shows as unpaid. Promptly forwarding it helps prevent unnecessary reminders.

What if Royal is not in network with my insurance?

If we are out of network, don’t panic. This does not automatically mean you owe the full balance.

What to expect:

Your insurance may send multiple notices while reviewing the claim.
Royal will continue working directly with your insurer to settle the claim.
Sometimes your insurer may ask you for additional paperwork (like coordination-of-benefits forms).

Tip: Respond quickly to any requests from your insurance company. Delays in paperwork can slow down claim resolution.

I have Medicare. Why am I receiving a statement?

Medicare covers ambulance transports that are medically necessary and reasonable. You are generally responsible for 20% coinsurance. If you have supplemental insurance, that plan may pay the 20%.

You may receive a bill if:

Medicare processed your claim but applied coinsurance.
Medicare denied the claim in error (Royal will file an appeal on your behalf).
The transport did not meet Medicare’s strict rules (in that case, Medicare requires us to bill you).

Good to know: If you appeal and Medicare reverses its decision, Royal will refund you.

Why isn’t my insurance covering this? Do I have to pay now?

Sometimes insurance needs more information, like proof of medical necessity or a record of your hospital admission. Your statement will indicate if Royal is waiting on you or your insurance.

If you’re not sure:

Call us at the billing department.
We’ll check the claim status and guide you on what’s needed.

Action tip: Don’t ignore the statement. Even if insurance is still reviewing, keeping in touch with us helps avoid delays or confusion.

I received a bill from collections. Did Royal send me there?

Royal will never send an account to collections unless:

We’ve mailed at least three invoices over 105 days, and
We received no response.

We try to contact you first by phone and mail. Collections is the very last step. If you’ve received a collection notice: Call us immediately. Often, we can still resolve it directly with Royal and prevent further action.

Will this affect my credit score?

No. As of January 1, 2025, California law prohibits medical debt from being reported to credit bureaus.

This means unpaid medical bills cannot lower your credit score in California.

What if I already paid the hospital?

Hospital bills and ambulance bills are completely separate. A payment to the hospital will not cover ambulance charges. If you made a payment directly to the hospital, you may still receive a statement from Royal.

What if my Royal statement shows $0 due?

That means your insurance covered the entire cost. You do not need to make any payment, and no further action is required. Keep the statement for your records.

Why did I get more than one statement?

It is normal to receive more than one statement during the billing process. Each statement may reflect updated information from your insurance, such as payments received or coverage adjustments.

You may receive up to three statements over about 105 days. A new statement does not always mean new charges. Often it is an update on what your insurance has processed.