Agree. I would be utterly shocked if this exact same scam didn't play out for every ambulance call in San Francisco (And according to this article, it's actually completely normal that the "networks" are nonexistent, so multiply that by every city and town!)

What percentage of patients are likely to be taking ANY action that leads to insurance paying? Either spending (as someone else shared) 5 phone calls trying to convince them, or knowing what regulator to file a complaint with - those are the only options. All other options involve someone else eating that cost. I bet less than 10% get them to pay, so the fine should start at $10,000 - and escalate if they show no improvement.