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The estate of the patient is responsible for the bill. In the absence of payment by the estate, most states allow the bill to be passed to a current spouse or nearest relative. If it wasn't the ambulance's fault the patient passed at the hospital, don't you think they deserve the payment? If it's a hardship situation, just tell them that and they will work something out with you. Ambulances are always trying to ensure patient care; the cash really isn't the primary focus.

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Q: Is the spouse of a man who was transported to the hospital in an abulance and died six days later in Pennsylvania responsible for the ambulance charges?
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If aid is given in an emergency and the person giving aid leaves to get help or equipment such as an AED and the person that needs the help dies or becomes crippled in some way are you liable?

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