Air am­bu­lance bills sky high

Ris­ing op­er­at­ing costs add sticker shock; know what to ex­pect

Albany Times Union - Sunday - - BUSINESS - By Tom Mur­phy Associated Press

A he­li­copter trip to a hos­pi­tal may not be the only shock a pa­tient faces af­ter a bad ac­ci­dent. The next one could hit when the bill ar­rives.

Rides in so-called air am­bu­lances can lead to bills of more than $20,000 de­pend­ing on a per­son’s cov­er­age, and in­sur­ance ex­perts say big in­voices are be­com­ing more com­mon as costs rise and cov­er­age shifts.

Air am­bu­lances trans­port 400,000 peo­ple each year in the U.S., ac­cord­ing to in­dus­try es­ti­mates. Most trips are from one hos­pi­tal to an­other. But they also play a vi­tal role in getting se­ri­ously in­jured or ill peo­ple fast help dur­ing what doc­tors call “the golden hour” — the ini­tial win­dow af­ter an ac­ci­dent when a pa­tient’s chances for re­cov­ery are bet­ter. Here’s a deeper look at the is­sue:

A spi­ral­ing ex­pense

Me­dian prices for he­li­copter air am­bu­lance ser­vices dou­bled from $15,000 to about $30,000 from 2010 to 2014, ac­cord­ing to a U.S. Gov­ern­ment Ac­count­abil­ity Of­fice re­port last year.

Pa­tients with pri­vate in­sur­ance can get stuck with most of that bill if the he­li­copter that picks them up is not in their cov­er­age net­work. In those cases, the air am­bu­lance com­pany can bill the pa­tient for the left­over balance af­ter the in­surer pays part of it. The GAO re­port said it was un­clear how of­ten pa­tients are billed like this.

The main rea­son pa­tient costs are ris­ing is be­cause the ex­pense of run­ning air am­bu­lances has more than dou­bled in the past decade, but re­im­burse­ment from the

gov­ern­ment-funded Medi­care pro­gram hasn’t changed, said Blair Beg­gan, a spokes­woman with the trade group As­so­ci­a­tion of Air Med­i­cal Ser­vices. She added that Medi­care re­im­burses about 58 cents for ev­ery dol­lar air am­bu­lance com­pa­nies spend trans­port­ing pa­tients, and some com­mer­cial in­sur­ers have been re­duc­ing their re­im­burse­ment to bring it closer Medi­care rates.

That, Beg­gan said, can force air am­bu­lance com­pa­nies to leave in­surer net­works.

The GAO re­port noted that air am­bu­lance providers don’t face the type of com­pe­ti­tion that could re­strain costs. Pa­tients have lit­tle con­trol over the de­ci­sion to call for an air trans­port and can’t avoid com­pa­nies that may be too ex­pen­sive and out­side their in­sur­ance net­work.

Some pre­ven­tive mea­sures

There are lim­ited safe­guards for avoid­ing a big bill.

Some air am­bu­lance com­pa­nies will sell mem­ber­ships that cost less than $100 a year. Those will take care of flight ex­penses, but they of­ten ap­ply to only one com­pany. A pa­tient still might wind up stuck with a big bill if a com­pet­ing com­pany re­sponds to the call.

Some in­sur­ers will of­fer riders to em­ployer-spon­sored health cov­er­age that al­low work­ers to pay a few ex­tra bucks a month in or­der to have any air am­bu­lance flight cov­ered as though it were in their net­work.

Han­dling the big bill

Don’t panic if a five-fig­ure in­voice ar­rives in your mail­box from an air am­bu­lance com­pany. There may be a way to resolve it, or at least knock down the amount.

Start by con­tact­ing your in­surer to make sure the claim has been pro­cessed cor­rectly. Some air am­bu­lance com­pa­nies pro­vide pa­tient ad­vo­cates who do this.

An in­sur­ance bro­ker also may be able to dou­ble-check the claim’s ac­cu­racy or check for any po­ten­tial dis­counts.

An air am­bu­lance com­pany will some­times knock 10 per­cent off the bill without ask­ing the cus­tomer to prove that it would be a fi­nan­cial hard­ship, said Marietta, Ohio, bro­ker Kristen First. Even deeper re­duc­tions may be avail­able for pa­tients who pro­duce tax fil­ings, check stubs or other items show­ing how much of a strain the bill would im­pose.

First said her agency had a cus­tomer do that, and the air am­bu­lance provider chopped a bill of about $25,000 down to $3,500.

Genna Martin / The Her­ald via AP

More than 400,000 peo­ple in the U.S. re­quire air am­bu­lance trans­port each year, ac­cord­ing to in­dus­try es­ti­mates.

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