Southlake man learns how astronomical air ambulance bill can be
A helicopter flying a critically injured patient to a hospital can save his life, but when he finds out what the air ambulance bill is, he might have a heart attack. The average cost for the ride is now over $40,000. A med evac invoice is the poster child of our skyrocketing health care costs.
On Monday an article in the Dallas Morning News showed how enormous a bill can be. A young doctor in Southlake was severely injured and was rushed by ground ambulance to a local hospital in Wichita Falls. He had to be immediately flown 100 miles to John Peter Smith Hospital in Fort Worth, the closest level one trauma center.
Sadly, after eight operations, the doctor had to have his arm amputated. A few days later as he was recovering in the hospital, he received the first of many demanding calls from the company wanting him to pay a stunning $56,603. Yes, you read that correctly.
The doctor’s health insurance company only paid about $12,000 — and only after being forced to do so since the ambulance company was out-of-network with his Blue Cross Blue Shield plan. Right after his crash, he was obviously not in a condition to verify whether the ambulance company was in-network and demand a different helicopter.
Most of these companies choose not to be in-network. If they are, they refuse to bill health insurance plans, instead billing the patient for the full amount. Or sometimes they bill Aetna or Blue Cross, which pays what it considers to be the reasonable cost of the ride. The patient is stuck with the balance, like here. The helicopter company then hires aggressive bill collectors and attorneys to file lawsuits when the exorbitant expense is not paid in full. Medical bills are the leading cause for people to file bankruptcies that ruin their credit.
The man still owed a shocking balance of $44,631. This is in addition to other inflated hospital and doctor bills he has to pay. This is a serious problem for many people after they are in a car or truck collision.
Why is an air ambulance bill so expensive?
The article points out that the company, Air Evac Lifeteam, is owned by a giant holding company based in Dallas-Fort Worth. Just last year it purchased the second largest air helicopter company in a multi-billion dollar deal and is now the largest company in the United States. It is a subsidiary of the giant Wall Street private equity firm of Kohlberg Kravis & Roberts which has a stock market value of almost $23 billion. The top three Medevac companies now control most of these flights.
An analyst studied the costs of a med evac ride and determined that one should cost only $11,000. The U.S. government only pays an average of $6,556 if the ride is reimbursed by Medicare and Medicaid pays even less.
The company defended its vastly marked-up rates, saying that Medicare and Medicaid rates do not fully reimburse them and they must look to car wreck cases with people with health insurance plans to make up the difference.
But patient’s rights advocates say that the real reason is that Wall Street investors have found a highly lucrative industry to take over. By comparison, ground ambulances also carry patients who are critically injured or ill and don’t charge any where near that much. In addition, a trip by air is not always necessary, but the patient is rarely votes (assuming he is in a condition to think clearly) and the cost is never disclosed before he is whisked away.
I already have trouble explaining to my clients how a typical ground ambulance bill is $1,600 and emergency room bills with testing often exceed $10,000.
Other analysts say the reason for the extraordinary rates is an oversupply of these helicopters that results in many sitting idle with expensive flight crews all day.
Furthermore, there are no regulations that control their costs. Lobbyists have prevented any legislation from passing in state houses or in the U.S. Congress that would curtail excessive charges. Instead, these companies are treated like American Airlines under the Airline Deregulation Act and are allowed to charge whatever the market will bear.
There are no legal cases the patient can rely upon if he thinks that he was taken advantage of. The Austin court of appeals ruled in favor of the helicopter companies in February, reversing the trial court that held that the state of Texas can regulate how much it paid the companies when it pays workers compensation claims. The general counsel for the insurance company observed at trial that “air ambulances charge 500 to 700 percent of their costs. These charges are often $40,000 or more versus actual costs of $7,000 or so.”
Unfortunately, other courts across the country are also siding with these giant companies and saying the sky is the limit for whatever they want to charge. There are no court decisions restricting how much health insurance companies and individuals have to pay them.
As the unfortunate doctor from Southlake said: “It’s unfair. It’s random, it’s arbitrary. It’s whatever price they want to set. And to put that onto a person who’s already been through what I’ve been through, I hate to say it, but it’s cruel.” He now has a prosthetic arm. And huge medical bills.
Steps to take to reduce an excessive air helicopter bill – or any medical bill
- Read your health insurance policy. Make sure the service is covered and that the ambulance company or medical provider was in network. File on your policy and stay after it so that it pays the bill.
- Negotiate with the company when there is a balance. Explain your financial situation and other medical bills that you are required to pay. Offer to pay a small sum monthly. Or file a complaint with a state agency and engage in dispute resolution to cut the bill.
- Hire a good personal injury lawyer. I see these bills on a number of cases and have experience reducing the balances. I also fight to get the maximum damages for my clients.
Excessive medical helicopter bills are a common problem that could affect the victim of a vehicle collision
I wrote last year about a young man whose family initially got hit with the full cost of the air ambulance – a whopping $58,000 – after he was involved in a motorcycle crash. Even after the health insurance company paid $15,000, the young man still had to pay $43,000.
Being in a car wreck is a horrible experience. It causes a great deal of pain, emotional distress, lost wages, and other damages. It shouldn’t also cause financial ruin.
If you are a loved one is every the victim of a vehicle accident, do not hesitate to contact me for a complimentary consultation.