Navigating the Complexities of Air Ambulance Bills: A Personal Journey
As a mother, facing a $60,000 bill for an air ambulance transport is a daunting challenge. In February 2022, my daughter, just five years old, faced a critical medical emergency that landed us in the emergency room with a life-threatening diagnosis. Unfortunately, the hospital wasn’t equipped to perform the necessary surgery due to her age, prompting the ER doctors to arrange for her transfer via air ambulance to a specialized children’s hospital. This facility was over 300 miles away, and to make matters more complex, she was also battling COVID-19 at the time.
Since that harrowing day, we have been embroiled in a frustrating dispute with our insurance provider, Anthem Blue Cross. For more than two and a half years, we have contested their decision to deny coverage for the air ambulance transport, which they deemed “not medically necessary.” While they did cover the costs for ground ambulance services to and from the airport, the air transport remains unresolved. This classification as “not medically necessary” has unfortunately left us without the protections afforded by the No Surprises Act. To add urgency to our situation, the air ambulance provider has given us 30 days to either start making payments or face collections.
We still have one personal appeal remaining and can pursue a third-party appeal with our insurance, yet we find ourselves in a pressing situation. The air ambulance company is unwilling to delay payment discussions while we navigate the appeal process. My primary concern is that initiating payments could imply an acceptance of the debt, even as I want to protect our credit score.
In our pursuit of a resolution, we have made numerous calls, sent countless emails, and even conducted in-person meetings, but the air ambulance company remains resolute in their demand for payment or the threat of collections looms over us.
I am reaching out to seek advice from others who may have encountered similar obstacles. Given the nature of this situation—a dire emergency where I had no ability to choose or negotiate service costs—insights or suggestions on how to handle this financial burden would be immensely helpful.
Update: After weighing the advice from the supportive community around me, we decided to engage the media to bring attention to our plight. Thankfully, we connected with an exceptional investigative reporter, and as a result, Anthem has now agreed to cover the claim! You can read more about our story in the investigative piece here: [KGW Investigations: Air Ambulance Bills
First and foremost, I want to commend you on your perseverance and commitment to advocating for your daughter during such a challenging situation. Navigating health insurance claims, especially for emergency medical services, can be fraught with complexities, and your determination is inspiring.
Now that Anthem has agreed to pay the claim following media intervention, it’s a significant victory, but I appreciate that the stress of the situation is not entirely resolved. Here are some practical steps and insights to consider moving forward, both in managing this issue and preparing for any potential future challenges.
Managing the Current Situation:
Document Everything: Even with the claim being resolved, continue to keep detailed records of all correspondence with both the air ambulance service and your insurer. Document dates, times, who you spoke with, and the content of those conversations. This information can be invaluable if you encounter any issues in the future.
Payment Plans: If the air ambulance company continues to press for payment before the appeal process concludes, ask if they can offer a formal payment arrangement. Sometimes, they will agree to set up a low monthly payment until the appeal is resolved, which can help alleviate immediate financial pressure without admitting liability.
Consumer Assistance Programs: Investigate whether there are any local consumer assistance programs or organizations that help residents navigate medical billing disputes. Organizations like the Oregon Medical Insurance Pool (OMIP) may have resources or additional support.
Understanding Your Rights:
No Surprises Act: It’s good that you are aware of the No Surprises Act, which protects patients from unexpected medical bills. Since your situation involved an emergency and the air ambulance was not an elective choice, ensure that you and your insurer recognize the impact of this law, especially if Anthem initially denied coverage. While it seems that this road is now less relevant if coverage has been rectified, it’s always a good angle to explore in future disputes.
Involve Your State’s Insurance Commissioner: If problems with your insurer arise again, consider contacting the Oregon Department of Consumer and Business Services. They handle disputes between consumers and insurers and may take action on your behalf against unfair billing practices.
Preventive Measures for the Future:
Review Your Insurance Policy: Take some time to review your current insurance policy to understand what is covered—especially transportation costs such as air ambulances. Consider reaching out to a health insurance broker or consultant who can help clarify these details.
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