Air ambulance review.

I don’t understand how it is possible to involuntarily obligate a unconsciousness patient to pay for a helicopter transport. I am not against helicopter transport when appropriate, per se’. I just don’t understand. In what other situation can someone be made to purchase something without their consent?
 
Morgan3820 said:
I don’t understand how it is possible to involuntarily obligate a unconsciousness patient to pay for a helicopter transport. I am not against helicopter transport when appropriate, per se’. I just don’t understand. In what other situation can someone be made to purchase something without their consent?
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Same with most things medical, problem is what if you die before you can wake up read the fine print and sign?

Think bills are better to deal with than death.
 
Morgan3820 said:
I just don’t understand.
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FYI: The transportation is prescribed by the doctor or 1st responder without consent just as any other "procedure." Where the air service is provided by a public entity, no bills are sent to patient like for Maryland State Police. So it depends....
 
Morgan3820 said:
I don’t understand how it is possible to involuntarily obligate a unconsciousness patient to pay for a helicopter transport. I am not against helicopter transport when appropriate, per se’. I just don’t understand. In what other situation can someone be made to purchase something without their consent?
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Because in emergency situations (unconscious), informed consent is not possible. Doesn’t matter if the patient is going by ground or air, they are obligated to treat the patient. Whether or not the patient has money to pay for said treatment is immaterial.
 
The real problem with air ambulance service is that it is not governed by the same rules as other medical providers. Because they are governed by FAA, prices can’t be regulated. Whereas a hospital or other provider may have a contracted for rate - say Medicare or state Medicaid or what a BC/BS may negotiate. So not only is a patient left with no choice about being air flighted - the $57,000 bill they get is usually not covered by their medical insurer so the air ambulance company is free to pursue the injured patient for payment directly. This needs to change.


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You know, a $50K helicopter ride sounds bad but when you consider that an F-22 costs $60K per hour, it’s really a bargain.
 
Wasn't there a time when this service was government funded?
 
Interestingly enough, the Medevac operator that I fly for only makes revenue that keeps the doors open on approximately 30% of their air ambulance transports. A vast majority of our patients are low-income and we receive a small amount of compensation via medicare, but barely enough to cover the actual operational costs of the flight, much less pay to keep crews on standby and aircrafts at the ready 24 hours a day.

What is happening is a lot of insurance companies are refusing to pay for air ambulance services, and therefore the cost is being passed on to those who can afford it.

The first question I asked when I applied for this job was if we sent people to collections and took houses away, the answer was no.

I’m not sure if that was true or not however.
 
DavidWhite said:
Interestingly enough, the Medevac operator that I fly for only makes revenue that keeps the doors open on approximately 30% of their air ambulance transports. A vast majority of our patients are low-income and we receive a small amount of compensation via medicare, but barely enough to cover the actual operational costs of the flight, much less pay to keep crews on standby and aircrafts at the ready 24 hours a day.

What is happening is a lot of insurance companies are refusing to pay for air ambulance services, and therefore the cost is being passed on to those who can afford it.
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It’s also being passed on to many who can’t afford it. Most medical providers have contracted-for rates. A $100 invoice gets paid at about $30 from Medicare. However since air ambulance operators are not subject to these billing regulations they are free to bill the patient directly for the balance. I’m not questioning the life saving work that is done and the importance of it - but the current system is leaving people with huge bills that they can’t pay.


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Tommar98 said:
It’s also being passed on to many who can’t afford it. Most medical providers have contracted-for rates. A $100 invoice gets paid at about $30 from Medicare. However since air ambulance operators are not subject to these billing regulations they are free to bill the patient directly for the balance. I’m not questioning the life saving work that is done and the importance of it - but the current system is leaving people with huge bills that they can’t pay.


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Like anything else, there are some very unscrupulous operators in the medevac world.

That being said I completely agree with your sentiment - I think it starts with the insurers who refuse to pay for lifesaving medical services when those insured by them generally assume they are covered for anything above their deductible.
 
When I had the heart attack I refused to be transported by helicopter and went by fixed wing instead. At a pre-negotiated price from a company I requested thereby dropping the price by 2/3. And the insurance paid all but 500 bucks of the bill.

The air ambulance company here uses helicopter to transport patients from the local hospital to another city with a higher level of medical care. The average cost for the 45 minute flight is around 70K. The insurance company will negotiate a lower price and pay that, but then the air ambulance company can and will go after the patient for the rest of the money. Before the air ambulance company lays hands on the patient the insurance company has already approved payment (on a 90 day billing) and the hospital has already reserved a room. When I was in air ambulance the cost to transport a patient by fixed wing was around 18K, and was approved by insurance companies.

Sac Arrow said:
Wasn't there a time when this service was government funded?
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When I was in air ambulance If a patient did not have insurance there was a government program where we could apply for reimbursement after the flight. But thank goodness some kind of care oftenly called after a former president came along and saved us from that unnecessary program to help under/uninsured folks.

Flights off of the reservation or for first Americans is covered by Medicare, and only pays 7500 per flight, no matter how long the flight is.

The only flights we didn't get paid for were the flights where the patient died, no one claimed the body and the patients name was never found out.

Yes, it does happen.
 
Sac Arrow said:
Wasn't there a time when this service was government funded?
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FWIW: There still are public funded helicopter EMS ops where the patient pays zero. Back in the day, along with public funded ops a number of large hospitals got into the EMS business like Herman Hospital Life Flight and Samaritan Air Care where it was more a "closed" system on the billing. It wasn't until the community-based/for-profit model took off that brought the billing issues and service saturation to the forefront. However, until Congress decides to tweak the Airline Deregulation Act, most EMS helicopter ops are exempt from any price controls.
 
Bill Jennings said:
I’ve been a subscriber since about ‘12 or so. Most of the places I ride motorcycle are covered by one of their affiliates.
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Yep. In your area you’re covered. The odds of another provider picking you up are slim. Just stay off The Tail of The Dragon man!
 
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Velocity173 said:
Yep. In your area you’re covered. The odds of another provider picking you up are slim. Just stay of The Tail of The Dragon man!
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Broke my radius there 19 years ago, required 10 screws and two plates. Rode 2hrs back home on the back of a buddies bike. How’s that for med transport?
 
DavidWhite said:
Do you work for a GMR company as well?
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Yessir.

Disclaimer: My opinions don’t reflect the opinions or policies, of GMR their affiliates.

There, I’m legal now and can’t get fired. :)
 
DavidWhite said:
Haw! We’re coworkers!
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Lol! I know a guy getting ready to transfer to the fixed wing (dark) side. I don’t even come close to fixed wing CAMTS requirements so I’ll continue to slug it out flying an egg beater at 300 ft and 130 kts. :(
 
Well, I might as well go thru and dissect some of the article’s BS.

1. Pilot’s aren’t pressured to take flights. If we were, we’d sue the company and own it. This ain’t your daddy’s 1980s HEMS. If anything, I’d get fired if I took a flight in questionable weather vs not accepting one.

2. Oh, and to the author, it’s not called HEMS anymore. The FAA doesn’t like what the “E” stands for.

3. Comparing US HAA accidents to UK? That’s a joke right? We probably have more HAA bases just in California than all of the UK.

4. Yep, twin engine is safer than single. No denying that. But...wait for it, it ain’t because of engine failure.:confused:

5. To the nurse (Cline) If your pilot landed in 0 vis then report them and stop spreading false rumors about dangerous pilots . And if you’re that worried about “risking your life” on a flight, find something else to do. Although I’m sure you’re not going to go back to the grind of an ER hospital nurse.

6. This “modest” amount of $5,998 Medicare reimbursement for a flight is chump change. A couple of 6 inch parts on our aircraft that I won’t disclose cost almost that amount. An ECU box alone costs more than most people’s planes on POA. Estimates to break even on a patient flight are around $10K. Medicare ain’t gonna cover it.

7. Why is the flight charged at $50K? Well, I won’t go into the company management $$$ trail outside of an operational perspective but as stated above, Insurance pays only a small percentage. How about indigent care? We eat all of those costs. $98 million profit to AMC? Well then why have they closed 30 bases alone this year and more on the way? Oh, and MOST companies don’t go putting liens on people’s houses who can’t pay either. They work with the patient and setup a payment plan that amounts to basically peanuts a month. The author cherry picked a couple of examples for effect. Don’t even mention the thousands around the country that have a flight program and paid nothing out of pocket. Don’t even mention the programs that provide free air medical transport for their entire county either.

8. Jeez, you went and put two important graphs up. How about highlighting the fact that we’ve whittled down that atrocious 1980s accident rate to one that’s comparable to any other Part 135 operation today. Training, equipment upgrades and safety culture.

9. Helicopter shopping? Yeah, if a base is reporting WOXOF (old school) but the hospital is 10 miles away in the clear, I don’t know, maybe call another helicopter that’s not at that particular base??? That’s not helicopter shopping. That’s thinking outside the box, using good judgment and utilizing all your resources available. And to blame the Ohio “Survival Flight” crash on helicopter shopping when we have no idea right now why they crashed is completely inappropriate. Did you even look at the nearest AWOS to the accident site? Oh yeah, there’s already “protocols” in place for turn downs. We call it FAR 135.617.

10. 500-600 helicopters ain’t gonna cut it. Why? Because our rural hospitals are closing at an alarming rate and over 20 % right now (including my own) are on the brink of closure. That means more patients due to distance alone will have to be transported by helo. If anything, they can’t meet the demand of rural hospitals because the local HAA provider is already out on a flight for another hospital. 1,000 helicopters is a good number.

Another poorly written example of sensationalized journalism.
 
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Sac Arrow said:
Wasn't there a time when this service was government funded?
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We’re I live we have a Marine Air Station. The Pedro helicopters would be called for medical evacuations. They were awesome.. Anytime, day or night, fair or foul weather, didn’t matter. Perfect safety record. Landed anywhere. And all free to the patient as it was logged as training. Then the new commercial operator complained and that was the end of that. I made sure I mentioned this to the Lifeflight guys when I had a chance.
 
Velocity173 said:
CAMTS requirements
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Don't get me started. Around here it is pronounced CANTS....

For those that don't know. CAMTS...Commission On Accreditation Of Medical Transport Systems...

CAMTS is an independent non-profit organization that audits and accredits medical transportation services in the US. But....states and government agencies require medical transportation companies to be CAMTS Accredited in order to operate. Yet participation is voluntary.

Voluntary, yet required... Just an organization designed to pull money from a company and line the pockets of over paid bureaucrats. Ambulance companies that go above and beyond CAMTS accreditation standards are considered as not meeting standards..... Do as I say, follow that straight line and don't try to do something better.

But I digress... there does need to be standardization.
 
Morgan3820 said:
I don’t understand how it is possible to involuntarily obligate a unconsciousness patient to pay for a helicopter transport. I am not against helicopter transport when appropriate, per se’. I just don’t understand. In what other situation can someone be made to purchase something without their consent?
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Taxes.

Which, incidentally, is how air ambulance works too. A minority with better insurance and/or more wealth ends up subsidizing the majority who 'can't' pay.
 
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