OKLAHOMA CITY – Medical air transport is a $4 billion industry in the U.S.
Helicopters are faster and more agile than a ground ambulance. They save lives.
But, firing up the engine of a medical transport helicopter will cost you about $25,000 before the bird ever leaves the ground. After that, it could be $300 per mile.
Jodi Lopresto of Lexington, Oklahoma almost died when a DUI driver slammed into her, head on last year.
Mediflight rushed Lopresto to the trauma center in Oklahoma City.
Then, within 24 hours, while Lopresto was still in ICU, the parent company to Mediflight, Air Methods, started calling about the bill.
“They want to jump and take advantage of you as soon as they can because that’s when you’re at your weakest,” Lopresto said.
Lopresto has great medical insurance, Blue Cross Blue Shield. She paid her premiums, and she was up to date on her car insurance with an extra policy for uninsured motorist. She did everything right.
“I never thought it would be me,” Lopresto said. “You never think, that’s going to be me.”
Blue Cross Blue Shield paid a reasonable amount, $5980.08. Air Methods billed Lopresto for the balance, $32,979.67.
Lopresto tried to fight the bill with some help from attorney Noble McIntyre but billing practices for medical chopper services are un-regulated in Oklahoma.
They’re considered out-of-network for most insurance policies.
“It’s just not right,” said McIntyre. “They’re going after a victim for $32,000 she doesn’t have for an injury she didn’t cause for a 25 mile helicopter trip. It’s just unconscionable.”
So far Jodi Lopresto has refused to pay on her $32,979.67 balance from Air Methods.
Lopresto said the company has threatened to send her to collections over the bill.
She has joined a class action lawsuit against the company.
Albert Strubhar of Perkins, Oklahoma was speechless when he got the bill from Air Methods.
His wife, Miriam flew 15 miles from Edmond Regional Hospital to OU Medical Center after a serious complication from the delivery of their daughter Debora.
“Wow. I never imagined,” said Strubhar about the $32,330.34 bill. “I never imaged it would be that much.”
The Strubhars are Christian missionaries who live primarily in Nicaragua. They cannot afford medical insurance.
Air Methods offered the family a cash price of $8,000 to pay the bill outright, a 75 percent discount.
Their church raised the money to cover the bill.
“God’s people, people all over the country I have never heard of are helping out,” said Strubhar.
Air Methods was unable to discuss the details of Jodi Lopresto or Miriam Strubhar’s cases because of HIPAA guidelines.
Air Methods’ Director of Corporate Communications, Christina Brodsly provided this statement:
Everyone deserves access to lifesaving care. And much like an emergency room, Air Methods cares for those in need regardless of the their ability to pay. That means we sometimes don’t receive payment for our services, and the payments we receive for Medicare or Medicaid patients don’t come close to covering the actual cost we incur for providing our service. Those who can demonstrate a diminished ability to pay, Air Methods has a charity care application to bring the costs down and reduce the patient’s bill based on individual financial circumstances. In addition, Air Methods has a membership program called OmniAdvantage. For $49 a year, OmniAdvantage provides members and their entire household with the security of knowing that they are covered for any balance due after insurance, if transported via an Air Methods air ambulance.
We seek every efficiency and innovation to keep our costs down, but 80 percent of our costs for operating an air medical base are fixed, meaning we incur those costs just by staying ready at all times. The cost to maintain readiness 24 hours a day, seven days a week, 365 days a year include a 24/7-ready aircraft, flight crew, clinical crew, certifications, maintenance, training, logistics, safety and quality. These costs are by and large fixed in nature and a portion of which must be allocated to each flight. The Company has invested more than $100 million over the past five years in advancing safety and technologies in our operations, and became the first air medical provider and helicopter company to enter the FAA’s voluntary Safety Management System (SMS) program. In addition, Air Methods is accredited by the Commission on Accreditation of Medical Transport Systems (CAMTS) and vetted in critical care treatment and transport. At Air Methods, safety and quality is our highest priority.
And we believe that every life is worth saving.
In Oklahoma, most medical helicopter companies are considered out-of-network providers.
In some cases, commercial health insurance policies will have a provision to pay for a portion of the transport, but it is a fraction of the total bill.
In those cases, the helicopter company bills the patient for the remaining $20,000, $30,000 or $40,000.
That’s exactly what happened to this Air Evac Lifeteam patient, who has asked NewsChannel 4 to protect his identity.
The bill from Air Evac Lifeteam was $37,106.69. The patient’s commercial medical insurance offered to pay Air Evac $10,067.93 to take care of the bill. According to the insurance company, that is ten percent higher than Medicare reimbursement.
Air Evac Lifeteam refused the deal, taking only $5000 from insurance in order to bill the patient for the remainder, $32,106.69.
The patient is on a plan to pay $50 a month for the next 53 years.
According to Air Evac Lifeteam, they are unable to discuss details about this patient because of federal privacy guidelines.
Air Evac Lifeteam Public Relations Manager, Shelly Schneider provided the following information:
Air Evac Lifeteam has the lowest charge of any air medical service in the state of Oklahoma. The average Air Evac Lifeteam charge is $32,000. Nationwide, the average charge for an air medical transport is $34,000. In general, if the patient has commercial insurance that does not pay close to the billed charges, the patient will have a balance bill due. Medicaid patients have no balance bill and typically, Medicare patients are only required to pay the 20 percent co-pay and deductible. If the patient has medical insurance through Blue Cross/Blue Shield of Oklahoma, or is an AirMedCare Network member, he or she will not receive a balance bill. Air Evac Lifeteam is In Network with Blue Cross/Blue Shield of Oklahoma. Those insured under that plan would only pay the co-pay and deductible.
We also encourage individuals to proactively purchase an Air Evac Lifeteam membership – a participating provider in the AirMedCare Network. If Oklahoma residents have an AirMedCare membership and are flown for a life- or limb-threatening injury or illness by an AMCN participating provider, the member has no further out-of-pocket expenses for the flight. An AirMedCare Network membership is $65 per year, and covers the entire household. There are 130,521 AirMedCare Network members in the state of Oklahoma, and more than 1.75 million AMCN members across the country. There are 245 AMCN participating locations across 32 states.
Air Evac Lifeteam is called by an EMS provider, first responder or hospital, we do not ask for insurance information before accepting a flight. We provide access to a higher level of care, and the cost to provide that access is 87 percent fixed. The costs include the lease and maintenance of the aircraft, and staffing a base 24 hours a day, seven days a week with professionally trained and credentialed flight nurses, flight paramedics, pilots and mechanics.
Congress is currently working on a solution to the problem of unaffordable charges for air ambulance service.
H.R. 822 would amend the Social Security Act to require more extensive date reporting by air ambulance companies in order to increase reimbursements for medical flight service under the Medicare program.
In Oklahoma, the State Insurance Department confirms they have received complaints about air ambulance company billing practices.
The complaints are nearly identical to those of the patients featured for this report.
A spokesperson for the commissioner told NewsChannel 4 the department’s hands are tied.
If the citizens of Oklahoma want change in this industry, they need to call their state legislator.