Life Flight Charges Not covered by Ins!!

[bkward]

What is the name of your state (only U.S. law)? Floirda
My husband was flown by Lift Flight in June after a serious fall. He was billed $14,000 of which our insurance (BCBS of FL) paid $4,000. This was the maximum allowed according to our policy. Our coinsurance was $1,065.00. I sent the $4000 plus $1065 to Life Flight. Now they want me to pay the difference which is not regulated by BCBS since they are not a provider. If they had a contract with BCBS they would only be allowed to charge what BCBS allowed but since they are not, they can basically charge whatever they wish. We of course were not told in advance what the charges would be and now have $10,000 to pay that our insurance doesn't cover. So far the Life Flight company has refused to negotiate any terms with us. Is it legal for them to charge whatever they wish and then hold our credit "hostage" if we refuse to pay? I know they will turn it over to the credit company if we do not pay. We have outstanding credit and do not wish to lose it but also cannot afford to pay $10,000 for a 20 min. helicopter ride. Is it legal for them to put it against our credit? We did not call them. They were called by the land ambulance drivers and he was told he had to go by air. What negotiating power do we have? Can we expect them to settle for less than the$10,000? What is a realistic figure to try to settle for? Can we send them just $20 per mo and be covered or is there a certain amount we are required to send?What is the name of your state (only U.S. law)?

[ecmst12]

It is a legitimate debt and they can and will report it on your credit. You should speak to your insurance company to make sure they paid in accordance with the terms of your policy. Most of the time, emergency services are paid at the full billed rate (at whatever percentage the policy specifies) since it was an emergency and the member did not have a choice of what provider was used. However your policy may have a maximum for this specific service. But check with them to be sure. If they did pay correctly, then they have done all they are obligated to do and you owe the rest.

The provider may accept a good faith payment arrangement. $20/month is not good faith and they do not have to accept it. They can sue you and get a judgement and your assets can be seized, your wages garnished. You have no leverage here so be nice when you try to negotiate with them. Isn't your husband's life worth whatever you have to pay for it? Life flight services are expensive for a reason.

[tranquility]

You don't really have any negotiating power. You probably will have ot pay the full amount eventually. I would think they would try to work out a payment plan, but they don't have to.

Things were bad. To save your husband's life, they spent a lot of money. Even without profit, there was a direct cost of thousands of dollars in fuel, capital costs and salary to the people to do the flight.

Who should pay for that?

[lealea1005]

Originally Posted by bkward

What is the name of your state (only U.S. law)? Floirda
We of course were not told in advance what the charges would be and now have $10,000 to pay that our insurance doesn't cover.

Are you saying that you wanted them to stop treating your husband long enough to check whether they were a network provider and get written authorization from him for life flight to transport him?!?

The paramedics on scene made a judgement call to save your husband's life. If they are not contracted by BCBS, they are under no obligation to accept a fraction of their usual fee as payment in full.

As suggested earlier, set up a reasonable, regular payment plan with them. To pay off a bill of approximately $8900 at $20/mo will take about 37 years, not including the interest they will be permiited to add.

[vestagrayanna]

Okay, first things first. If you cannot eventually reach a settlement with the air ambulance company, yes, it would be a valid debt that is reportable. But, your main goal should be (and it seems you are trying) to reduce the charges. I have a little personal experience with these services and they are a bear to deal with. As someone earlier mentioned, be sure that BCBS is considering this in network due to the emergent nature. I suspect they are. I also suspect the riduculous charges stem from a UCR provision of your plan. UCR = Usual, Customary, Reasonable. This won't be easy, but if you can, enlist the assistnace of the insurer. Air ambulance charges are first based upon whether a fixed wing or rotary type of aircraft. Then, they apply a charge based upon mileage. Those are going to be fixed rates by the company. You need to find a basis to challence the UCR by looking at all air ambulance companies in the area and what their usual rate of reimbursement is AT CONTRACTED RATES. Make phone calls, do what you must to determine what this company's typical reimbursement is. Also, rattle the chains of the payer. Follow the appeals process in your plan to dispute the amount of the charges. You asked a dollar amount that is reasoable. In my opinion, unless flown a LONG way, the $4,000 allowed by BCBS is reasonable. But, as I said these companies are a bear. I once battled one over a 36 mile trip to the tune of $26,000. Successfully reduced it to $7,000. As another aside, that brings up medical necessity. It's really difficult to question medical necessity of an air ambulance ride without 20/20 hindsight, but it can be done. Of course, in reality one does not want to question emergent care, but if one can argue that ground transportation was reasonable considering mileage and injuries, its theoretical at this point. Argue it. Once you are blue in the face from trying to defeat the ridiculousness of the charges, then figure a way to settle it. But, in my opinion, not until. You have a hard row to hoe, but, if you do your homework and work hard, it could pay off.

[perrydonna88@ya]

I was wondering how this all panned out? I am in the same boat(helicopter) so to speak and i am in the process of figuring this out right now- our ins is charging us also- the reasonable and customary charges are ridiculous! I honestly feel like these things are out of our hands and control. This was also an emergent situation with our newborn daughter- and I know to those of you who are reading this- yes my child's life is worth the life saving effort that these people put forth- but I am also not a millionaire and would like to provide a decent home and life for my children- one trip and your looking at years of payments. Hope to hear soon.

[Antigone*of*Greece]

Necroposting in our forum is bad decorum. You should start a new thread detailing your situation. Chances are this original poster will not come back here.