Sky-high copter costs not the norm

Sunday, September 8, 2013

by Dan Casey

Debbie Franco of Roanoke got an alarming email late in August from her daughter who lives in Maryland. Franco’s son-in-law, Chris, had been seriously injured in an ATV accident on Tangier Island, in Virginia’s portion of the Chesapeake Bay.

Chris was a passenger on the ATV, and he broke an arm in two places. Rescue workers at the scene decided to fly him to a hospital. Even though the isolated island is part of Virginia, a Maryland State Police helicopter responded.

Franco was concerned, because she had read my recent columns about frighteningly high $22,000 to $32,000 bills people in western Virginia are getting for air ambulance flights to Carilion Roanoke Memorial Hospital. She called Chris, and he was concerned, too.

They were both happily surprised to learn that Chris’ bill for the flight would be zero. That’s true for every patient who winds up in a Maryland medevac helicopter.

All medevac flights in the state are handled by Maryland State Police, and there’s no charge to the patients, said Elena Russo, a Maryland State Police spokeswoman. The program is funded by an annual fee tacked onto Maryland vehicle registration bills.

In some cases, there’s no charge in Virginia, either. But that depends on where you live or where you suffer a horrible injury.

If you need helicopter transport in the Richmond area or in far Southwest Virginia, there’s a good chance there will be no transportation charge. That’s because Virginia state police operate medevac helicopters based in Abingdon and Chesterfield County.

Like with Maryland, the service is funded through the Department of Motor Vehicles, said state police Lt. H. Jay Cullen, commander of the Virginia State Police Aviation Unit.

If you’re flown to the Inova Trauma Center in Fairfax County, you’re also likely to pay little or nothing. That’s because the primary medevac helicopter contractor is Fairfax County police. “We do not charge,” said Mary Ann Jennings, the department’s spokeswoman.

Until 2010, state police had a helicopter stationed near Lynchburg, too. Centra Lynchburg General Hospital provided the medical crew. But Lynchburg General Hospital cancelled that agreement in favor of a private contractor, Petroleum Helicopters Inc., Cullen told me.

But that doesn’t necessarily mean patients flown to Lynchburg General are getting sky-high helicopter bills. “We do our own billing,” said Diane Riley, a Lynchburg General spokeswoman. “We have contract pricing with all the major insurance carriers, including Anthem.”

That means that helicopter flights are covered by insurers, who pay a discounted rate for the flights. Patients typically pay a small fraction of that in coinsurance.

UVa Medical Center in Charlottesville does its own billing for hospital transports and accepts what insurance companies pay, said spokesman Eric Swensen. At Riverside Health System in Newport News, the helicopter contractor does the billing, spokesman Peter Glagola said. But it’s an Anthem provider and accepts what the insurer pays, he added.

Sentara Norfolk General Hospital owns the Nightingale Regional Air Ambulance and contracts with a company to fly it, said spokesman Dale Gauding. “It is billed through Sentara Healthcare. Our average [charge], plus or minus, is around $10,000 and we accept insurance, and we don’t balance bill,” Gauding said.

For 20 or so years, that’s the way it worked at Carilion, until February 2012, when Carilion switched air transport business models and contracted with a new provider, Med Trans Air Transport Corp.

Carilion got a third helicopter out of that deal. But since then, many patients have been getting billed $20,000 or more for emergency flights. Insurance, if a patient has it, will typically pay $6,000-$8,000 of that, depending on the length of the flight. The patient is responsible to Med Trans for the entire balance. (Unless they’re covered by Medicare, in which case they pay much less).

That’s because Med Trans does its own billing, and it has no agreements with any private health insurers in Virginia — but it does accept Medicare.

I’ve heard from a number of patients who owe Med Trans thousands of dollars that the company has recently suspended its collection efforts pending negotiations with Anthem. Those have been going on since February 2012 without result.

“Med Trans and Anthem have not yet reached an agreement, but the discussion is ongoing and moving in a positive direction,” said Carilion spokesman Eric Earnhart.

When they had a helicopter in Lynchburg, Virginia State Police used to fly patients to Carilion more frequently, said Cullen, the state police aviation commander. Earnhart said he’s aware of only one state police helicopter transport to Carilion in the past year.

At least for the time being it seems like here’s the score: If you end up on an emergency flight to just about any major hospital in Virginia, the likelihood is that you’ll pay nothing or a small fraction of the “retail price,” provided you have Medicare or some other insurance.

But if you’re not on Medicare, and your life-threatening stroke or accident happens in Western Virginia, and you are flown to Roanoke Memorial Hospital, you will wind up with a shockingly high bill.

It kind of makes you wish Virginia State Police would put some medevac helicopters around here, huh?

Original Article:  http://www.roanoke.com