Thursday, August 10, 2017

$30K air ambulance trip highlights lack of regulation on rates


TEXAS - While a Plano man is livid about receiving a near-$30,000 bill for being flown 47 miles between hospitals in West Texas, KVUE found air ambulance services are not regulated in terms of price. The Texas Department of Health and Human Services only regulates in terms of qualifications of on-board medical staff and on-board medical equipment.

Hugh Sparks of Plano was driving with his son on Highway 380 near Haskell when they stopped to take pictures of the wide variety of snakes that were crossing the road. At some point, he said he was bit by a rattlesnake, so they drove to the nearest hospital. 

He was given his first doses of anti-venom at the closest hospital until the medical team told him he would need to be taken by helicopter to a bigger hospital in Abilene. The air ambulance bill, for the 47-mile trip to Abilene, was $43,514.56. Blue Cross Blue Shield agreed to pay $13,827.15. That left Sparks holding a bill for $29,687.41.

The federal Airline Deregulation Act of 1978 does not allow for state or local regulation of rates for commercial carriers, including air ambulance services. So, they can charge whatever they want.

But in many cases, especially in rural areas where there may only be one service provider companies encourage purchasing a membership and paying a monthly fee which allows for customers not to get billed for any amount beyond what their insurance covers. 

As for public air ambulance services, like STAR Flight in Travis County, local governments operating the service set their own rates as well. In June Travis County Commissioners set the base rate for STAR Flight service at $15,500 with additional fees of $200 per mile. At that rate the 47 mile ride from the  hospital in Haskell to the bigger one in Abilene would have cost $24,900. Assuming his insurance would have covered the same $13,827 he would still have had an out of pocket bill of at least  $11,073. 

Original article  ➤ http://www.kvue.com





Snake bites hurt. Sometimes, so do the medical bills to treat them.

Hugh Sparks, of Plano, was bitten by a rattlesnake in June while on a road trip with his son to see the Alamo 7 Solar Project in Haskell.

The pair snapped photos of several snakes crossing the road.

When they stopped to take a closer look at one Sparks thought was harmless, it bit him.

"It bit me, and I told Briet, I said, 'That was no prairie rat snake.' But the thing did not have rattles," Sparks explained.

Sparks was taken to a hospital in Haskell, given anti-venom and then flown by an Air Evac Lifeteam helicopter to another emergency room in Abilene.

Though his injuries may have looked bad at the time, Sparks says the real shock was when he opened his ambulance bill.

The total cost of his air ambulance ride was $43,514. His insurance company, Blue Cross Blue Shield, agreed to cover $13,827, leaving Sparks with nearly $30,000 to pay out of pocket.

"Misjudgments happen. This is why we have insurance," he said.

Insurance companies blame air ambulance providers, who, they say, can charge whatever they want because they're unregulated.

Providers point the finger right back, saying insurance reimbursement isn't enough to cover costs.

It leaves patients like Sparks to make up the difference for a potentially life-saving flight that left him buried in debt.

Neither Blue Cross Blue Shield nor Air Evac Lifeteam could comment on Sparks's case.

They suggest someone in his situation should appeal a claim with his insurance company. Air Evac Lifeteam said they also work with patients who qualify for financial help.

Consumers can also file a complaint with the Texas Department of Insurance.

Most air ambulance companies offer insurance. It costs $65 per household per year.

Story and video ➤ http://www.nbcdfw.com

4 comments:

Anonymous said...

Mr. Sparks intentionally involved himself with snakes, he should have known the risk.

Anonymous said...

This bill isn't that bad, Sparky. Star Flight is 15,000.00 for any transport in Travis County and 25,000.00 for any transport from outside the county. So this other bill is inline with those fees.

Anonymous said...

Had this man died en route to Abilene, or suffered any further irreversible damage then the doctors, nurses and hospital would be on the hook for negligence. Trauma rules dictate the choices made. The patient can always leave Against Medical Advice. That is his right.

Mark Ebben said...

"The patient can always leave Against Medical Advice. That is his right." 47 miles as the crow flys. I'd be interested in knowing how long an EMT ambulance would take time wise and that he had 1 anti bite treatment before he left - was it really critical time wise? I'm sure they want him at a higher level medical center.