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Started By
Message
OT Lawyers (and Doctors, to a degree)
Posted on 11/2/18 at 11:26 am
Posted on 11/2/18 at 11:26 am
My 19 year-old son was in a car accident six months ago and had to be airlifted by helicopter to a nearby hospital. About a month after the accident we got a bill for over $46,000 from the company that provided the helicopter service. We were shocked, to say the least. I immediately called and gave them my insurance information and asked them to file. About a month later, I received a letter from the company saying that my insurance company had denied coverage, and they included a grievance/appeal letter that they asked my son to sign and return so that they could send it to my insurance company. We sent it back signed. About a month after that, we got a notice from the insurance company that they had paid over $7000 on the claim. The next day, we received another form letter from the company that they want to send to the insurance company saying that the payment that they received is unacceptable and that we are certainly not able to afford to pay off the balance. They also sent a HIPPA release form for my son to sign, giving them permission to access his medical records. I am pretty apprehensive about pushing this, especially giving them a HIPPA release. Am I right or should I allow them to continue the appeal for more money from my insurance company?
ETA: I don't see any reason for the helicopter company to need access to my son's medical records.
ETA: I don't see any reason for the helicopter company to need access to my son's medical records.
This post was edited on 11/2/18 at 11:28 am
27
Posted on 11/2/18 at 11:28 am to High C
The company that does air evacs in this area sells subscriptions. Less than $100/year covers a family.
Posted on 11/2/18 at 11:30 am to High C
You need to talk to a lawyer that represents you. You are seeking specific legal advice and shouldn't trust any you receive here.
Posted on 11/2/18 at 11:40 am to High C
I am not a lawyer, but I think the answer here is wanton violence against everyone involved.
Posted on 11/2/18 at 11:40 am to High C
Get Gordon, get it done
This post was edited on 11/2/18 at 11:41 am
Posted on 11/2/18 at 11:40 am to High C
Was your son at fault for the accident?
Why was your insurance claim denied coverage?
Why was your insurance claim denied coverage?
Posted on 11/2/18 at 11:44 am to High C
The first thing I would do is tell you to deal with your insurance company first...ignore the bills. Find out (from your insurance company) what was billed, what was denied and what was paid. If something was denied, find out why. Get the explanation of payment. The first thing you need to see is what isn't being paid and why. That is info you should get from your insurance company and NOT the transport service. Once you have determined what is and what is not covered and what your cost sharing is, it will help what say what your next step should be.
Im not totally sure on ambulance, helicopter services but they are usually only reimbursable in certain medically necessary situations. Meaning, your insurance company won't pay for one if you say you have a headache. Its possible that they want to see what the medical records say because your insurance company might be denying the charge saying it wasn't medically necessary. Again, I'd refer you back to your insurance company for that info.
quote:
I don't see any reason for the helicopter company to need access to my son's medical records.
Im not totally sure on ambulance, helicopter services but they are usually only reimbursable in certain medically necessary situations. Meaning, your insurance company won't pay for one if you say you have a headache. Its possible that they want to see what the medical records say because your insurance company might be denying the charge saying it wasn't medically necessary. Again, I'd refer you back to your insurance company for that info.
Posted on 11/2/18 at 11:45 am to High C
In all seriousness get a lawyer
This post was edited on 11/2/18 at 12:08 pm
Posted on 11/2/18 at 11:47 am to High C
(no message)
This post was edited on 11/2/18 at 11:53 am
Posted on 11/2/18 at 11:47 am to High C
I'm not a lawyer, but it sounds as if this is pretty much standard procedure for the airlift service seeing as they have this shite ready to go every step along the way.
Chances are they're just vying for more money from insurance and will write it off eventually, but don't take this as legal advice.
I suggest you contact an attorney.
Chances are they're just vying for more money from insurance and will write it off eventually, but don't take this as legal advice.
I suggest you contact an attorney.
Posted on 11/2/18 at 11:51 am to High C
You need to talk to an attorney who specializes in auto insurance claims. If the airlift was deemed medically necessary I don't see how your insurance could refuse to pay though.
Posted on 11/2/18 at 11:53 am to High C
Did he fly around the globe a couple times and then see a specialist in Switzerland? $46k is freaking ridiculous. The medical billing industry is out of freaking control.
I fully understand the costs here, but I can rent a Helicopter ride for 60 minutes for $500. There's no way it should cost $46k for 3 hours of flight time.
First thing I'd do is tell them that they either talk to you today or you contact your lawyer tomorrow and everything else is through your lawyer.
I fully understand the costs here, but I can rent a Helicopter ride for 60 minutes for $500. There's no way it should cost $46k for 3 hours of flight time.
First thing I'd do is tell them that they either talk to you today or you contact your lawyer tomorrow and everything else is through your lawyer.
Posted on 11/2/18 at 12:01 pm to High C
just tell them your son didn't consent to a helicopter ride
Posted on 11/2/18 at 12:02 pm to High C
Acadian Ambulance sucks.
Posted on 11/2/18 at 12:05 pm to High C
don't sign anything unless it's to hire a lawyer. You can get a free initial consultation with most lawyers.
Posted on 11/2/18 at 1:12 pm to High C
You really need to see a lawyer on this. There are so many facts missing from your analysis that a lawyer would need to question you on to accurately give you advice. Given the amount of money involved it is worth the consultation.
Posted on 11/2/18 at 1:21 pm to High C
I only respond to this because I work for an attorney - Never, ever sign anything without talking to a lawyer first. DO NOT SIGN OFF ON A HIPPA RELEASE. Go see a lawyer - Thats what they are for.
Posted on 11/2/18 at 1:23 pm to High C
Is this the auto or medical insurance you are dealing with. If it’s your health insurance, they may be expecting auto insurance to pick up the tab.
Other posters are correct. If the insurance company is rejecting the claim due to no medical necessity, them the ambulance service will need the medical records to show there was medical necessity requiring an airlift.
Lawyer ASAP.
Other posters are correct. If the insurance company is rejecting the claim due to no medical necessity, them the ambulance service will need the medical records to show there was medical necessity requiring an airlift.
Lawyer ASAP.
Posted on 11/2/18 at 1:43 pm to High C
What 4444 said, get a lawyer, talk to insurance and find out what the hang up is. As with all medical billing, there’s what is charged and what is allowable. The allowable is contracted with each insurance company and the Med Flight service. usually what I hear is $7-15k is what’s covered. The flight service shouldn’t be able to request more than allowable, and you may have a deductible that you’ll have to pay, but it shouldn’t be the remainder of the $46k.
I’m usually on the receiving end of the helicopter rides, as I’m a trauma surgeon. The helicopters, while needed in some instances, is way overused. Especially for $50k a ride. We’re collecting data with hopes to show that a large majority of helicopters are unnecessary. We have people discharged from the ER after a flight, and sometimes the ground crew will arrive prior to the air crew when coming from the same scene.
I’m usually on the receiving end of the helicopter rides, as I’m a trauma surgeon. The helicopters, while needed in some instances, is way overused. Especially for $50k a ride. We’re collecting data with hopes to show that a large majority of helicopters are unnecessary. We have people discharged from the ER after a flight, and sometimes the ground crew will arrive prior to the air crew when coming from the same scene.
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