Sky Rage: He said he didn't want the medical helicopter but was flown anyway

Sky Rage: He didn't want medical helicopter but was flown anyway

GAGEVILLE, OH - Since our first report on a private, for profit air ambulance company -- we've heard from many viewers who received huge bills from Air Methods.  One family says their son didn't want to be transported, but he was taken anyway and then received a $60,000 bill. 
 
Gageville, Ohio is a quiet, peaceful, rural community in Ashtabula county.  It's where the Artmans call home. 
 
20-year-old Tate is the man of the house most days since his father works an hour away.  His mom, Melissa stays at home and home schools his younger brother. 
 
So the day they heard a boom in the basement, it was Tate who went to investigate. 
 
They think it was a power surge, but it was enough to knock Tate off his feet and set him on fire. 
 
"I had a polyester shirt which just melted to me. I ran to the bathroom and jumped in the shower," Tate recalls.
 
Melissa called 911, but Tate worried the fire would spread. 
 
"After I was in the bathroom, in the shower for about a minute I went back downstairs and put it out," Tate said.
 
A few minutes later paramedics arrived and rushed Tate to University Hospitals Conneaut Medical Center. 
 
On the way there, Tate heard unwelcome news. 
 
"It was the paramedics that said they may lifeflight me – and I told them I wasn't going. I said that it would cost too much. And then when I got to the hospital, they pretty much just ignored it and took me anyway," Tate says. 

Melissa was out front filling out the insurance paperwork, when she got back to see her son she was concerned. 

"He told me they were going to sedate him and I asked why and he didn't know why he was guessing it was because he kept saying he wasn't going to go," Melissa says. 

Tate was conscious and communicating.  Not only was he concerned about the cost, he didn't think he needed to be flown when an ambulance was waiting outside to drive him. 

"It wasn't that bad, it wasn't life threatening, I still could get up and walk around," Tate said. 

But the Emergency medical staff thought his injuries were more serious.  Tate was burned over 32% of his body, but those were first degree.  His hands, ear and chest were blistering third degree burns.  Something the medical staff likely considered beyond their scope of care.  So they called for a MedEvac.  An air ambulance owned and operated by Air Methods.  

University Hospitals has contracted with this provider since 1998.  Tate says his refusal to fly fell on deaf ears. 

"They pretty much told me when I got there that I was going on it. And it was too late to cancel it," Tate says. 

He finally gave up arguing and he and his mom boarded the helicopter for the 66 mile ride to MetroHealth's burn unit. 

Tate says he was cleaned, bandaged and released in about two hours and on his way home. 

"I came home that day. If it was that serious I would have been staying in the hospital for a few days," he says. 

University Hospital's Director of EMS Institute Dan Ellenberger says the hospital does have protocol for when to call for a helicopter, however the final decision goes to the Emergency room physician. 

However, a March 2015 study in the Journal of Trauma and Acute Care Surgery found a third of air ambulance rides weren't medical necessary. 

By the time Tate's injuries healed, he and his family say they were burned again.  This time in the form of a $60,000 bill from Air Methods. 

Their insurance, Anthem, covered all the hospital bills and the ground ambulance, but only covered $14,000 of the Air Methods bill. 

Tate still owes over $45,000. 

Since the accident on January 31st, 2016, the family has now exhausted all of their insurance appeals.  They've hired an attorney to help negotiate with the company but say Rocky Mountain Holdings, Air Methods parent company, hasn't returned his calls. 

There are several lawsuits pending against Air Methods, a company that operates in 48 states.  A Federal Class Action was filed in Ohio this past February on behalf of patients who believe they were over billed. 

In a statement, Air Methods said: 

“Air Methods is in essence an airborne ICU, ready to deploy 24/7/365. Patients flown by helicopter air ambulances are the most serious, time-sensitive cases, including traumatic brain injuries, burn victims, strokes and heart attacks. Our crews only respond when called upon by a physician or first responder, and our hospital and EMS partners call the closest air medical provider for optimal patient care; it’s about getting the patient to the most appropriate medical facility within the critical time frame.

The average cost of being ready to deploy at a moment’s notice is $3 million per base per year, which includes the flight nurses, flight medics, EMS pilots, mechanics, crew quarters, fuel and the multi-million dollar aircraft.

Yet, 7 out of 10 of our patients have either Medicare, Medicaid, some other government insurance.  Our charges are comparable to average charges by other non-subsidized air medical service providers, and the fundamental problem our industry is facing is that current reimbursement rates by Medicare, Medicaid and some private insurance fall woefully short of what it actually costs to carry our air medical transports.

To continue to provide access to our lifesaving services for the people and communities that need it the most, we must start by fixing the drastically low reimbursements from Medicare and Medicaid services. We strongly support the proposed federal legislation that would resolve the Medicare reimbursement shortfall by updating reimbursement rates. Also, insurance companies must be willing to reimburse for emergency air medical services. Unfortunately, some highly-profitable insurance companies play a major role by placing the financial burden on patients through increasing insurance premiums and reductions of coverage.

We balance bill only as a last resort and, even in these cases, we work with patients one-on-one to recover what they deserve from their insurance company and to determine what they can reasonably pay. After the emergency is over, our team of patient advocates work closely with our patients to help them navigate the complex and often frustrating process of seeking fair reimbursement from insurance companies. In addition, we have a long-established charity care program in place to support patients who need further financial assistance.

As a responsible provider, we are working toward long-term and meaningful solutions and we continue to try to build collaborative partnerships with insurers who share our goal of putting the patient first and recognize the value of our lifesaving services.

In certain states, including Ohio, we’ve developed innovative solutions to help get patients out of the middle of the billing process, including Air Methods Advantage, which is a membership program that ensures covered members will never have to pay out-of-pocket for emergency transports provided by Air Methods. Membership in this innovative program starts at just $40/year. You can find more information on the program HERE." 

Ellenberger says there's still two and a half years on the Air Methods contract with the hospital but at its end, they will review their options.  Meanwhile he meets monthly with Air Methods representatives and billing is often discussed. 

In a statement University Hospitals said: 

"if billing issues are brought to our attention by patients, we work with Air Methods to try and resolve the issues and help our patients, but the final billing decisions are Air Methods'." 

The Artmans' are overwhelmed by the bills that are in Tate's name and feel like they may have only one recourse. 

"I think we're just going to end up having Tate claim bankruptcy, it's sad because he's just starting out in life and is already going to have this mark on him because of an accident and some helicopter company that's making millions off of people," Melissa said. 

Tate was well in his right to refuse medical transport.  Legal experts say you can as long as your mind is not impaired by intoxication, a mental health condition or a physical condition causing confusion or loss of consciousness.  

But because Tate and his mother did get on the helicopter he doesn't have a case to sue and is still faced with the bill. 

 

© 2017 WKYC-TV


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