Just got a bill today from PHI Medical Services for $38,357 for the 20 minute helicopter ride I took after my August 6 crash. My insurance company, Blue Cross Blue Shield will only cover $10,000 of it as the provider was "out of network" and the contracted price for "in network" air ambulance providers is capped at $10,000 minus a $2000 Deductible leaving me with out of pocket expense of over $30,000, not counting the rest of my medical bills. I can either pay it and then file for bankruptcy or tell them all to pack sand. You have no choice of an "in network" provider when you are laying on the side of the road, the EMTs on site made the call. Might be better to take your chances and insist on a regular ambulance or just die in the side of the road. When you get out of the hospital, you quickly find out you are facing huge pain as well as huge bills that keep coming in. Just picking up my wrecked bike set me back $580 for towing and storage. This air ambulance crap is a racket and the insurance companies are also.

* Last updated by: Kruz on 9/15/2015 @ 10:59 PM *

That sucks bigtime. Maybe a payment plan?

$100 per month for 300 months maybe? That's like 25 years. This has turned into a nightmare and none of us are immune, if you go down hard they're going to call in an air ambulance and you have no real choice in the matter.

Kruz
I know this is after the fact, but several of the larger air med companies (I do not represent any of them) have a subscription type service that will either right off the portion of the bill your insurance does not cover or will pay you a cash amount should you require air transport regardless of the service you use.

I am very sorry to hear of the predicament you are in and I cannot defend the industry because I agree the fees are exorbitant. Also you are correct, the EMS provider on the ground with you will call the closest appropriate air service to transport you in the majority of cases. If you are awake and alert, you do have a choice. You are still free to refuse care, refuse air transport or refuse transport from a particular service. However when you are lying on the road and in pain it is difficult to keep all that information at hand, and I know the EMS service likely will not let you know you have these options in the interest of speed.

Part of the problem is that many of the air services around the US are now very large corporations with share holders and profit as a priority. I am fortunate that I work for one of the few remaining Hospital owned operators that is non-profit. That's not to say the service is cheap, it is still very expensive to be transported by air. However it is nowhere near what many of the for profit agencies charge.

Helicopters are incredibly expensive to operate, parts prices are set by manufacturers with no real way for other manufacturers to offer the same part for a particular helicopter (thank you FAA). A door handle and mechanism can cost as much as $15000. That is for a simple door handle, and i am not exaggerating.

I hope you find resolution to the problem, but just remember, you can only pay what you are capable of and that it. The service provider is aware of this and i believe you can negotiate. If not then you might threaten to follow the course you have already suggested. They would rather get some money than none.

Not sure if laws are different for this in Tx, but here in CA, ins has no choice but to pay. I went through similar bs when I was hit. There is no in network when it is an emergency. It is whats closer and or available. I had an attorney to help me wade through all the crap. Also sued the SOB that hit me.

Hope yall can get this taken care of without being in-debt for the next 30 years.

Thanks guys, I contacted HR at my company this morning and told them what is going on, we have over 600 employees on Blue Cross so maybe they can get something done with that large a pool. Neither side wants to budge, I signed an agreement letter this morning with PHI to represent me to try and collect from Blue Cross. I don't think there's a good guy here, PHI wants to make a nice profit and I understand rotor wing aircraft are very expensive to operate. Blue Cross wants out cheap and will leave me high and dry if they can. Somehow this is going to work it's way out, Blue Cross has the deep pockets here, not me and PHI knows this.

GPfan, I had Careflight air ambulance insurance but was picked up by PHI, I wonder if I can work that angle?

Here's the post op shot of my right femur/hip socket, long rod and two screws into the hip socket. I sure hope that holds up or I am screwed!

* Last updated by: Kruz on 9/16/2015 @ 2:23 PM *

Have ye no faith in my metal, Mr. Caruso?

EDIT: aaaaaaaaand... I sees yer lil' nub in that radiograph! HA HA!

<====3

* Last updated by: hagrid on 9/16/2015 @ 3:13 PM *

Sorry to hear man. Wow... about $40k seems to be the going rate.

Wow Kruz, very sorry to hear of the ordeal. Two years ago my son went down during a track day and was air lifted to a trauma center. I had to fight with my insurance carrier to get them to pay as well. In my case my health provider was looking for my bike insurance carrier (Rider) to pick up a portion of the bill. Rider of course said no because the accident took place on track. Once I got Rider to submit a letter to my healthcare provider explaining that everything went through ok.

Word of advice to everyone... Always contact the hospital or whoever is asking for the large sum of money to see if there is any negotiation possible. I have unfortunately had 5 major surgeries in the last 8 years for back and shoulder problems. After one of the surgeries I received the bill which indicated I was eligible for a payment plan. The bill was only around $1,000 so I was going to just write the check but decided I would go ahead and take the payments to keep my money in my bank earning interest. Well - HERE'S THE IMPORTANT PART - when I called they told me I could get the bill reduced by 30% if I paid it in full within 30 days! Had I just written the check as I was initially going to do I would have never learned that I could get the bill reduced by $300!!!

* Last updated by: BigSarg on 9/16/2015 @ 7:54 PM *

Kruz -- John, wow, sorry to hear of your get off, please elaborate! That's a serious boo-boo! Be careful and aware of Blood Clots, they are a common side effect of these sorts of lower body injuries -- I know, I suffered a P.E. because of this sort of crap! What bike got wadded up?

"Sometimes, however, organizations such as the Patient Advocate Foundation, http://www.patientadvocate.org/ a nonprofit based in Hampton, Va., that helps patients fight insurance denials, can help negotiate lower rates. “If it’s a true emergent situation, even if the provider is out of network, we can negotiate with the insurer to pay an in-network rate,” says Erin Moaratty, chief of external communications for PAF.

Negotiating for an in-network rate can often reduce the bill from an out-of-network provider by 30 to 35 percent, says Candice Butcher, president and chief executive of Medical Billing Advocates of America."

RE: $38,357 Helicopter Ride
09/16/15 8:17 PM
Kruz -- John, wow, sorry to hear of your get off, please elaborate! That's a serious boo-boo! Be careful and aware of Blood Clots, they are a common side effect of these sorts of lower body injuries -- I know, I suffered a P.E. because of this sort of crap! What bike got wadded up?

www.drblast.com

Hello Donny, haven't talked to you in a long time. Wadded up my '07 CBR1000RR, the wreck brought $3500 so I was happy to get that. Don't know what happened, there were no witnesses to my accident, it happened on a corner I ridden hundreds of times before about five miles from my house. Stuffed it into the tirn and felt something let go, I don't know if I lost the front or the rear or both but she went sideways and then caught traction and snapped straight up and pitched me over the high side. I landed about 30 feet from the bike face down on my right side and then tumbled. It was a right hander and most of the damage to the bike was on the left side consistent with a high side. Speed was in the 65 to 70 mph range so I hit pretty hard, just landed wrong. Leg is healing OK but my neck is really bothering me.

* Last updated by: Kruz on 9/17/2015 @ 7:12 AM *

Alg8er, thanks for that information, I'll try them.

"GPfan, I had Careflight air ambulance insurance but was picked up by PHI, I wonder if I can work that angle?"

Scour that contract and see if they have some sort of coverage assistance in cases such as yours where you were not afforded the opportunity to choose a provider. Also call them (877) 339-2273. tell them the story and see if they know why PHI Airmedical transported you and not Careflight. There maybe a turf war and you maybe able to argue that if given the opportunity you would have chosen Careflight. Keep in mind that if the closest careflight Heli was already on a mission then your call would have been rolled to the next closest.

Don't give up, I am glad PHI is working with you, it is in their own best interest to do so.

Where were you flown to? Dallas or Plano? Im curious about how many miles (statute miles) you were charged for. IIRC the fees per mile are around 85-100 national average. (it has been some time since I looked at that info)

LOL HAGRID "EDIT: aaaaaaaaand... I sees yer lil' nub in that radiograph! HA HA!"

This is a fine example of a positive Throckmorton sign..Penis tends to point toward the side of injury. It is weird but and is a joke term, but strangely it happens frequently. Not a sign you can rely on because statistically it is not accurate enough but always something to talk about when reviewing pelvic films of patients.

EDIT: aaaaaaaaand... I sees yer lil' nub in that radiograph! HA HA!

That's actually my thigh, I'm big but not that big lol!

Plano? Im curious about how many miles (statute miles) you were charged for. IIRC the fees per mile are around 85-100 national average. (it has been some time since I looked at that info)

They flew me to Parkland in Dallas. My company HR just told me they tried to intervene but BCBS will not budge, I'm on the hook for just over $30,000. This whole thing is surreal, apparently in-network contractors are getting paid $10,000 and able to keep the lights on, the $38,000 charge appears to be beyond unreasonable at a remarkable 380% markup. Either they have an incredibly inefficient operation or are padding the bill here. At this point I don't really care, the amount is unpayable without putting my financial future at risk so I'm not going to sweat it. They can drop the price dramatically or arrange a payoff plan that might last decades, or both. I asked for a ground ambulance that day, not a helicopter, as I knew this was exactly what the final outcome was going to be. EMTs insisted on the chopper explaining the femoral artery may be severed, I wish I had refused the air ambulance now but hindsight is always 20/20.

* Last updated by: Kruz on 9/17/2015 @ 8:45 AM *

Donny, there was a significant physchological angle to this accident. Please take a look at my thread about losing someone on a ride in the General forum. Two weeks prior a young man was killed on the same road in almost the same spot. I had met him at a gas station only moments earlier and he wanted to follow me. I tried to dissuade him and said I would be going fast but he insisted. 90 seconds later he died in a head on collision with a service truck, apparently tried to follow me into the very first corner and lost control of his bike and ran wide into the opposing lane. This whole thing has been a perfect storm, I was never right after that and considered giving up riding for good. Instead of quitting, my reaction was to push myself ever harder in an attempt to regain my confidence. I should have taken a few months off and sought counseling now looking back but that's not what I did. This crash was inevitable, I was grief stricken over an event I had no control over and it was dominating my life. Perfect storm.

That's actually my thigh, I'm big but not that big lol!

Why Mr. Caruso. I had no idea you were so demure. I shouldve realized, in retrospect, in light of your Emmy studded career.

I admit, I'm no doctor or radiologist, but your "lady tickler" is clearly evident.

Mrs. Caruso is clearly a well pleased woman.

John! That is horrible! I crashed in 2005 as you remember me telling you and Tommy. Since then, I've resumed riding, but, not 'pushing' it like I used to do. I even thought about migrating over to a cruiser type bike, but, that sort of machine is not good for evasive and aggressive riding which one must undertake to ride out of a situation. Having your feet in front of you just ain't cutting it for super defensive riding -- which is actually sort of offensive riding. Hope you heal up and get that helicopter bill resolved!

* Last updated by: Donny on 9/17/2015 @ 8:30 PM *

Yes, I recall you telling me about having a high side accident during a race, don't recall the extent of your injuries though. It is hard to come back mentally from such an accident. I still have four good sportbikes and a cruiser in the garage but little desire to ride them. I too will have to rethink my levels of aggression if and when I resume riding. My days of pushing the limit are probably over for good. At this point my prognosis for fully recovering my leg function look promising, of more concern is the damage to my neck. These trigger points in the scapulae seem resistant to standard treatment, e.g massage, gentle stretching and anti-inflammatory meds. I'm on a stronger muscle relaxant now Tizadine and hoping for some relief.

* Last updated by: Kruz on 9/18/2015 @ 6:58 AM *

Hey, say hello to Tommy if you get the chance, last time I talked to him was back in '09, kinda lost touch after moving up here to Dallas.

Kruz, it's interesting. Your story is on our local forum. The "experts" have concluded that you should have been a better rider and then you wouldn't have crashed. I tried to explain that no matter how freaking good you are, sometimes shit just happens. Didn't get much support. Hang in there.

Mad